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Objective The aim of this study was to estimate the six-month prevalence of mental illness in children with chronic physical illness (multimorbidity), examine agreement between parent and child reports of multimorbidity, and identify factors associated with child multimorbidity. Method The sample included 263 children aged 2–16 years with a physician-diagnosed chronic physical illness recruited from the outpatient clinics at a pediatric hospital. Children were categorized by physical illness according to the International Statistical Classification of Diseases and Related Health Problems (ICD)-10. Parent and child-reported six-month mental illness was based on the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). Results Overall, 101 (38%) of children had a parent-reported mental illness; 29 (25%) children self-reported mental illness. There were no differences in prevalence across ICD-10 classifications. Parent-child agreement on the MINI-KID was low (κ = 0.18), ranging from κ = 0.24 for specific phobia to κ = 0.03 for attention-deficit hyperactivity. From logistic regression modeling (odds ratio [OR] and 95% confidence interval), factors associated with multimorbidity were: child age (OR = 1.16 [1.04, 1.31]), male (OR = 3.76 [1.54, 9.22]), ≥$90,000 household income (OR = 2.57 [1.08, 6.22]), parental symptoms of depression (OR = 1.09 [1.03, 1.14]), and child disability (OR = 1.21 [1.13, 1.30]). Similar results were obtained when modeling number of mental illnesses. Conclusions Findings suggest that six-month multimorbidity is common and similar across different physical illnesses. Level of disability is a robust, potentially modifiable correlate of multimorbidity that can be assessed routinely by health professionals in the pediatric setting to initiate early mental health intervention to reduce the incidence of multimorbidity in children.

Multiple informants are often used in the assessment of child psychopathology; however, parent-child agreement is low in child psychiatry. The objective of this exploratory study was to assess informant agreement on the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) in a clinical sample of children with mental disorders and their parents, and to examine health and demographic factors associated with agreement.MINI-KID results were analyzed for 88 parent-child dyads. Children were between 8-17 years old and were receiving in- or outpatient services for at least one mental disorder at a pediatric hospital. Kappas were calculated to assess parent-child agreement and logistic regression models were used to identify factors associated with agreement.Agreement was low to moderate (κ=0.19-0.41) across the MINI-KID modules. Household income was associated with agreement for major depression, generalized anxiety, and attention-deficit hyperactivity disorder. Recruitment setting and parent psychological distress were associated with agreement for generalized anxiety and separation anxiety, respectively. Age, sex, and child disability/impairment were not associated with agreement.Parent-child agreement on the MINI-KID was low to moderate, and few factors were associated with agreement. These initial findings reaffirm the need for multiple informants when assessing psychopathology in children and can be used by health professionals to facilitate parent-child discussions in clinical settings in child psychiatry.De multiples informateurs sont souvent utilisés pour évaluer la psychopathologie de l’enfant; cependant, l’entente parent-enfant est faible en psychiatrie de l’enfant. L’objectif de la présente étude exploratoire était d’évaluer l’entente des informateurs à l’égard du mini-entretien neuropsychiatrique international pour enfants et adolescents (MINI-KID) dans un échantillon clinique d’enfants souffrant de troubles mentaux et de leurs parents, et d’examiner les facteurs de santé et démographiques associés à l’entente.Le résultats du MINI-KID ont été analysés pour 88 dyades parent-enfant. Les enfants avaient entre 8 et 17 ans et recevaient des services ambulatoires ou hospitalisés pour au moins un trouble mental dans un hôpital psychiatrique. Les kappas ont été calculés pour évaluer l’entente parent-enfant et des modèles de régression logistique ont servi à identifier les facteurs associés à l’entente.L’entente était de faible à modérée (κ = 0,19–0,41) dans tous les modules du MINI-KID. Le revenu du ménage était associé à l’entente pour la dépression majeure, l’anxiété généralisée, et le trouble de déficit de l’attention avec hyperactivité. Les paramètres du recrutement et la détresse psychologique parentale étaient associés à l’entente pour l’anxiété généralisée et l’angoisse de séparation respectivement. L’âge, le sexe et la déficience/incapacité de l’enfant n’étaient pas associés à l’entente.L’entente parent-enfant au MINI-KID était faible à modérée, et peu de facteurs étaient associés à l’entente. Ces premiers résultats réaffirment le besoin de multiples informateurs pour évaluer la psychopathologie des enfants et peuvent être utilisés par les professionnels de la santé pour animer les discussions parent-enfant dans les milieux cliniques de psychiatrie de l’enfant.

This manuscript serves to provide an overview of the methods of the Multimorbidity in Children and Youth across the Life-course (MY LIFE) study, profile sample characteristics of the cohort, and provide baseline estimates of multimorbidity to foster collaboration with clinical and research colleagues across Canada.MY LIFE is comprised of 263 children (2-16 years) with a physical illness recruited from McMaster Children's Hospital, their primary caregiving parent, and their closest-aged sibling. Participants are followed with data collection at recruitment, 6, 12, and 24 months which includes structured interviews, self-reported measures, and biological samples and occur in a private research office or at participants' homes. Post-COVID-19, data collection transitioned to mail and telephone surveys.At recruitment, children were 9.4 (4.2) years of age and 52.7% were male. The mean duration of their physical illness was 4.5 (4.1) years; 25% represent incident cases (duration1 year). Most (69.7%) had healthy body weight and intelligence in the average range (73.5%). Overall, 38.2% of children screened positive for ≥1 mental illness according to parent report (24.8% screened positive based on child self-report). Compared to 2016 Census data, the MY LIFE cohort overrepresents families of higher socioeconomic status.Multimorbidity is common among children and these baseline data will serve to measure relative changes in the mental health of children with physical illness over time. MY LIFE will provide new information for understanding multimorbidity among children, though underrepresentation of lower socioeconomic families may have implications for the generalizability of findings.Le présent manuscrit sert à présenter un aperçu des méthodes de l’étude sur la multimorbidité chez les enfants et les jeunes tout au long de la vie (MA VIE), à esquisser des caractéristiques d’échantillon de la cohorte et à fournir des estimations de base de la multimorbidité pour faciliter la collaboration avec les collègues cliniques et chercheurs du Canada.MA VIE comprend 263 enfants (de 2 à 16 ans) souffrant d’une maladie physique recrutés à l’hôpital pour enfants de McMaster, leur principal parent aidant, et leurs frères et sœurs les plus rapprochés en âge. Les participants sont suivis par une collecte de données lors du recrutement, à 6, 12, et 24 mois, ce qui comporte des entrevues structurées, des mesures auto-déclarées, et des échantillons biologiques qui sont prélevés dans un bureau privé de la recherche ou au domicile de participants. La collecte de données post-COVID-19 a effectué une transition par la poste et les sondages par téléphone.Lors du recrutement, les enfants avaient 9,4 (4,2) ans et 52,7 % étaient de sexe masculin. La durée moyenne de leur maladie physique était de 4,5 (4,1) ans; 25 % représentaient des cas incidents (durée1 an). La plupart (69,7 %) avait un poids corporel sain et une intelligence dans la moyenne (73,5 %). En général, 38,2 % des enfants avaient un dépistage positif pour ≥ 1 maladie mentale selon le rapport des parents (24,8 % avaient un dépistage positif selon l’auto-déclaration des enfants). Comparativement aux données du recensement de 2016, la cohorte MA VIE surreprésente les familles de statut socio-économique plus élevé.La multimorbidité est commune chez les enfants et ces données de départ serviront à mesurer les changements relatifs de la santé mentale des enfants souffrant de maladie physique avec le temps. MA VIE fournira de nouvelles informations pour comprendre la multimorbidité chez les enfants, quoique la sous-représentation des familles au faible statut socio-économique puisse avoir des implications pour la généralisabilité des résultats.

Objective: To estimate the alignment between the Ontario Ministry of Children and Youth Services (MCYS) expenditures for children’s mental health services and population need, and to quantify the value of adjusting for need in addition to population size in formula-based expenditure allocations. Two need definitions are used: “assessed need,” as the presence of a mental disorder, and “perceived need,” as the subjective perception of a mental health problem. Methods: Children’s mental health need and service contact estimates (from the 2014 Ontario Child Health Study), expenditure data (from government administrative data), and population counts (from the 2011 Canadian Census) were combined to generate formula-based expenditure allocations based on 1) population size and 2) need (population size adjusted for levels of need). Allocations were compared at the service area and region level and for the 2 need definitions (assessed and perceived). Results: Comparisons were made for 13 of 33 MCYS service areas and all 5 regions. The percentage of MCYS expenditure reallocation needed to achieve an allocation based on assessed need was 25.5% at the service area level and 25.6% at the region level. Based on perceived need, these amounts were 19.4% and 27.2%, respectively. The value of needs-adjustment ranged from 8.0% to 22.7% of total expenditures, depending on the definition of need. Conclusion: Making needs adjustments to population counts using population estimates of children’s mental health need (assessed or perceived) provides additional value for informing and evaluating allocation decisions. This study provides much-needed and current information about the match between expenditures and children’s mental health need.

Objectives:To present the 6-month prevalence and sociodemographic correlates of mental disorders and mental health–related service contacts in a sample of children (4 to 11 years) and youth (12 to 17 years) in Ontario.Methods:The 2014 Ontario Child Health Study is a provincially representative survey of 6537 families with children aged 4 to 17 years in Ontario. DSM-IV-TR mental disorders were assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) and included mood (major depressive episode), anxiety (generalized anxiety, separation anxiety, social phobia, specific phobia), and behaviour disorders (attention-deficit/hyperactivity disorder, oppositional-defiant disorder, conduct disorder).The MINI-KID was administered independently to the primary caregiver and youth aged 12 to 17 years in the family’s home.Results:Past 6-month prevalence of any mental disorder ranged from 18.2% to 21.8% depending on age and informant. Behaviour disorders were the most common among children, and anxiety disorders were the most common among youth. Among children and youth with a parent-identified mental disorder, 25.6% of children and 33.7% of youth had contact with a mental health provider. However, 60% had contact with one or more of the providers or service settings assessed, most often through schools.Conclusions:Between 18% and 22% of children and youth in Ontario met criteria for a mental disorder but less than one-third had contact with a mental health provider. These findings provide support for strengthening prevention and early intervention efforts and enhancing service capacity to meet the mental health needs of children and youth in Ontario.

Objectives: To present the 12-month prevalence and correlates of suicidal ideation and attempts in a sample of youth in Ontario. Methods: Data come from the 2014 Ontario Child Health Study, a provincially representative survey of families with children in Ontario. Youth aged 14 to 17 y ( n = 2,396) completed a computer-assisted, self-administered questionnaire in their home to assess the occurrence of suicidal ideation, suicidal attempts, and associated correlates, including non-suicidal self-injury, mental disorders, substance use, peer victimization and exposure to child maltreatment. Socio-demographic information was collected from the parent. Logistic regression models were used to identify correlates that distinguished between youth reporting: 1) no suicidal ideation or attempts, 2) suicidal ideation but no attempts, and 3) suicidal ideation and attempts. Results: The 12-month prevalence of suicidal ideation and attempts was 8.1% and 4.3%, respectively. All clinical and behavioural correlates were significantly higher among youth reporting suicidal ideation or attempts, as compared with non-suicidal youth. In adjusted models, depression and non-suicidal self-injury were each independently associated with elevated odds of suicidal ideation (OR = 4.84 and 4.19, respectively) and suicidal attempt (OR = 7.84 and 22.72, respectively). Among youth who reported suicidal ideation, the only variable that differentiated youth who attempted suicide v. those who did not, in adjusted models, was non-suicidal self-injury (OR = 3.89). Conclusions: Suicidal ideation and attempts are common among youth in Ontario, often co-occurring with mental disorders and high-risk behaviours. These findings underscore the need for effective prevention and intervention strategies, particularly for youth depression and non-suicidal self-injury.

Objectives:To determine if levels of neighbourhood poverty and neighbourhood antisocial behaviour modify associations between household poverty and child and youth mental health problems.Methods:Data come from the 2014 Ontario Child Health Study—a provincially representative survey of 6537 families with 10,802 four- to 17-year-olds. Multivariate multilevel modelling was used to test if neighbourhood poverty and antisocial behaviour interact with household poverty to modify associations with children’s externalizing and internalizing problems based on parent assessments of children (4- to 17-year-olds) and self-assessments of youth (12- to 17-year-olds).Results:Based on parent assessments, neighbourhood poverty, and antisocial behaviour modified associations between household poverty and children’s mental health problems. Among children living in households below the poverty line, levels of mental health problems were 1) lower when living in neighbourhoods with higher concentrations of poverty and 2) higher when living in neighbourhoods with more antisocial behaviour. These associations were stronger for externalizing versus internalizing problems when conditional on antisocial behaviour and generalized only to youth-assessed externalizing problems.Conclusion:The lower levels of externalizing problems reported among children living in poor households in low-income neighbourhoods identify potential challenges with integrating poorer households into more affluent neighbourhoods. More important, children living in poor households located in neighbourhoods exhibiting more antisocial behaviour are at dramatically higher risk for mental health problems. Reducing levels of neighbourhood antisocial behaviour could have large mental health benefits, particularly among poor children.