Preventing mental disorders in children: a public health priority.
BACKGROUND
Mental disorders affect 14% of children, cause significant long-term disability and are arguably the leading health problems that Canadian children face after infancy. Treatment services alone cannot meet children's mental health needs. In addition to treatment, prevention programs hold potential to reduce the number of children with disorders in the population. Effective programs exist for preventing conduct, anxiety and depressive disorders, three of the most prevalent disorders in children. Therefore, we investigated the state of Canadian programs in comparison with prevention programs described in the literature for these three disorders.


METHODS
We identified children's mental health and early child development (ECD) programs across Canada with national or provincial/territorial scope and significance and with potential relevance to mental health. We then interviewed policy-makers to determine which programs included goals related to mental health, and incorporated key features from programs known to be effective for preventing the three disorders of interest.


RESULTS
No prevention programs specific to children's mental health were identified. However, 17 ECD programs incorporated generic goals related to mental health and incorporated key features seen in effective prevention programs. Only Ontario's Better Beginnings, Better Futures (BBBF) explicitly included mental health within its major program goals, incorporated multiple features seen in effective (conduct disorder) prevention programs and demonstrated positive child mental health outcomes.


CONCLUSIONS
The lack of Canadian prevention programs specific to children's mental health is concerning. ECD programs have the potential to improve child mental health outcomes within their wider mandates. BBBF is an exemplar for such programs. However, new investments in implementing (and evaluating) programs that specifically aim to prevent mental disorders are required to improve the mental health of children in the population. Preventing children's mental disorders must be a Canadian public health priority.
Waddell
Charlotte
C
Children's Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, Vancouver, BC. charlotte_waddell@sfu.ca
McEwan
Kimberley
K
Peters
Ray DeV
RD
Hua
Josephine M
JM
Garland
Orion
O
D000293:Adolescent; D016497:Adolescent Health Services / Q000592:standards*; D001008:Anxiety Disorders / Q000517:prevention & control; D002170:Canada; D002648:Child; D002662:Child Health Services / Q000592:standards*; D002675:Child, Preschool; D019955:Conduct Disorder / Q000517:prevention & control; D003866:Depressive Disorder / Q000517:prevention & control; D005260:Female; D006291:Health Policy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008605:Mental Health Services / Q000592:standards*; D011050:Policy Making; D011322:Primary Prevention / Q000592:standards*; D016730:Program Development; D015397:Program Evaluation