Role of pre-existing adversity and child maltreatment on mental health outcomes for children involved in child protection: population-based data linkage study

ObjectivesTo determine mental health outcomes for children with a history of child protection system involvement, accounting for pre-existing adversity, and to examine variation in risk across diagnostic groupings and child protection subgroups.DesignA longitudinal, population-based record-linkage study.ParticipantsAll children in Western Australia (WA) with birth records between 1990 and 2009.Outcome measuresMental health diagnoses, mental health contacts and any mental health event ascertained from International Classification of Diseases codes within WA’s Hospital Morbidity Data Collection and Mental Health Information System from birth until 2013.ResultsCompared with children without child protection contact, children with substantiated maltreatment had higher prevalence of mental health events (37.4% vs 5.9%) and diagnoses (20% vs 3.6%). After adjusting for background risks, all maltreatment types were associated with an almost twofold to almost threefold increased hazard for mental health events. Multivariate analysis also showed mental health events were elevated across all child protection groups, ranging from HR: 3.54 (95% CI 3.28 to 3.82) for children who had entered care to HR: 2.31 (95% CI 2.18 to 2.46) for unsubstantiated allegations. Maternal mental health, aboriginality, young maternal age and living in socially disadvantaged neighbourhoods were all associated with an increased likelihood of mental health events. The increase varied across diagnostic categories, with particularly increased risk for personality disorder, and frequent comorbidity of mental health and substance abuse disorders.ConclusionsYoung people who have been involved in the child protection system are at increased risk for mental health events and diagnoses. These findings emphasise the importance of services and supports to improve mental health outcomes in this vulnerable population. Adversities in childhood along with genetic or environmental vulnerabilities resulting from maternal mental health issues also contribute to young people’s mental health outcomes, suggesting a role for broader social supports and early intervention services in addition to targeted mental health programmes.

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Incidence and Predictors of Mental Health Outcomes Among Survivors of Adolescent and Young Adult Cancer: A Population-Based Study Using the IMPACT Cohort

Journal of Clinical Oncology ◽

10.1200/jco.20.02019 ◽

2021 ◽

pp. JCO.20.02019

Author(s):

Riddhita De ◽

Rinku Sutradhar ◽

Paul Kurdyak ◽

Suriya Aktar ◽

Jason D. Pole ◽

...

Keyword(s):

Mental Health ◽

Young Adult ◽

Health Outcomes ◽

Psychotic Disorder ◽

Population Based ◽

Mental Health Outcomes ◽

Adolescent And Young Adult ◽

Increased Risk ◽

The Impact

PURPOSE Risk and predictors of long-term mental health outcomes in survivors of adolescent and young adult (AYA) cancers are poorly characterized. Mental health is consequently neglected in long-term follow-up. METHODS We identified all AYA in Ontario, Canada age 15-21 years when diagnosed with one of six common cancers between 1992-2012 using a population-based database, and compared them with matched controls. Linkage to provincial healthcare data allowed analysis of rates of outpatient (family physician and psychiatrist) visits for psychiatric indications and time to severe psychiatric events (emergency room visit, hospitalization, and suicide). Demographic-, disease-, and treatment-related predictors of adverse outcomes, including treatment setting (adult v pediatric), were examined. RESULTS Among 2,208 survivors and 10,457 matched controls, 5-year survivors experienced higher rates of outpatient mental health visits than controls (671 visits per 1,000 person-years v 506; adjusted rate ratio [RR] 1.3; 95% CI, 1.1 to 1.5; P = .006). Risk of a severe psychiatric episode was also increased among survivors (adjusted hazard ratio [HR], 1.2; 95% CI, 1.1 to 1.4, P = .008). Risk of a psychotic disorder–associated severe event was doubled in survivors (HR, 2.0, 95% CI, 1.3 to 2.4; P = .007) although absolute risk remained low (15-year cumulative incidence 1.7%; 95% CI, 1.0 to 2.7). In multivariable analysis, survivors treated in adult centers experienced substantially higher outpatient visit rates compared with those treated in pediatric settings (RR 1.8; 95% CI, 1.0 to 3.1; P = .04). CONCLUSION Survivors of AYA cancer are at substantially increased risk of adverse mental health outcomes, with those treated in adult centers at particular risk. Although absolute incidence was low, survivors were at increased risk of psychotic disorder–associated severe events. Long-term mental health surveillance is warranted, as is research into effective interventions during or after cancer treatment.

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Mental health outcomes after major trauma in Ontario: a population-based analysis

Canadian Medical Association Journal ◽

10.1503/cmaj.180368 ◽

2018 ◽

Vol 190 (45) ◽

pp. E1319-E1327

Author(s):

Christopher C.D. Evans ◽

Yvonne DeWit ◽

Dallas Seitz ◽

Stephanie Mason ◽

Avery Nathens ◽

...

Keyword(s):

Mental Health ◽

Health Outcomes ◽

Major Trauma ◽

Population Based ◽

Mental Health Outcomes

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Improving Mental Health Outcomes for Children and Youth Exposed to Abuse and Neglect

Healthcare Quarterly ◽

10.12927/hcq.2011.22360 ◽

2011 ◽

Vol 14 (sp2) ◽

pp. 22-31 ◽

Cited By ~ 1

Author(s):

Ene Underwood

Keyword(s):

Mental Health ◽

Health Outcomes ◽

Mental Health Outcomes ◽

Children And Youth ◽

Abuse And Neglect ◽

Outcomes For Children

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Social services Interventions and the Mental Health and Mortality of care leavers: a population based data linkage study in Northern Ireland and Finland

International Journal for Population Data Science ◽

10.23889/ijpds.v4i3.1252 ◽

2019 ◽

Vol 4 (3) ◽

Author(s):

Aideen Maguire ◽

Anne Kouvonen ◽

Dermot O'Reilly ◽

Hanna Remes ◽

Joonas Pitkänen ◽

...

Keyword(s):

Mental Health ◽

Northern Ireland ◽

Health Outcomes ◽

Social Services ◽

Psychiatric Hospital ◽

Poor Mental Health ◽

Mental Health Outcomes ◽

Care Intervention ◽

Increased Risk ◽

Self Harm

BackgroundResearch has highlighted the poor mental health of looked after children compared to those never in care. However, little is known on what becomes of these children and their mental health trajectories after they leave the care of social services. In addition, previous studies are limited in their ability to differentiate between type of social care intervention received; kinship care, foster care or residential care. AimTo utilise nationwide social services data from two countries (Northern Ireland (NI) and Finland), with similar populations but different intervention policies, linked to a range of demographic and health datasets to examine the mental health outcomes of young adults in the years following leaving care. MethodsData from both countries on children born 1991-2000 were linked to social services data, hospital admissions, prescribed medication data and death records. Mental health outcomes were defined after the age of 18years (when statutory care provision ends) examined by care intervention and included admissions to psychiatric hospital, for self-harm and death by suicide. ResultsThe gender split in care in Finland is reflective of the population but more males are in care in NI. Initial results from Finnish data suggest those exposed to care in childhood have an increased risk of self-harm, psychiatric hospital admission and suicide after the age of 18years compared to those never in care. After adjusting for gender, age of entry to care and deprivation at birth those exposed to any care intervention had 3 times the risk of suicide (HR=3.06, 95% CI 1.18,7.98). Risk increased with duration in care but was equivalent across care intervention types. Analysis on the NI data is underway. ConclusionFull results will be available December 2019 and will explore which care pathways are most associated with poor mental health outcomes informing discussion around intervention opportunities and policy.

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Association Between Overt and Subtle Experiences of Discrimination and Violence and Mental Health in Homosexual and Bisexual Men in Mexico

Journal of Interpersonal Violence ◽

10.1177/0886260519898423 ◽

2020 ◽

pp. 088626051989842

Author(s):

Juan C. Mendoza-Perez ◽

Luis Ortiz-Hernandez

Keyword(s):

Mental Health ◽

Sexual Orientation ◽

Health Outcomes ◽

Physical Violence ◽

Gender Nonconformity ◽

Mental Health Outcomes ◽

Bisexual Men ◽

Cross Sectional Survey ◽

Increased Risk ◽

And Bisexual

The aim of this study was to determine whether the experiences of direct or subtle forms of discrimination and violence are associated with mental health in Mexican gay, homosexual, and bisexual (GHB) men. A cross-sectional survey was conducted online; the sample consisted of 4,827 GHB men. Ten forms of overt and subtle sexual orientation–based discrimination and violence (SO-DV) were assessed. Linear and logistic regression models were used to evaluate the association between SO-DV experiences and mental health outcomes. Physical violence was reported less frequently than the other forms of SO-DV. As the number of settings in which SO-DV were experienced increased, a stronger association with negative mental health outcomes was observed. Experiences of subtle SO-DV were associated with increased distress, lower vitality, and increased risk of suicidal ideation. Disapproval of gender nonconformity was associated with negative mental health outcomes independently of violence based on sexual orientation. Subtle forms of SO-DV are more common than direct and overt forms. Both types of SO-DV could negatively affect mental health. Studies investigating these negative experiences are required to gain an understanding of the health inequalities faced by non-heterosexual populations.

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Adolescent Concussion and Mental Health Outcomes: A Population-based Study

American Journal of Health Behavior ◽

10.5993/ajhb.43.2.3 ◽

2019 ◽

Vol 43 (2) ◽

pp. 258-265 ◽

Cited By ~ 7

Author(s):

Max N. Yang ◽

Kristen Clements-Nolle ◽

Brian Parrish ◽

Wei Yang

Keyword(s):

Mental Health ◽

Health Outcomes ◽

Population Based ◽

Mental Health Outcomes ◽

Population Based Study

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Community Support as a Moderator of Postdisaster Mental Health Symptoms in Urban and Nonurban Communities

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2013.74 ◽

2013 ◽

Vol 7 (5) ◽

pp. 443-451 ◽

Cited By ~ 9

Author(s):

Jenny S. West ◽

Matthew Price ◽

Kirstin Stauffacher Gros ◽

Kenneth J. Ruggiero

Keyword(s):

Mental Health ◽

Health Outcomes ◽

Protective Factor ◽

Community Support ◽

Recovery Process ◽

Population Based ◽

Mental Health Outcomes ◽

Depression Symptoms ◽

Interpersonal Effects ◽

Disaster Exposure

AbstractObjectiveWe examined the association between disaster exposure, community support, and mental health outcomes in urban and nonurban participants of Galveston and Chambers counties after Hurricane Ike. The moderating effect of community support was evaluated as a protective factor relative to postdisaster mental health.MethodsA representative population-based sample of 157 urban and 714 nonurban adults were interviewed 12 to 17 months after the hurricane about their mental health functioning, disaster exposure, and perceptions of community support.ResultsA series of multiple regressions demonstrated that disaster exposure was associated with mental health outcomes for both groups. The strength of the association varied across population samples.Community support moderated the association between interpersonal effects of the disaster and posttraumatic stress disorder (PTSD) and depression outcomes in nonurban participants and the association between property damage and PTSD in urban participants.ConclusionsCommunity support played a larger role in reducing PTSD and depression symptoms associated with the interpersonal effects of a disaster in the nonurban sample only. Communities may play a more beneficial role in the recovery process in nonurban areas that have elevated levels of injury or death attributed to a disaster. (Disaster Med Public Health Preparedness. 2013;0:1–9)

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