Western Australian adolescent emotional wellbeing during the COVID-19 pandemic in 2020.

BACKGROUND: The impacts of the COVID-19 pandemic have been vast and are not limited to physical health. Many adolescents have experienced disruptions to daily life, including changes in their school routine and family's financial or emotional security, potentially impacting their emotional wellbeing. In low COVID-19 prevalence settings, the impact of isolation has been mitigated for most young people through continued face-to-face schooling, yet there may still be significant impacts on their wellbeing that could be attributed to the pandemic. METHODS: We report on data from 32,849 surveys from Year 7-12 students in 40 schools over two 2020 survey cycles (June/July: 19,240; October: 13,609), drawn from a study of 79 primary and secondary schools across Western Australia, Australia. The Child Health Utility Index (CHU9D) was used to measure difficulties and distress in responding secondary school students only. Using comparable Australian data collected six years prior to the pandemic, the CHU9D was calibrated against the Kessler-10 to establish a reliable threshold for CHU9D-rated distress. RESULTS: Compared to 14% of responding 12-18-year-olds in 2013/2014, in both 2020 survey cycles almost 40% of secondary students returned a CHU9D score above a threshold indicative of elevated difficulties and distress. Student distress increased significantly between June and October 2020. Female students, those in older Grades, those with few friendships or perceived poor quality friendships, and those with poor connectedness to school were more likely to score above the threshold. CONCLUSIONS: In a large dataset collected during the first year of the COVID-19 pandemic, the proportion of secondary school students with scores indicative of difficulties and distress was substantially higher than a 2013/2014 benchmark, and distress increased as the pandemic progressed, despite the low local prevalence of COVID-19. This may indicate a general decline in social and emotional wellbeing exacerbated by the events of the pandemic. TRIAL REGISTRATION: ANZCTRN (ACTRN12620000922976). Retrospectively registered 17/08/2020. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380429&isReview=true .

Early mental health morbidity and later smoking at age 17 years.

BACKGROUND: We examined the relationship between the onset and pattern of childhood mental health disorders and subsequent current smoking status at age 17 years. METHOD: Data were from a prospective cohort study of 2868 births of which 1064 supplied information about their current smoking at 17 years of age. The association between the onset and pattern of clinically significant mental health disorders in the child and subsequent smoking at age 17 years was estimated via multivariable logistic regression. RESULTS: Relative to 17 year olds who never had an externalizing disorder, 17-year-olds who had an externalizing disorder at age 5, 8 or 14 years were, respectively, 2.0 times [95% confidence interval (CI) 1.24-3.25], 1.9 (95% CI 1.00-3.65) or 3.9 times (95% CI 1.73-8.72) more likely to be a current smoker. Children with an ongoing pattern of externalizing disorder were 3.0 times (95% CI 1.89-4.84) more likely to be smokers at the age of 17 years and those whose mothers reported daily consumption of 6-10 cigarettes at 18 weeks' gestation were 2.5 times (OR 2.46, 95% CI 1.26-4.83) more likely to report smoking at 17 years of age. Associations with early anxiety and depression in the child were not found. CONCLUSIONS: Current smoking in 17-year-olds may be underpinned by early emergent, and then, ongoing, externalizing disorder that commenced as young as age 5 years as well as exposure to early prenatal maternal smoking. The associations documented in adults and adolescents that link tobacco smoking and mental health are likely to be in play at these early points in development.

Maternal death and the onward psychosocial circumstances of Australian Aboriginal children and young people.

BACKGROUND: This study sought to determine the social and emotional impact of maternal loss on Aboriginal children and young people using data from the Western Australian Aboriginal Child Health Survey (WAACHS). METHOD: Data were from a population-based random sample of 5289 Aboriginal children aged under 18 years. Interview data about the children were gathered from primary carers and from their school teachers. Probabilistic record linkage to death registrations was used to ascertain deaths. Association between maternal death and subsequent psychosocial outcomes was assessed using univariate analyses and logistic regression. RESULTS: Of the 5289 Aboriginal children, 57 had experienced the death of their birth mother prior to the survey. Multi-variable adjustment accounting for age and gender found that, relative to children who were living with their birth mother, children whose birth mother had died were at higher risk for sniffing glue or other substances [odds ratio (OR) 3.4, 95% confidence interval (CI) 1.3-8.7], using other drugs (OR 2.8, 95% CI 1.2-6.8), talking about suicide (OR 2.6, 95% CI 1.2-5.7) and attempting suicide (OR 7.0, 95% CI 1.6-31.1). CONCLUSIONS: Although the death of a birth mother is relatively rare and the vast majority of Aboriginal children with adverse developmental outcomes live in families and are cared for by their birth mother, the findings here suggest that the loss of a birth mother and the circumstances arising from this impart a level of onward developmental risk for mental health morbidity in Australian Aboriginal children.