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Original research
Natural history of mental health competence from childhood to adolescence
  1. Meredith O'Connor1,2,
  2. Sarah J Arnup1,
  3. Fiona Mensah1,2,
  4. Craig Olsson1,2,3,
  5. Sharon Goldfeld1,2,
  6. Russell M Viner4,
  7. Steven Hope1,4
  1. 1Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
  2. 2Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
  3. 3Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Deakin University, Geelong, Victoria, Australia
  4. 4UCL Great Ormond Street Institute of Child Health, London, UK
  1. Correspondence to Dr Steven Hope, UCL Great Ormond Street Institute of Child Health, London, UK; s.hope{at}ucl.ac.uk

Abstract

Background Mental health competence (MHC) involves psychosocial capabilities such as regulating emotions, interacting well with peers and caring for others, and predicts a range of health and social outcomes. This study examines the course of MHC from childhood to adolescence and patterning by gender and disadvantage, in Australian and UK contexts.

Methods Data: Longitudinal Study of Australian Children (n=4983) and the Millennium Cohort Study (n=18 296). Measures: A measure capturing key aspects of MHC was derived summing items from the parent-reported Strengths and Difficulties Questionnaire, assessed at 4–5 years, 6–7 years, 10–11 years and 14–15 years. Analysis: Proportions of children with high MHC (scores ≥23 of range 8–24) were estimated by age and country. Random-effects models were used to define MHC trajectories according to baseline MHC and change over time. Sociodemographic patterns were described.

Results The prevalence of high MHC steadily increased from 4 years to 15 years (from 13.6% to 15.8% and 20.6% to 26.2% in Australia and the UK, respectively). Examination of trajectories revealed that pathways of some children diverge from this normative MHC progression. For example, 7% and 9% of children in Australia and the UK, respectively, had a low starting point and decreased further in MHC by mid-adolescence. At all ages, and over time, MHC was lower for boys compared with girls and for children from disadvantaged compared with advantaged family backgrounds.

Conclusions Approaches to promoting MHC require a sustained focus from the early years through to adolescence, with more intensive approaches likely needed to support disadvantaged groups and boys.

  • health inequalities
  • life course epidemiology
  • mental health

Data availability statement

Data used in this manuscript are available upon reasonable request from the Longitudinal Study of Australian Children (https://growingupinaustralia.gov.au/) and the Millennium Cohort Study (https://cls.ucl.ac.uk/cls-studies/millennium-cohort-study/). In partnership with the Australian Data Archive, the National Centre for Longitudinal Data (NCLD) facilitates access to LSAC data using Dataverse (https://dataverse.ada.edu.au/dataverse.xhtml?alias=lsac). Millennium Cohort Study data are held by the UK Data Service for all the sweeps (first survey https://doi.org/10.5255/UKDA-SN-4683-1; second survey http://doi.org/10.5255/UKDA-SN-5350-3; third survey http://doi.org/10.5255/UKDA-SN-5795-3; fourth survey http://doi.org/10.5255/UKDA-SN-6411-6; fifth survey http://doi.org/10.5255/UKDA-SN-7464-2; sixth survey http://doi.org/10.5255/UKDA-SN-8156-2).

https://doi.org/10.1136/jech-2021-216761

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    Data availability statement

    Data used in this manuscript are available upon reasonable request from the Longitudinal Study of Australian Children (https://growingupinaustralia.gov.au/) and the Millennium Cohort Study (https://cls.ucl.ac.uk/cls-studies/millennium-cohort-study/). In partnership with the Australian Data Archive, the National Centre for Longitudinal Data (NCLD) facilitates access to LSAC data using Dataverse (https://dataverse.ada.edu.au/dataverse.xhtml?alias=lsac). Millennium Cohort Study data are held by the UK Data Service for all the sweeps (first survey https://doi.org/10.5255/UKDA-SN-4683-1; second survey http://doi.org/10.5255/UKDA-SN-5350-3; third survey http://doi.org/10.5255/UKDA-SN-5795-3; fourth survey http://doi.org/10.5255/UKDA-SN-6411-6; fifth survey http://doi.org/10.5255/UKDA-SN-7464-2; sixth survey http://doi.org/10.5255/UKDA-SN-8156-2).

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    Footnotes

    • Twitter @DrMeredithO, @sharon_goldfeld, @russellviner

    • Contributors MO’C and SJA contributed to the planning, conduct and reporting of the work described in this article, had access to the data, performed the statistical analysis, and wrote the first draft of the manuscript. SH contributed to and provided oversight for the planning, conduct and reporting of the work described in this article. SG, CA, FM and RMV contributed to the planning and reporting of the work described in this article. MO’C is guarantor and accepts full responsibility for the finished work and the conduct of the study.

    • Funding MO’C and SJA were supported by the Melbourne Children's LifeCourse initiative, funded by a Royal Children’s Hospital Foundation Grant (2018-984). SG is supported by Australian National Health and Medical Research Council (NHMRC) Career Development Fellowship 1082922, and FM is supported by NHMRC Career Development Fellowship 1111160. SH and RMV were supported by an MRC/AHRC/ESRC Adolescence, Mental Health and the Developing Mind Initiative engagement award (MR/T046260/1). Work conducted at the Murdoch Children’s Research Institute is supported by the Victorian Government's Operational Infrastructure Support Program. All research at Great Ormond Street Hospital NHS Foundation Trust and UCL Great Ormond Street Institute of Child Health is made possible by the NIHR Great Ormond Street Hospital Biomedical Research Centre. The Longitudinal Study of Australian Children is conducted in partnership between the Department of Social Services (DSS), the Australian Institute of Family Studies (AIFS) and the Australian Bureau of Statistics (ABS). The Millennium Cohort Study is funded by grants to former and current directors of the study from the Economic and Social Research Council (Professor Heather Joshi, Professor Lucinda Platt and Professor Emla Fitzsimons) and a consortium of government funders. The authors would like to thank all the Longitudinal Study of Australian Children and Millennium Cohort Study families for their participation. The findings and views reported in this article are those of the authors and should not be attributed to DSS, AIFS, the ABS, the NHS, the NIHR or the Department of Health.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.