9 - Secondary prevention of childhood mental health problems

Summary

Introduction

Secondary prevention of child mental health problems is the prompt recognition and treatment of the early stages of emotional and behavioural problems in children and adolescents. It should prevent their escalation and the development of chronicity or secondary complications. Psychological problems are not uncommon in childhood: at any one time about one in six children will show excessive or inappropriate emotional responses or behaviours which are associated with substantial personal distress or impair ordinary psychosocial development and functioning (Hill, 1996). The term psychiatric disorder is used to cover the problems of this appreciable minority of children and teenagers (here termed children for short) and is often preferred as a term to mental illness which is retained to describe more severe or entrenched problems of apparently endogenous origin. Many children with problems of emotions, behaviour or relationships (childhood psychiatric disorder) have developed them in relation to adversity, and they can quite often be regarded as problems in adaptation or adjustment; hence the older term ‘maladjusted’. More boys than girls are affected, hence our use of male pronouns. Most are brought to the notice of health services by their mothers.

Because children are not the instigators of their own referral, clinical problems of children's emotions, behaviour and relationships present to doctors only when they have become a source of concern to parents or teacher. This means they are often well established, even ingrained, when first seen.