By Jimena Carías (This was a team project I had one classmate who helped me do this research).
For my team research project, we used the article Establishing a Level Foundation for Life: Mental Health Begins in Early Childhood. The article was part of ongoing work from the Center on the Developing Child at Harvard University. The study reiterated that mental problems can occur in young children and that in some cases, these problems can have serious consequences for learning, social skills, and physical health. As a result, we cannot separate mental health from cognitive development, language development, and social competence.
One of the challenges mentioned in the article is identifying mental illness in young children. Will young children show the same symptoms adult show? How can we determine if a child is having behavioral problems or mental health issues? Children can show clear characteristics of anxiety disorders, post-traumatic disorder, depression, and neurodevelopmental disabilities such as autism. Between the ages of 2-17 alone, children can present serious emotional disorder, anxiety disorder, disruptive behavior disorder among others, Egger & Arnold (2006).
Diagnosing young children with mental health issues can be harder than it is for adults. Determining symptoms to identify mental illness in younger children presents a huge challenge. The article mentions that children with mental illness could present some of the following symptoms when a child struggles to let things go, when a child takes too long to recover from adversity, or when the child lacks curiosity. But none of these symptoms is one hundred percent accurate.
Mental health treatment in young children is another gray area. Young children might get drug-based treatments that haven’t been yet tried in children their age. The article talked about other interventions to promote sound mental health in young children and how we can apply these interventions in some environments where toxic stress is a factor in the children´s reality.
The intense intervention mentioned in the article included synergic work between the family, childcare providers, health care provider, and environment to help ensure the mental wellbeing of the child. “The science of childhood development shows that the foundation for sound mental health is built early in life, as early experiences – which includes children’s relationships with parents, caregivers, relatives, teachers, and peers – shape the architecture of their developing brain”-Center on the Developing Child.
The second article Persistent Fear and Anxiety Can Affect Young Children’s Learning and Development also written by the Center on the Developing Child at Harvard University, explored why traumatic experiences may affect how children learn, solve problems and relate to others. It emphasized that children need a secure environment to grow, learn, and develop healthy brains and bodies. The article introduced the concept of brain architecture, explaining that the brain as the structure that provides the foundation for all learning, behavior, and health and comparing it to a house’s foundation. A strong house foundation where emotional well-being and social competence are provided will nurture cognitive abilities, but a weak foundation could have negative effects lasting into adulthood.
The brain is an integrated organ and its multiple functions operate in coordination with one another. Cognitive, emotional and social capacities are inextricably intertwined throughout a human’s life course. Science shows that early exposure to adverse circumstances that produce persistent fear and chronic anxiety can have lifelong effects on brain architecture.
Both articles shared similarities, one was their emphasis on how toxic stress affects children. The second article focused on how toxic stress weakens brain architecture, which can lead to lifelong problems, it could even impair the development of neural connections.
But the study performed in Persistent Fear and Anxiety Can Affect Young Children’s Learning and Development talked more about the stressors that create fear and anxiety in young children. The article mentioned how child maltreatment often occurs in families that face excessive levels of stress. “Critically, 1 in every 7 children, and nearly 1 out of every 40 infants, in the United States experience some form of maltreatment, including chronic neglect or physical, emotional, or sexual abuse”.
U.S. Department of Health and Human Services, Administration on Children, Youth, and Families. (2009). Child maltreatment 2007. Washington, DC: U.S. Government Printing Office
The article states the difference between typical childhood fears and fears and anxiety elicited by traumatic situations such as physical or sexual abuse or exposure to violence. Behavioral neuroscience research in animals shows that serious fear triggering events can have significant long-lasting impacts on the developing child, beginning in infancy. Also, studies show that children do not naturally outgrow early learned fear responses over time and simply removing a child from a dangerous environment will not by itself undo the consequences of early fear learning.
In both articles from Harvard University, they had a section for policy gaps and suggestions to provide sound mental health to children and recommendations to prevent or address the effects of traumatic experiences in children such as ensuring that early identification and treatment for anxiety in young children are available through existing services for families.
A question arose while reading both articles. What represents good mental health in a child and an adolescent? The World Health Organization defines in their report Child and adolescent mental health policies and plans “that child and adolescent mental health is the capacity to achieve and maintain optimal psychological functioning and well being. It can also be defined as a state of wellbeing in which every individual realizes their own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community”.
Good mental health will give better educational and behavioral outcomes. That’s why good mental health needs to be nurtured in our education system. Caring for the students’ wellbeing will result in a better classroom environment and create functional adults. The benefits of incorporating mental health policies in schools have a positive impact on children’s development. Mental health and wellbeing of children and adolescents have a value in its own right.
Educational settings become the second most important place for the development of children’s and adolescents’ mental health. And in WHO’s report, they make a great emphasis on school staff training to support children’s psychosocial development. Including sound mental health in the school’s curriculum to make a difference in the lives of some students.
But as teachers, or even as part of our communities what can we do to help promote sound mental health and the wellbeing of children and adolescents? In the article, Enhancing Resilience and Mental Health of Children and Adolescents by integrated School- and Family-based Approaches makes a call for action by promoting resilience in school and families. Resilience is an essential concept for developing preventive, protective, and promotive aspects of children and adolescent mental health. Resilience is how we bounce back from adversity, resilience is when something is broken and instead of disposing of it, we use the broken pieces to create something new, something functional.
The article introduced the concept of family resilience “the capacity of the family system to withstand and rebound from adversity, strengthened and more resourceful. More than coping with or surviving an ordeal, resilience involves positive adaptation, (re) gaining the ability to thrive, with personal and relational transformation and positive growth forged through the experience. A family resilience perspective is grounded in a deep conviction in their potential for repair and growth.
There is a need to combine family-based approaches with school-based approaches. It is important to explain children and adolescents the meaning of adversity, how to overcome adversity, a positive outlook in various situations, to create spaces for open emotional sharing and collaborative problem-solving.
Another recent alternative is Telehealth. Telehealth is the distribution of health-related services and information via electronic information and telecommunication technologies. The article Addressing Students’ Mental Health Needs via Telehealth mentions that school-based centers aren’t always a reality especially in urban school districts. Rates of depression and anxiety in children and adolescents have been steadily increasing over the past 15 years. In 2017, 13.3% of the US population aged 12-17 had at least one major depressive episode [2]. In response, telehealth services in schools have increased.
National Institutes of Mental Health. Prevalence of Major Depressive Episode Among Adolescents. National Institutes of Mental Health website. https://www.nimh.nih.gov/health/statistics/maj or-depression.shtml#part_155031. Updated February 2019. Accessed December 13, 2019
These articles reflect on the importance of Mental Health in children and adolescents. Young children, children, and adolescents can all suffer from a mental health illness. Their treatments should vary in age and by case. As a prospective teacher, I have the obligation to advocate for my future student’s wellbeing and sound mental health. However, there is a need to begin advocating for a mental health policy that prepares teachers and parents to better serve our youth and provide them with what they need to become functional adults.
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References
National Scientific Council on the Developing Child. (2008/2012). Establishing a Level Foundation for Life: Mental Health Begins in Early Childhood: Working Paper No. 6. Updated Edition. https://developingchild.harvard.edu/resources/establishing-a-level-foundation-for-life-mental-health-begins-in-early-childhood/
National Scientific Council on the Developing Child (2010). Persistent Fear and Anxiety Can Affect Young Children’s Learning and Development: Working Paper No. 9. https://developingchild.harvard.edu/resources/persistent-fear-and-anxiety-can-affect-young-childrens-learning-and-development/
World Health Organization WHO (2005) Child and Adolescent Mental Health Policies and Plans (2005) Geneva, (Mental Health Policy and Service Guidance Package). https://www.who.int/mental_health/policy/services/9_child%20ado_WEB_07.pdf?ua=1
Basu D, Nagpal S, Mutiso V, Ndetei DM, Lauwrens Z, Hadfield K, et al. Enhancing resilience and mental health of children and adolescents by integrated school- and family-based approaches, with a special focus on developing countries: A narrative review and call for action World Soc Psychiatry 2020;2:7-19. http://www.worldsocpsychiatry.org/temp/WorldSocPsychiatry217-1483694_040716.pdfSteve North, (2020), Addressing Students’ Mental Health Needs via Telehealth. https://www.ncmedicaljournal.com/content/ncm/81/2/112.full.pdf
