A Mental Health Pandemic? Assessing the Impact of COVID-19 on Young People's Mental Health.

BACKGROUND: Research indicates that young people have been a particularly vulnerable group when it comes to negative mental health outcomes following COVID-19, with some authors warning of a 'mental health pandemic'. MATERIALS AND METHOD: Using a survey approach, this study explored the effects of lockdowns on the mental health of 1995 16-year-olds in Northern Ireland. Respondents completed the 12-item version of the General Health Questionnaire (GHQ-12) along with closed- and open-ended questions about COVID-19. RESULTS: Results from regression analysis showed that being female, identifying as non-heterosexual and perceiving that mental health had worsened during lockdown were the best predictors of poor mental health. In the open responses, young people reported significant concerns about their mental health and their educational outcomes. They also felt that their needs were not given the same priority as those of adults during lockdown. CONCLUSIONS: The results suggest that the COVID-19 lockdowns adversely affected the mental health of many young people in Northern Ireland with the effects most acute for females and those identifying as non-heterosexual. Future research should explore the longer-term impact of the pandemic on the mental health of these vulnerable young people and identify what support mechanisms need to be put in place to mitigate the negative effects of any future crises.

Comparing the effectiveness of two reciprocal reading comprehension interventions for primary school pupils in disadvantaged schools.

BACKGROUND: Effective reading comprehension teaching is an aspiration of education systems across the world. Teaching incorporating reciprocal reading theory and evidence is an internationally popular approach for improving comprehension. AIMS: This paper uses two large cluster randomized controlled trials of similar reciprocal reading interventions implemented in different ways to compare their effectiveness. SAMPLE: The two interventions had the same teacher professional development, reciprocal reading activities and dosage/exposure, but varied in their implementation, with one delivered as a whole-class ('universal') version for pupils aged 8-9 years and the other a small group ('targeted') version for pupils aged 9-11 years with specific comprehension difficulties. METHODS: Two large-scale cluster RCTs were conducted in 98 schools with N = 3699 pupils in the universal trial and N = 1523 in the targeted trial. RESULTS: Multi-level models showed significant effects for the targeted version of the intervention on pupil reading comprehension (g = .18) and overall reading (g = .14). No significant effects were found for the whole class version. A sub-group analyses of disadvantaged pupils showed the targeted intervention's effects were even larger on reading comprehension (g = .25). CONCLUSIONS: The evidence suggested that this reciprocal reading intervention worked best when implemented in small groups and targeted for pupils with specific comprehension difficulties and particularly for pupils in disadvantaged circumstances. COMMENTS: This evaluation shows that even if a reading comprehension intervention is underpinned by strong theory and evidence-based practice, its effectiveness can still depend on implementation choices.

Exploring the association between mental wellbeing, health-related quality of life, family affluence and food choice in adolescents.

Young people choose energy-dense, nutrient-poor diets, yet understanding of potential determinants is limited. Associations between food choices, mental wellbeing, health-related quality of life (HRQoL) and family affluence were explored to identify targets for intervention to promote dietary health and wellbeing in young people. Adolescents were recruited via post-primary schools in the UK and surveyed at two time-points when aged 13-14 years and 15-16 years. The questionnaire enquired about mental wellbeing using the Short Warwick-Edinburgh Mental Wellbeing Scale, HRQoL using the KIDSCREEN-10, socio-economic status using the Family Affluence Scale and food choice by Food Frequency Questionnaire (FFQ). With missing and anomalous cases excluded, the sample comprised 1208 cases. Factor analysis on the FFQ indicated five food choice factors: 'Junk Food'; 'Meat'; 'Healthy Protein'; 'Fruit/Vegetables'; 'Bread/Dairy'. Multivariate regression analysis indicated that frequent consumption of Junk Food was associated with being male and lower mental wellbeing. Frequent Meat intake was associated with being male and with lower HRQoL. Frequent choice of Bread/Dairy foods was more common among males and associated with higher wellbeing and greater affluence. Those who consumed Fruit/Vegetables frequently were more likely to be female, have higher HRQoL, higher mental wellbeing, and greater family affluence. These direct associations endured between time points. The dietary factors were not mutually exclusive. Those who frequently chose Junk Food were less likely to choose Fruit/Vegetables. Frequent choice of Meat was associated with more frequent choice of Junk Food and Healthy Protein. Intervention to improve dietary and psychological health in young people should target males, those in less affluent households, seek to reduce consumption of 'junk' food, and increase fruit and vegetable intake.

(Re)examining the Relationship Between Children's Subjective Wellbeing and Their Perceptions of Participation Rights.

In recent years wellbeing has been linked increasingly with children's rights, often characterised as central to their realisation. Indeed it has been suggested that the two concepts are so intertwined that their pairing has become something of a mantra in the literature on childhood. This paper seeks to explore the nature of the relationship between wellbeing and participation rights, using a recently developed 'rights-based' measure of children's participation in school and community, the Children's Participation Rights Questionnaire (CPRQ), and an established measure of subjective wellbeing - KIDSCREEN-10. The data for the study came from the Kids' Life and Times (KLT) which is an annual online survey of Primary 7 children carried out in Northern Ireland. In 2013 approximately 3800 children (51 % girls; 49 % boys) from 212 schools participated in KLT. The findings showed a statistically significant positive correlation between children's overall scores on the KIDSCREEN-10 subjective wellbeing measure and their perceptions that their participation rights are respected in school and community settings. Further, the results indicated that it is the social relations/autonomy questions on KIDSCREEN-10 which are most strongly related to children's perceptions that their participation rights are respected. Exploration of the findings by gender showed that there were no significant differences in overall wellbeing; however girls had higher scores than boys on the social relations/autonomy domain of KIDSCREEN-10. Girls were also more positive than boys about their participation in school and community. In light of the findings from this study, it is suggested that what lies at the heart of the relationship between child wellbeing and children's participation rights is the social/relational aspects of both participation and wellbeing.

The inclusion of open-ended questions on quantitative surveys of children: Dealing with unanticipated responses relating to child abuse and neglect.

Web surveys have been shown to be a viable, and relatively inexpensive, method of data collection with children. For this reason, the Kids' Life and Times (KLT) was developed as an annual online survey of 10 and 11 year old children. Each year, approximately 4,000 children participate in the survey. Throughout the six years that KLT has been running, a range of questions has been asked that are both policy-relevant and important to the lives of children. Given the method employed by the survey, no extremely sensitive questions that might cause the children distress are included. The majority of questions on KLT are closed yielding quantitative data that are analysed statistically; however, one regular open-ended question is included at the end of KLT each year so that the children can suggest questions that they think should be asked on the survey the following year. While most of the responses are innocuous, each year a small minority of children suggest questions on child abuse and neglect. This paper reports the responses to this question and reflects on how researchers can, and should, deal with this issue from both a methodological and an ethical perspective.

Psychometric properties of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) in Northern Ireland.

BACKGROUND: The Warwick-Edinburgh Mental Well-being Scale (WEMWBS) is a relatively new measure and to date has been validated in student samples in England and Scotland, and in population samples in Scotland. No data exist on the psychometric properties of the WEMWBS when used within a general population in Northern Ireland, a region that might be expected to differ in health and well-being given its troubled history. AIMS: This paper represents the first attempt to assess mental well-being in Northern Ireland using this new questionnaire. METHOD: Data came from the 2009/2010 Continuous Household Survey and analyses are based on the responses of 3355 people aged 16 years and over who completed the full WEMWBS. RESULTS: The results suggest that the data collected using the WEMWBS among a large-scale random sample of adults in Northern Ireland are comparable to those produced for adults in other parts of the UK. CONCLUSION: The findings from this study are important as any measure of mental well-being purported to have been validated for the UK needs to include Northern Ireland, given that region's recent history in terms of the civil conflict and its potential impact on the health and well-being of its population.

Kids' Life and Times: using an Internet survey to measure children's health-related quality of life.

OBJECTIVE: To examine the psychometric properties of an Internet version of a children and young person's quality of life measure originally designed as a paper questionnaire. METHODS: Participants were 3,440 children aged 10 and 11 years in Northern Ireland who completed the KIDSCREEN-27 online as part of a general attitudinal survey. The questionnaire was animated using cartoon characters that are familiar to most children and the questions appeared on screen and were read aloud by actors. RESULTS: Exploratory principal component analysis of the online version of the questionnaire supported the existence of five components in line with the paper version. The items loaded on the components that would be expected based on previous findings with five domains--physical well-being, psychological well-being, autonomy and parents, social support and peers, and school environment. Internal consistency reliability of the five domains was measured using Cronbach's alpha, and the results suggested that the scale scores were reliable. The domain scores were similar to those reported in the literature for the paper version. CONCLUSIONS: These results suggest that the factor structure and internal consistency reliability scores of the KIDSCREEN-27 embedded within an online survey are comparable to those reported in the literature for the paper version.

Civil conflict in Northern Ireland and the prevalence of psychiatric disturbance across the United Kingdom: a population study using the British household panel survey and the Northern Ireland household panel survey.

BACKGROUND: To date, no large-scale cross-comparative study of psychiatric morbidity in the United Kingdom has been carried out until recently when the Northern Ireland Household Panel Survey (NIHPS) included the General Health Questionnaire (GHQ-12) in 2001. The GHQ-12 has been included in the British Household Panel Survey (BHPS) since 1991 for England and since 1999 for both Scotland and Wales. The purpose of this article is to compare rates of psychiatric morbidity across the United Kingdom, given that one region in particular, Northern Ireland, has experienced political conflict and civil strife for more than 35 years. AIMS: To assess the impact of low-intensity warfare on rates of psychiatric morbidity in Northern Ireland and to compare these with psychiatric morbidity rates across England, Scotland and Wales. METHOD: The sample consisted of 17,343 respondents completing the GHQ-12 across the United Kingdom. In England, 8286 respondents completed the GHQ-12 while 2729, 3165 and 3163 respondents from Wales, Scotland and Northern Ireland completed the GHQ-12 respectively. Results were then weighted according to population size. RESULTS: Rates of psychiatric morbidity varied across each UK region. Wales had the highest mean GHQ-12 score (11.54), followed by Northern Ireland (11.41). English respondents had the lowest mean score (11.02). The difference in mean scores across the four regions in the UK was statistically significant (F= 5.04, df = 3, p < 0.001). Post-hoc analyses indicated that the mean scores for England differed significantly from those for Wales and Northern Ireland but not for Scotland. Region accounted for less than 1% of the variation in GHQ-12 scores. CONCLUSIONS: Psychiatric morbidity rates for adults in Northern Ireland are comparable to other parts of the United Kingdom and we propose that individuals in Northern Ireland use a range of coping strategies to moderate the impact of the conflict in everyday life. These include habituation to the violence, denial and social cohesion, evidenced in the tightly knit Unionist and Nationalist communities. Particular concern was noted over GHQ-12 scores for Wales and while social and economic factors are acknowledged in our commentary, we conclude that further research appears to be crucial in understanding and preventing poorer rates of mental health in this region.