Kappan Home PDK Home

Sad, Bad, Mad: Responding to The Health of Canada's Children By Heather-jane Robertson

THE TEACHER who ruled the one-room school I attended in the late 1950s had only a meager supply of pedagogical references. The books behind her desk seemed to be limited to the teacher's editions of our readers and textbooks -- versions that we students were prevented from examining too closely. After all, these hefty volumes contained "the answers." At the end of her shelf leaned a few small books designed to guide and advise the isolated teacher, and I often wondered what they contained. One that seemed darkly mysterious to my 8-year-old mind was called Mental Hygiene for Children.

In those unenlightened times, "mental" was the epithet of choice hurled thoughtlessly at anyone and everyone who behaved in even slightly peculiar ways. I knew that "hygiene" had to do with washing hands and cleaning fingernails, which were inspected every morning by our teacher. In the name of hygiene, those of us who failed the fingernail inspection were sent to the cloakroom and required to brush our nails until our fingertips were scarlet. This could explain why I found the concept of "mental hygiene" puzzling and somewhat frightening. I could only imagine that mental hygiene entailed a kind of vigorous brain-scrubbing, which, even though it had not yet been undertaken by the stern Mrs. Baker, might be initiated in response to any behavior of which she did not approve. Such were the simple fears of simpler times.

It is unlikely that many of today's students fear being ambushed by teachers wielding brain-scrubbers, but according to a new report published by the Canadian Institute of Child Health, the "mental hygiene" of children and youths needs our urgent attention.1 The Health of Canada's Children is the institute's third and most comprehensive report. Its ambitious scope is even more remarkable because the data that appear in each of the 11 thematically arranged chapters were assembled by experts, volunteers, activists, and young people themselves.

Predictably, scrutiny of the available data reveals how much information remains to be captured and raises questions about whether conventional indicators of such complex phenomena as mental health are adequate in changing times. The analytical problems multiply when changes to Canada's health-care system are factored in. For example, if fewer youths are being admitted to hospitals for psychiatric reasons, is the need for acute care decreasing, or is any decline in hospital admissions merely the inevitable result of the reduction of available psychiatric beds?

Such interpretive dilemmas aside, using the results of several national longitudinal surveys and a few provincial studies, the report presents more than mere snapshots. Trend lines are developing, as well as policy implications for governments and schools, and even for how parents greet their children at the end of the day -- although such patterns may not fit the technical definition of "policies." Among the report's more notable findings:

• Children are acquiring the same indifference to others of which adults are often accused. Among children aged 4 to 11, parents report that only 40% of boys and 54% of girls "often" show sympathy; only 39% of boys and 51% of girls "often" offer help to other children.
• Asked whether other students in their classes were "often" or "always" kind and helpful, almost 80% of Danish and Swedish 13-year-olds said that they were. Fewer Canadian students saw their peers this way: only 42% of boys and 50% of girls expressed this view, although these numbers are considerably above the 34% and 39% of American boys and girls who saw habitual helpfulness in others.
• Parents admit that both direct and indirect aggression increases as their children age: by 11 years of age, 16% of boys are exhibiting "direct aggression," such as hitting others, while 14% of girls practice "indirect aggression," such as social exclusion.
• Bullying behavior seems to have increased between 1994 and 1998, although it is possible that growing attention to this problem has raised awareness and influenced reporting rates. In 1994, 36% of boys and 29% of girls in grade 10 reported being bullied "during this school term"; by 1998, these figures had risen to 43% and 35%.
• Parents of children aged 8 to 11 frequently report that their children exhibit one or more of the symptoms associated with hyperactivity. More than half of all boys were seen as exhibiting poor concentration, distractibility, impulsivity, and restlessness.
• Although the authors are cautious about interpreting emotional symptoms as evidence of clinical mental health problems, many parents are reporting behaviors that trouble them. Thirty-seven percent of children aged 8 to 11 are "too fearful or anxious," according to their parents; 17% of boys and 14% of girls are seen as "not as happy as other children."
• According to parents, a substantial number of children aged 8 to 11 are demonstrating "conduct symptoms," which are reported almost twice as often for boys as for girls. Eleven percent of boys are reported to destroy things that belong to others, 14% threaten others, and 36% get into "many" fights. Parents of these children are far more likely to use "ineffective" or "aversive" parenting styles than are other parents.
• Taken together, these findings suggest that a very high percentage of children and youths are at high risk for encountering future problems. Fully 24% of males and 17% of females between the ages of 4 and 11 demonstrate symptoms consistent with conduct, hyperactivity, or emotional disorders. Risk factors include low family income, which is itself predicted by single-parent family status.
• Negative perceptions of family life increase when family composition changes. Sixty-one percent of children aged 10 to 11 who live with only their biological mother report that their family relationships are "difficult," compared with 28% of those who live with both biological parents. The presence of a stepfather reduces the perception that relationships are difficult to 45% but increases children's experience of "erratic" punishment to 50%, compared with 33% and 34% for those living with both biological parents or with only their mothers.
• Family connectedness, which is strongly associated with good mental health, declines in early adolescence. While 25% of 12-year-olds identify themselves as "strongly connected" to their families, by age 14 this figure drops to 12%. Low levels of connectedness are strongly correlated with high-risk behaviors: 59% of those who felt unconnected had smoked marijuana, compared with 21% of the connected, and the unconnected were four times as likely to have had sex before the age of 14, although this group represents only 12% of the population.
• More youths, particularly boys, are spending more unsupervised time hanging out with their friends. In 1998, 33% of eighth-grade boys were out with friends five or more evenings each week, compared with 23% of girls. Four years earlier, only 28% of boys were out this often, although the rate for girls was the same. These figures compare with 19% of American boys and 15% of American girls of the same age who report "hanging out" five evenings or more per week.
• The cluster of variables that make up "school connectedness" predict student achievement and well-being. Not surprisingly to those with experience with middle-grade students, connectedness falls markedly after grade 7, when 23% of students exhibit high levels, to a low of 7% by grade 10. By high school graduation, numbers have rebounded slightly to 12%.
• Parents may be getting smarter, or perhaps young people are becoming more forgiving. Results from 1990, 1994, and 1998 indicate that progressively more youths between grades 6 and 10 thought that their parents understood them, although girls (at 46%) are somewhat less likely than boys (53%) to feel understood.
• Three sets of data collected over eight years suggest that loneliness, which is more often self-reported by girls than boys, continues to be a problem for many young people. Twenty-one percent of 10th-grade girls report feeling lonely "rather" or "very" often, compared with 11% of boys. In 1998, 37% of girls said that they "often" wished they were someone else, a decline of four percentage points since 1990.
• The alleged crisis in girls' self-esteem said to occur during the first years of adolescence is not confirmed by this report. While 21% of youngsters aged 12 to 14 are reported to have lower levels of self-esteem, no significant gender differences were found. By ages 18 to 19, the number of youths with moderate levels of self-esteem rises, and those with low self-esteem decreases. However, girls continue to be at greater risk of suffering from depression. Twelve percent of girls and 6% of boys between the ages of 15 and 19 have experienced at least one episode of "major depression."

In summarizing their findings, the authors contend that "the leading group of conditions that lower life quality and reduce life chances of Canadian children and youth . . . are emotional and behavioral problems and early learning difficulties." They argue that remedial efforts to help children in difficulty must involve the child, the family, and the community. Schools must increase their efforts to enhance the "connectedness" of high-risk children and youth, but by themselves, underfunded schools are rather feeble agents of intervention.

Meanwhile, policy makers should be investigating and addressing the circumstances that contribute to the manifestations of poor mental health. For example, is it significant that rates of childhood asthma have increased from 2% of children under 14 in 1978 to 12% in 1996? What are the links between the increased use of environmental pesticides, poor air quality, and neurobehavioral effects, including learning disabilities? What problems are being masked by doubling the number of Ritalin pills prescribed between 1994 and 1998? Why are 10% fewer youths eating fruit daily, and should schools be peddling soft drinks when by grade 10, 60% of boys drink "the real thing" every day, and 45% of girls want to lose weight? Is fascination with the Internet and with other sedentary activities to blame for the rapid decline in the number of children and youths who report being physically active outside school hours?

These and other questions deserve the kind of attention that demonstrates that Canadians are prepared to improve the quality of children's lives. The "Children's Agenda" represented a concerted effort by nongovernmental organizations, activists, and a smattering of politicians to invest some of Canada's $13-billion budget surplus in programs for children, from subsidized, regulated child care to income supplements for poor families. When the dust settled after an intense yearlong debate within the Liberal caucus, tax cuts won and children lost. For every dollar the federal government spent on tax cuts, it "re-invested" exactly two cents in health care, the only program available to many parents worried about their children's mental health.

The Health of Canada's Children received considerable media attention and prompted more than a few hand-wringing editorials from the same folks who had spent a year promoting tax cuts above all else. The National Post, however, was a little more direct. In an editorial headed "Children Are in Danger -- Or Is It Taxpayers?" the Post accused the institute of being a "busybody organization" merely intent on raising parental anxiety and manufacturing yet another left-wing whine for the rich to pay more in taxes.2 If parents just tried a little harder and renounced their dependency on government, all children would be fine.

Terrific logic. I guess those students who don't see their classmates as "sympathetic and helpful" are onto something. They must be paying attention after all -- perhaps it's due to the Ritalin. Maybe I'm catching up to young people's increased propensity for aggression, because lately I've been fantasizing about visiting the offices of the National Post, brain-scrubber in hand.

2. Peter Foster, "Children Are in Danger -- Or Is It Taxpayers?," National Post, 24 August 2000, available at http://www.nationalpost.com.

PDK Home | Site Map
Kappan Professional Journal
Last updated 9 November 2000
URL: http://www.pdkintl.org/kappan/krob0011.htm
Copyright 2000 Phi Delta Kappa International