Course:KIN366/Concept Library/Mental Illness

Mental illnesses are characterized by alterations in thinking, mood and behavior and are associated with significant distress and impaired functioning over an extended period of time (PHAC, 2002). The most prevalent mental illnesses affecting children are depression, anxiety disorders, and disorders related to negative self-concept such as low self-esteem and negative body image (Biddle & Asare, 2011).

History

In recent years it has been found that physical activity can help combat the negative outcomes associated with mental illness in children (Biddle and Asare, 2011). In addition, research has found that sedentary behaviors such as increased screen time are detrimental to a child’s mental health (Biddle and Asare, 2011). In Canada, it is reported that nearly 1.1 million, or nearly 14% of children experience mental health issues (Waddell et al., 2007). Mental illness is responsible for an economic health burden in excess of 15 billion dollars annually. Given the increased future risk for physical and mental problems for children with mental illness, this is a major problem (Stephens and Joubert, 2001; Neutopenia, 2005). Treatment efforts often focus on pharmacological methods and psychological counseling for treating mental illness in children, but these approaches are time consuming, expensive and some medications can have negative side-effects (Neutropenia, 2005; Larun et al., 2006). On the contrary, physical activity interventions are inexpensive and can be tailored to small and large groups of children at school, home, or in the community (Larun et al., 2006). In summary, it's important that government policy, research, public education and funding support initiatives that promote healthy movement experiences for children.

Depression

Depression is a type of mood disorder that affects the way a child feels, and subsequently thinks and acts (CMHA, 2014). Major Depressive Disorder, the clinical form of depression, is characterized by feelings of hopelessness and “feeling down”, as well as a tendency to find little enjoyment in previously enjoyable activities (CMHA, 2014). The National Institute for mental health says that these depressive symptoms interfere with a child’s ability to sleep, study, eat, and enjoy life (NIMH, 2014). A 2006 Canadian community health survey found that adolescent suicide rates have not decreased in Canada over recent years like they have in other countries (Cheung and Dewa, 2006) Another study found that depression was present in up to 50% of youth suicides (Brent et al., 1993). With statistics for depression in children as they are, it is important to identify cheap, effective therapeutic approaches for treating depression.

Physical activity is effective for preventing and reducing depressive symptoms in children (Ahn & Fedewa, 2011; Biddle & Asare, 2011). According to Ahn and Fedewa (2011), “clinicians, school-based professionals, and parents should encourage physical activity in children, not only for the physical health benefits, but for the positive mental health outcomes as well.” It seems that individualized and class-wide interventions that involve moderate to high levels of intensity have the greatest effect on reducing depressive symptoms in children, especially children that are classified as overweight or obese (Ahn & Fedewa, 2011). In general, it is clear that more research and policy decisions need to be made that inform and support the use of physical activity interventions for improving depression in children (Larun et al., 2006).

Anxiety

Children’s Mental Health Ontario describes anxiety as feelings of worry, unease, fear and nervousness that may or may not be related to a stressful event. When a child’s ability to cope in certain situations is compromised, and when anxiety levels are high enough to interfere with daily functioning for an extended period of time, an anxiety disorder may be present (CMHA, 2015). Existing literature shows a positive correlation between increased levels of physical activity and decreased symptoms of anxiety in children (Biddle & Asare, 2011). For example, children who participated in a Tae Kwon Do program experienced less anxiety and higher self-control than children that were not part of a martial arts program (Diamond & Lee, 2011). A 2011 study by Ahn and Fedewa confirmed these findings, stating: “Increased levels of physical activity had significant effects in reducing depression, anxiety, psychological distress, and emotional disturbance in children" (p. 393). In fact, exercise may be as effective as cognitive behavioral techniques in reducing anxiety symptoms. Reducing anxiety through physical activity clearly benefits children during a time of increasing social and academic pressures.

Self- concept

Self-concept is defined as the perception children have of themselves and is influenced by what they think about their body, their various competencies, and their values (Strong et al., 2005). Self-esteem is important for positive self-concept and refers to how much a person values their self (Fox, 2000). Physical activity improves self-esteem in children (Biddle and Asare, 2011) and improves children’s perception of their own physical abilities (Bailey, 2006). Despite these findings, the relationship between children's self- concept and physical activity is complex. For example, participation in physical education classes may promote feelings of positive self-concept if they involve positive interaction and appropriate movement experiences. Conversely, participating in physical education classes may produce negative self-concepts if instruction occurs in an environment that is characterized by poor instruction, competition, discrimination and negative interactions with peers (Bailey, 2006).

Practical Applications

For parents, teachers, instructors and community leaders

The positive effects of physical activity on mental well-being do not occur automatically. It is important that leaders create an environment that fosters positive social interactions, engagement, enjoyment, inclusion and diversity (Biddle and Asare, 2011; Bailey, 2006). Equally important is that instructors and teachers educate themselves on the fundamentals of effective programming and movement experiences (Bailey, 2006). Advocating for physical activity in schools and at home, and sharing information and healthy practices between parents, teachers, community leaders and policy makers is critical to ensure that the mental health benefits of physical activity prevail (Bailey, 2006). This advocacy should also emphasize the importance of adequate time devotion and quality of the movement experiences (Bailey, 2006).

Helpful Resources

1. Participaction http://www.particpaction.com
2. Active Healthy Kids Canada http://www.activehealthykids.ca/Home.aspx
3. Active Canada 2020 http://www.activecanada2020.ca/

References

Ahn, S., & Fedewa, A. L. (2011). A meta-analysis of the relationship between children’s physical activity and mental health. Journal of pediatric psychology, jsq107. Retrieved from: http://jpepsy.oxfordjournals.org.ezproxy.library.ubc.ca/content/early/2011/01/10/jpepsy.jsq107.full.pdf+html

Bailey, R. (2006). Physical education and sport in schools: A review of benefits and outcomes. Journal of school health, 76(8), 397-401. Retrieved from: http://onlinelibrary.wiley.com.ezproxy.library.ubc.ca/doi/10.1111/j.1746-1561.2006.00132.x/epdf

Biddle, S. J., & Asare, M. (2011). Physical activity and mental health in children and adolescents: a review of reviews. British journal of sports medicine, bjsports90185. Retrieved from: http://bjsm.bmj.com/content/early/2011/07/31/bjsports-2011-090185.full

Brent, D. A., Perper, J. A., Moritz, G., Allman, C., Friend, A. M. Y., Roth, C., ... & Baugher, M. (1993). Psychiatric risk factors for adolescent suicide: a case-control study. Journal of the American Academy of Child & Adolescent Psychiatry, 32(3), 521-529. Retrieved from: http://www.sciencedirect.com.ezproxy.library.ubc.ca/science/article/pii/S0890856709652606

Cheung, A. H., & Dewa, C. S. (2006). Canadian community health survey: major depressive disorder and suicidality in adolescents. Healthcare Policy, 2(2), 76. Retrieved from: http://www-ncbi-nlm-nih-gov.ezproxy.library.ubc.ca/pmc/articles/PMC2585433/

Childrens Mental Health Ontario (2015). Anxiety Problems in Children and Adolescents. Retrieved from: http://www.kidsmentalhealth.ca/parents/anxiety.php

CMHA (2014). Children, Youth and Depression. Retrieved From: http://www.cmha.ca/mental_health/children-and-depression/

Diamond, A., & Lee, K. (2011). Interventions shown to aid executive function development in children 4 to 12 years old. Science, 333(6045), 959-964. Retrieved from: http://www.sciencemag.org.ezproxy.library.ubc.ca/content/333/6045/959.full

Fox, K. R. (2000). The effects of exercise on self-perceptions and self-esteem. Physical activity and psychological well-being, 13, 81-118. Retrived from: http://books.google.ca/books?hl=en&lr=&id=wCmCAgAAQBAJ&oi=fnd&pg=PA88&ots=RKATsnrOLJ&sig=wa8p-H5lhBBG9uk1KRlqfAi2qW4&redir_esc=y#v=onepage&q&f=false

Larun, L., Nordheim, L., Ekeland, E., Hagen, K. B., & Heian, F. (2006). Exercise in prevention and treatment of anxiety and de-pression among children and young people. Cochrane Database of Systematic Reviews, 4. Retrieved from: [1]

Neutropenia, L. I., & Use, A. R. A. (2005). A public health strategy to improve the mental health of Canadian children. Canadian Journal of Psychiatry, 50, 226-233. Retrieved from: http://ww1.cpa-apc.org:8080/publications/archives/cjp/2005/march2/Waddell-RP.asp

NIMH (2014). Depression. Retrieved from: http://www.nimh.nih.gov/health/topics/depression/index.shtml

PHAC (2002). A Report on Mental Illnesses in Canada. Retrieved from: http://www.phac-aspc.gc.ca/publicat/miic-mmac/chap_1-eng.php

Stephens, T., & Joubert, N. (2001). The economic burden of mental health problems in Canada. Chronic diseases in Canada, 22(1), 18-23. Retrieved from: http://www.phac-aspc.gc.ca/publicat/cdic-mcbc/34-4/assets/pdf/CDIC_MCC_Vol34_4_eng.pdf

Strong, W. B., Malina, R. M., Blimkie, C. J., Daniels, S. R., Dishman, R. K., Gutin, B., ... & Trudeau, F. (2005). Evidence based physical activity for school-age youth. The Journal of pediatrics, 146(6), 732-737. Retrieved from: http://www.sciencedirect.com.ezproxy.library.ubc.ca/science/article/pii/S0022347605001009

Waddell, C., McEwan, K., DeV. Peters, R., Hua, J. M., & Garland, O. (2007). Preventing mental disorders in children: A public health priority. Canadian Journal of Public Health/Revue Canadienne de Sante'e Publique, 174-178. Retrieved From: http://www.jstor.org/stable/pdf/41994906.pdf?acceptTC=true