Characteristics of children with a psychiatric disorder in 1999, 2004 and 2017: An analysis of the national child mental health surveys of England

Abstract

Background: While research has described the profile of children with poor mental health, little is known about whether this profile and their needs have changed over time. Our aim was to investigate whether levels of difficulties and functional impact faced by children with a psychiatric disorder have changed over time, and whether sociodemographic and family correlates have changed. Methods: Samples were three national probability surveys undertaken in England in 1999, 2004, and 2017 including children aged 5 to 15 years. Psychiatric disorders were assessed using the Development and Well-Being Assessment (DAWBA), a standardised multi-informant diagnostic tool based on the tenth International Classification of Diseases (ICD-10). The impact and difficulties of having a disorder (emotional, behavioural or hyperkinetic) were compared over time using total difficulty and impact scores from the Strengths and Difficulties Questionnaire (SDQ). Analyses explored the impact of having any disorder, as well as for each disorder separately. Regression Analyses explored the impact of having any disorder, as well as for each disorder separately. Regression analyses compared associations between disorder and sociodemographic factors over time. Results: Parent and adolescent reported total SDQ difficulty and impact scores increased between 1999 and 2017 for children and adolescents with disorder. No differences were noted when using teacher ratings. No differences in total SDQ difficulty score were found for children without disorder. Comparison of sociodemographic correlates across the surveys over time revealed that ethnic minority status, living in rented accommodation, and being in the lowest income quintile had a weaker association with disorder in 2017 compared to 1999. Conclusions: Our study reveals a concerning trend; children with disorder in 2017 experienced more severe difficulties and greater impact on functioning at school, home, and in their daily lives, compared to children in earlier decades. These findings underline the urgency for research and policy to identify and address the wider influences which may be increasingly affecting children’s ability to thrive.