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Published on: September 19, 2019
[Family context and child mental health problems in the Family Health Program]
Silvia Helena Tortul Ferriolli1, Edna Maria Marturano, Ludmila Palucci Puntel
1Programa de Pós-graduação em Saúde Mental, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, 14051-140 Ribeirão Preto, SP, Brazil.
Insights
Maternal stress and financial instability increase children's risk for emotional and behavioral problems. An organized family routine and environmental stability are protective factors for child mental health.
Area of Science:
- Child and Adolescent Psychiatry
- Family Medicine
- Public Health
Context:
- This study investigated family context variables impacting child mental health within Brazil's Family Health Program.
- A cross-sectional study involved 100 children (6-12 years) and their families in Ribeirão Preto, Brazil.
Purpose:
- To determine the association between family context factors and the risk of emotional/behavioral problems in children.
- To identify specific family environment indicators that may serve as risk or protective factors for child mental health.
Summary:
- Maternal stress was linked to general mental health issues (OR=2.2) and anxiety/depression symptoms (OR=1.6) in children.
- Financial instability was a risk factor for hyperactivity (OR=2.1), while organized routines and environmental stability showed protective effects (1/OR 1.2-1.9).
Impact:
- Findings can inform Family Health Program teams to support children and families by addressing identified risk factors.
- The Strengths and Difficulties Questionnaire is suggested as a tool for early identification of child mental health problems by healthcare teams.
Objective:
To assess the association between variables in the family context and the risk for emotional/behavioral problems in children enrolled in a Family Health Program.
Methods:
A cross-sectional design study was conducted with 100 children aged 6 to 12 years old and their families, especially their biological mothers (82%). All subjects were enrolled in center of the Family Health Program in the city of Ribeirão Preto, Southern Brazil, in 2001. Emotional/behavioral problems of the child, in levels considered as at risk for the development of disorders, were identified by means of the Strengths and Difficulties Questionnaire. Regarding conditions in the family context, the following variables were evaluated: socioeconomic level, adverse events, maternal stress, maternal depressive symptoms, organization, and structure of family environment. Data analysis was performed through univariate and multivariate logistic regression.
Results:
Maternal stress was associated with general mental health problems in the child (OR=2.2), while a daily routine with an organized timetable and greater range of activities to fill up their free time were associated with the absence of these problems (1/OR 1.3 and 1.9, respectively). Maternal stress was also a risk factor for anxiety/depression symptoms (OR=1.6). Regarding hyperactivity, financial instability was a risk factor (OR=2.1), and all indicators of environmental stability were protective variables (1/OR between 1.2 and 1.6).
Conclusions:
Information about family context indicators associated with mental health problems in schoolchildren may subsidize actions of the Family Health Program teams for the child and his/her family. The results indicate a possible employment of the Strengths and Difficulties Questionnaire by the teams, in order to identify early problems in child mental health.
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