Concurrent and prospective relationships between symptoms of depression, anxiety, attention deficit/hyperactivity disorder (ADHD), and conduct disorder (CD) and academic achievement were examined in a large sample of Canadian children. Students in Grade 5 (N = 715) completed the depression and anxiety subscales of the Behaviour Assessment System for Children – Second Edition. Parents reported on their child’s symptoms of ADHD and CD using the Brief Child and Family Phone Interview. Academic achievement was measured using teacher-rated learning skills and students’ grade point average (GPA) from their Ontario Student Record (OSR) in fifth grade and again in sixth grade (N = 627). Symptoms of depression, anxiety, ADHD, and CD were significantly negatively correlated with academic achievement at Time 1 and Time 2. After controlling for child’s sex, household income, maternal education, and days absent, children’s mental health problems accounted for an additional 12% and 11% of the variability in their Time 1 mean ratings of learning skills and GPA, respectively. Only symptoms of ADHD predicted Time 2 GPA (1% of the variance) after controlling for Time 1 GPA and other sociodemographic variables. Findings highlight the unique contribution of mental health problems in predicting academic achievement and point to the need to promote children’s mental health in schools.

Concurrent and prospective relationships between symptoms of depression, anxiety, attention deficit/hyperactivity disorder (ADHD), and conduct disorder (CD) and academic achievement were examined in a large sample of Canadian children. Students in Grade 5 (N = 715) completed the depression and anxiety subscales of the Behaviour Assessment System for Children – Second Edition. Parents reported on their child’s symptoms of ADHD and CD using the Brief Child and Family Phone Interview. Academic achievement was measured using teacher-rated learning skills and students’ grade point average (GPA) from their Ontario Student Record (OSR) in fifth grade and again in sixth grade (N = 627). Symptoms of depression, anxiety, ADHD, and CD were significantly negatively correlated with academic achievement at Time 1 and Time 2. After controlling for child’s sex, household income, maternal education, and days absent, children’s mental health problems accounted for an additional 12% and 11% of the variability in their Time 1 mean ratings of learning skills and GPA, respectively. Only symptoms of ADHD predicted Time 2 GPA (1% of the variance) after controlling for Time 1 GPA and other sociodemographic variables. Findings highlight the unique contribution of mental health problems in predicting academic achievement and point to the need to promote children’s mental health in schools.

Concurrent and prospective relationships between symptoms of depression, anxiety, attention deficit/hyperactivity disorder (ADHD), and conduct disorder (CD) and academic achievement were examined in a large sample of Canadian children. Students in Grade 5 (N = 715) completed the depression and anxiety subscales of the Behaviour Assessment System for Children – Second Edition. Parents reported on their child’s symptoms of ADHD and CD using the Brief Child and Family Phone Interview. Academic achievement was measured using teacher-rated learning skills and students’ grade point average (GPA) from their Ontario Student Record (OSR) in fifth grade and again in sixth grade (N = 627). Symptoms of depression, anxiety, ADHD, and CD were significantly negatively correlated with academic achievement at Time 1 and Time 2. After controlling for child’s sex, household income, maternal education, and days absent, children’s mental health problems accounted for an additional 12% and 11% of the variability in their Time 1 mean ratings of learning skills and GPA, respectively. Only symptoms of ADHD predicted Time 2 GPA (1% of the variance) after controlling for Time 1 GPA and other sociodemographic variables. Findings highlight the unique contribution of mental health problems in predicting academic achievement and point to the need to promote children’s mental health in schools.

Concurrent and prospective relationships between symptoms of depression, anxiety, attention deficit/hyperactivity disorder (ADHD), and conduct disorder (CD) and academic achievement were examined in a large sample of Canadian children. Students in Grade 5 (N = 715) completed the depression and anxiety subscales of the Behaviour Assessment System for Children – Second Edition. Parents reported on their child’s symptoms of ADHD and CD using the Brief Child and Family Phone Interview. Academic achievement was measured using teacher-rated learning skills and students’ grade point average (GPA) from their Ontario Student Record (OSR) in fifth grade and again in sixth grade (N = 627). Symptoms of depression, anxiety, ADHD, and CD were significantly negatively correlated with academic achievement at Time 1 and Time 2. After controlling for child’s sex, household income, maternal education, and days absent, children’s mental health problems accounted for an additional 12% and 11% of the variability in their Time 1 mean ratings of learning skills and GPA, respectively. Only symptoms of ADHD predicted Time 2 GPA (1% of the variance) after controlling for Time 1 GPA and other sociodemographic variables. Findings highlight the unique contribution of mental health problems in predicting academic achievement and point to the need to promote children’s mental health in schools.

M.A. / Mental health workers are becoming more and more aware of the need to address all youths at risk in South Africa. While different contexts place youths at different types of risks, of particular interest in this study, is the phenomenon of street youths – a visible manifestation of a disrupted political and socio-economic society. Over time, it has come to be recognised that it is not enough to simply place these children in institutions, but that it would be more helpful to understand who these children are as individuals. Knowing how they function on an emotional and psychological level, their culture, their values and their dreams has profound implications for interventions that aim at improving the quality of their lives. Moreover, understanding the needs of these youths in more depth provides them with the opportunity to be included in decision-making processes pertinent to their future as contributing members of society. In view of the above, this study examines the personality development of street youths with the purpose that mental health workers combine developmental principles into their interventions. Thus, it is argued that by building on the knowledge that these youths already have of themselves and their lives, and by carefully examining their developmental needs, more appropriate and responsible programs can be created. Many studies on street youths have found that there is a high incidence of pathology in street youths. Much of this has been attributed to the abusive, dysfunctional and neglected home environments that these youths come from, and is generally exacerbated by the life style they lead on the streets. Therefore, this study examines the context from which street youths have emerged with particular emphasis on family systems, social contexts, beliefs and values, and the general infrastructure of the community at a government level. It was decided to use projective testing on a sample of street youths in the hope of identifying to what extent these youths' development has been compromised. In this respect, their needs, traits, strengths, conflicts and defenses were examined. The results were then integrated with Maslow’s Hierarchy of Needs as well as Erikson’s Psychosocial Theory, and then examined against the backdrop of Bronfenbrenner’s Ecological Theory. The results of this study found that generally, healthy development in these youths has, indeed, been compromised. Any need for achievement, autonomy, dependency or security was found to be absent in these youths. It has therefore, been argued that these youths have been arrested at their first level of development, mainly because their primary focus is on fulfilling their basic physiological needs, to the extent that any higher order needs cannot be met. The results did, however, find that the majority of the youths in this sample are extroverted and flexible, and despite their living conditions, they are not negative or evasive. Whether these traits are inherent or learned is unknown, however, it is argued that these traits assist them to survive more successfully on the street. It was also found that, although these youths are not very adaptable, they are accessible, a possible survival skill making them more receptive to both welfare institutions and the public, on whom they depend on for their survival. Interestingly, it was found that a significant percentage of these youths indicate a presence of organicity. While the source of this may be due to extensive substance abuse, physical abuse or birth defects, its presence may also explain the presence (or absence) of other traits and conflicts in this sample. As such, these youths do indicate any significant pathological conflicts, except for paranoia. The presence of paranoia is to be expected in these children because, in order to survive, these youths need to be constantly alert to the dangers in their environment. This finding also lends support to the fact that these youths should not be pathologised but must rather be seen within the larger context of societal problems and issues. Finally, it was found that the youths in this sample do not indicate defenses. This is an unusual finding as by the time they reach adolescence, these youths should have developed certain defenses in order for successful negotiation of the environment to occur. Further study could shed light on why defenses were absent in these youths. In conclusion, it has also been argued that it is important to note that, because different studies indicate different results, it must be recognised that street youths experience street life differently, and that not all street youths experience negative life circumstances as equally stressful. Thus, it can be concluded that healthy personality development of street youths is not solely based on their experiences at home or on the street. It may also depend on predispositional traits, how they perceive their situations, how they construe themselves, their internal locus of control, their resilience levels and their social support systems.

In the United States traditionally many children have gone unserved. This has been partly due to barriers in accessing services and the result of a fragmented and disorganized system of care. However, in the last two decades substantial progress has been made in adressing these problems. This article reviews the need for children's mental health services in the United States, and describes recent attempts to improve coordination and access to the children's mental health service system. The introduction of systems of care, the expansion of school-based services, and innovations in the provision of community services are discussed. / Aún cuando en los Estados Unidos existe gran demanda de servicios de salud mental infantil, tradicionalmente muchos niños no han sido atendidos adecuadamente. Esto, en parte, se debe a los obstáculos en el acceso a los servicios y al resultado de un sistema de cuidado fragmentado y desorganizado. Sin embargo, en las últimas dos décadas se ha alcanzado un progreso sustancial en la manera de encarar estos problemas. Este artículo revisa la demanda de servicios de salud mental infantil que existe en los Estados Unidos y describe intentos recientes para mejorar la coordinación y el acceso al sistema de servicio de salud mental infantil. Se discuten la introducción de sistemas de cuidado, la expansión de servicios basados en la escuela y las innovaciones en la provisión de servicios a la comunidad.

Learners in South-African secondary schools face challenges of growing into mature, responsible and healthy human beings amidst all the changes and societal problems in schools. There are so many problems, referred to as the mental health crisis among children in South Africa that confront secondary school learners, such as poverty, violence, crime, suicide, involvement in gangs, teenage pregnancies but to name a few. Education does not stand in isolation from the wider society around it but it is constantly influenced and moulded by the forces of cultural and social and economic development. The educational task of the school is synonymous with the educational aim of adulthood and social responsibility. Many children are experiencing challenges in coping with their emotions such as aggression and managing anger in their daily lives that a need has arisen for the facilitation of aggression management for secondary school learners through a Psycho-Educational Programme. This programme included new skills that are necessary for successful living and learning, thus focusing on life skills that enable secondary school learners to apply their knowledge, attitudes and values – what humans think, feel and believe and how to cope with an emotion like aggression. The researcher followed a structured framework in four steps in order to conduct the research, which adhered to the requirements of a qualitative and quantitative strategy. In step one the researcher followed an inductive reasoning strategy with a contextual, descriptive and exploratory focus (situation analysis). Secondary school learners' experience of aggression in their school was explored through individual phenomenological interviews conducted with a purposively selected sample and by means of field notes made at the conclusion of the interview process. The interviews proceeded until data were saturated. Guba’s model of trustworthiness strategies: credibility, transferability, dependability and confirmability were applied. Each interview was audio taped and then transcribed. The data were then analysed according to Tesch’s (Creswell, 1994:154-155) descriptive, qualitative and systematic approach to data reduction where after a literature control was conducted. According to the data analysis four themes were identified: - learners experience aggression as part of their life; - aggression encompasses interpersonal relationships; - learners describe aggression as a negative experience; and - learners articulate measures to manage aggression. In step two the collected data from phase one was used to develop a Psycho-Educational Programme for secondary school learners who experience aggression in order to facilitate aggression management. During step three, two secondary schools were chosen. After selection the schools were randomly assigned as an experimental and control group. Secondary school learners were then randomly selected as participants from grade eleven learners at their schools. A questionnaire was used for pre-test and post-test purposes. Adherence to internal validity, external validity, reliability and objectivity ensured the trustworthiness of the process. The programme was presented to the experimental group only. The control group was treated exactly like the experimental group except that they did not receive the experimental treatment but a placebo programme as the group was only included for comparison reasons. In step four the evaluation of the Psycho-Educational Programme was done which enabled the researcher to focus clearly on the ultimate purpose of meeting the aims and purpose of this research study. The researcher can confidently express his trust and confidence in the Psycho-Educational Programme that was developed, implemented and evaluated. The evaluation of the data indicated that the questionnaires that were used as a measuring tool were reliable, appropriate and valid. The results indicated that the variables: self-awareness, interpersonal relationships and management of conflict were effectively included in the Psycho-Educational Programme and had a significant impact on the participants who took part in the experimental group. The placebo programme had no significant effect on the participants of the control group. In conclusion, mixed research methods of the qualitative and quantitative approaches were effective as it supported each other during this research study. / Prof. C.P.H. Myburgh Prof. M. Poggenpoel

This thesis draws on the 2014 Ontario Child Health Study (2014 OCHS) to address four contemporary and policy-relevant issues associated with measuring child and adolescent mental health need and children’s mental health service use in the general population. The first and second papers focus on the development and evaluation of instruments to measure child mental disorder. The first paper develops a simple, brief symptom checklist used to measure child mental disorder conceptualized as a dimensional phenomenon, a core concept in the 2014 OCHS. The second focuses on a briefer version of this checklist to measure child mental disorder dimensionally in general and clinical populations for the purposes of assessing and monitoring children’s mental health need. The third and fourth papers use these measures as the basis for assessing children’s mental health need in evaluations of policy-relevant health service questions. The third paper focuses on a substantive question about area-level variation in children’s unmet need for mental health services using 2014 OCHS data linked to government administrative data and 2016 Census data. The fourth paper estimates the extent to which child mental health service expenditures in 2014-15 were allocated according to children’s mental health need. Together, these papers respond to the need for simple, brief, self-report measures of child and adolescent mental disorders and show how these types of measures, in combination with administrative government data sources can advance our knowledge about policy and funding decisions in children’s mental health services research in Ontario. / Thesis / Doctor of Philosophy (PhD) / The goals of this thesis are to address issues relating to: (1) measuring child and adolescent mental health need using brief, self-report problem checklists and (2) using these measures to answer questions about children’s mental health service use and service expenditures in the general population in Ontario. The individual manuscripts in this thesis respond to the need for simple, brief, self-report measures of child and adolescent mental disorders and advance our knowledge about policy and funding decisions in children’s mental health services research in Ontario.

When children are detained and enter the foster care system, social workers screen them to determine if mental health services are needed. Formal referrals to mental health providers are made, however there is a significant wait time between referral and service delivery. The focus of this study was to explore these barriers to mental health services in an effort to identify approaches that might improve service access. Qualitative face-to-face interviews were conducted with key stakeholders using an Ecological Systems Theory to fashion a hermeneutic dialect and a joint construct toward a shared action plan. Data was collected from the interviews and thematically analyzed. The project informs service delivery systems of mental health for children and adults, both for micro and macro practice, by highlighting the need for increased collaboration between agencies and growing family engagement and empowerment to reduce stigma. These efforts will improve communication, define expectations, and diminish silos. The project also contributes to child welfare practices and policies for referrals of children’s mental health services by noting the need for an embedded mental health therapist within child welfare to accept referrals for services; the addition of one study site contractual children’s mental health service provider in the rural county that will accept referrals for children and families. In summary, the study identifies strategies to reduce wait time for service delivery, how those services are best accessed, as well as efforts to better engage families in treatment.

Parenting and family interactions are thought to play a critical role in children’s development and are often key targets in clinical interventions for children with behavioral problems. Multiple factors are thought to determine patterns of parenting behavior including child and parent characteristics as well as broader social and cultural factors (Abidin, 1992; Belsky, 1984; Maccoby, 1992). Because culture is thought to influence parenting, it is possible that inter-ethnic couples may experience a greater discrepancy than intra-ethnic couples in their parenting styles, but research considering the role of different cultural backgrounds and parenting has been sparse. The current study examined whether inter-ethnic couples showed greater differences in their parenting styles than couples in which parents were of the same ethnic background, and if so, whether consequences of discrepancy were reflected in children’s behavior. Marital conflict and the number of years spent co-parenting were also examined as potential predictors of variability between couples. Results indicated no significant differences between inter-ethnic and intra-ethnic couples in parenting style, and no significant associations between discrepancies in parenting style and child behavior. Marital conflict was found to be significantly associated with discrepancy in warmth for fathers in intra-ethnic relationships, in support for the spillover hypothesis (Margolin, 2001). This is the first study to examine parenting discrepancies between inter-ethnic and intra-ethnic couples. This research contributes to a growing understanding of the co-parenting relationship among inter-ethnic couples and has important clinical implications for family intervention with multi-cultural families.