Objectives: Research has shown that children who experience abuse and neglect are at much higher risk of experiencing negative outcomes such as physical and mental health problems, social skill deficits, and poor quality of life. The goal of this paper was to examine the relationship between polyvictimization and risk of harm to self and others, taking into account both age and sex differences. Methods: A total of 8980 participants (4156 with maltreatment history) were recruited from over 50 mental health facilities in Ontario, Canada. Group comparisons were completed to examine types of trauma experienced, and risk of harm to self and others. Results: Among our sample, we found that 29% of children and youth had experienced multiple types of interpersonal trauma. We also found that while female children and youth who had experienced trauma were at greater risk of harm to themselves, males were at greater risk of harming others. Further, our results highlight that children and youth who had experienced multiple types of maltreatment, regardless of age or sex, were at the greatest risk of harm to self and others. Implications: Findings from this research highlight that interpersonal trauma is multifaceted and add to existing evidence that there is a cumulative relationship between experiencing multiple types of maltreatment and risk in relation to harming oneself or others. Our findings underscore the importance of a background assessment that takes into account all forms of maltreatment in order to properly understand risk of harm and inform intervention.

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Throughout the COVID-19 pandemic, population surveys revealed increased levels of anxiety and depression, while findings from large-scale population data analyses have revealed mixed findings with respect to the mental health consequences for children and youth. The purpose of this study was to examine the impact of the COVID-19 pandemic on the well-being and health-compromising behaviors of adolescents (12–18 years) previously referred for mental health services. Data were collected (pre-pandemic n = 3712; pandemic n = 3197) from mental health agencies across Ontario, Canada using the interRAI Child and Youth Mental Health assessment. Our findings revealed no increased incidence of witnessing domestic violence nor experiencing physical, sexual, or emotional abuse. Further, there were no increases in the risk of self-harm and suicide, anxiety, or depression among our sample of clinically referred youth. Finally, results demonstrated no increase in problematic videogaming/internet use, disordered eating, or alcohol intoxication, and a decrease in cannabis use. Our findings add to the growing body of knowledge as to the impact of the COVID-19 pandemic on children and youth. Further, findings underscore the importance of understanding the nuanced impact of the pandemic on various subgroups of children, youth, and families and highlight the need for continued monitoring of outcomes for these children and youth.

Caregiver well-being plays an important role in children's development and a number of factors have been found to impact distress levels among caregivers of children and youth referred for mental health services. Further, caregiver distress impacts youth psychopathology, its acuity as well as related mental health interventions. The purpose of this study was to develop and validate an algorithm for identifying caregivers who are at greatest risk of experiencing caregiver distress. This algorithm was derived from, and will be embedded in, existing comprehensive interRAI child and youth instruments. Ontario data based on the interRAI Child and Youth Mental Health assessment instruments (ChYMH and ChYMH-DD) were analyzed to identify predictors of distress among caregivers of children and youth ages 4–18 years. Starting with proactive aggression, the algorithm uses 40 assessment items to assign one of 30 nodes that are grouped into five levels of risk. The interRAI ChYMH Caregiver Distress (iCCareD) algorithm was validated using longitudinal data from mental health agencies across Ontario and was found to be a good predictor among this sample with a c-statistic of 0.71 for predicting new or ongoing caregiver distress and 65% for both sensitivity and specificity using algorithm values of 3 or greater. This algorithm provides an evidence-based decision-support tool embedded within a comprehensive assessment tool that may be used by clinicians to inform their selection of supports and services for families.

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