This week we will be discussing an article published in the Journal of Child and Family Studies titled “Child Mental Illness and Mental Health Service Use: Role of Family Functioning”. This article, published in July 2020, was written by authors Oltean, Perlman, Meyer, and Ferro who identified and discussed which domains of family functioning were associated with various facets of child mental health. 


Why did they do it?

Childhood and adolescence is a period of time where many individuals begin to experience symptoms of mental health disorders, including internalizing (e.g., depression) and externalizing (e.g., attention-deficit/hyperactivity disorder) conditions. As the authors of this article discuss, various aspects of the family environment play a key role in shaping the mental and social experiences of children and adolescents. In an effort to expand on existing research, the authors of this study aimed to identify which domains of family functioning were associated with a variety of outcomes such as internalizing and externalizing disorders, past-year health professional consultations, hospitalizations, and length of hospital stay.

How did they do it?

The authors recruited 100 parents and children aged 8-17 years who received mental health services from a clinical tertiary care facility. They used the General Functioning subscale of the McMaster Family Assessment Device (FAD) to measure family functioning and sub-items from this scale to assess 6 specific family functioning domains: Problem Solving, Communication, Behaviour Control, Affective Involvement, 

Affective Responsiveness, and Roles. Additionally, the Mini International Neuropsychiatric Interview for Children and Adolescents was used to screen children for mental disorders, and validated items from the Canadian Community Health Survey were used to measure mental health service use. Sociodemographic information was also collected and incorporated into analyses.


What did they find?

Findings from this study indicated that specific domains of family functioning, particularly problem solving and communication, were associated with child mental health disorders and mental health service use. Specifically, the authors reported that higher scores on Affective Involvement and Problem Solving were associated with increased odds of major depressive disorder and social phobia, respectively. The authors also found relationships between neighborhood resources and child mental health, such that a lack of neighborhood resources and family supports, presence of adverse childhood experiences, and parental mental health stressors can negatively impact internalizing mental health problems for children. Lastly, higher scores on Communication and Behavior Control were associated with lower odds of generalized anxiety and social phobia, whereas higher scores on Communication were found to be associated with shorter hospital stays.


What does it all mean (our take)?

The relationship between family factors and child mental health outcomes is highly complex. Given this complexity, research such as the study reviewed here will prove to be critical in creating treatment models that are more preventative in nature. This information can be used to help evaluate child/adolescent risk for experiencing mental health difficulties and assign proactive interventions to potentially mitigate long term negative outcomes that are currently associated with mental illness. We thank the authors for conducting this work, and we look forward to reading more cutting edge research that will ultimately support the field’s endeavor to provide high integrity, preventative child/adolescent mental health services.

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