Prevalence of Mental Health Disorders Among Immigrant, Refugee, and Nonimmigrant Children and Youth in British Columbia, Canada

Abstract

IMPORTANCEThere remains limited understanding of population-level patterns of mental disorder prevalence for first-and second-generation immigrant and refugee children and youth and how such patterns may vary across mental disorders. OBJECTIVE To examine the diagnostic prevalence of conduct, attention-deficit/hyperactivity disorder (ADHD), and mood/anxiety disorders in immigrant, refugee, and nonimmigrant children and youth in British Columbia, Canada. DESIGN, SETTING, AND PARTICIPANTS This retrospective, population-level cohort study examined linked health administrative records of children and youth in British Columbia (birth to age 19 years) spanning 2 decades (1996-2016). Physician billings, hospitalizations, and drug dispensations were linked to immigration records to estimate time-in-British Columbia-adjusted prevalence of mental disorder diagnosis among children and youth from immigrant or refugee backgrounds compared with those from nonimmigrant backgrounds. Analyses were conducted from August 2020 to November 2021. MAIN OUTCOMES AND MEASURESThe diagnostic prevalence of conduct, ADHD, and mood/ anxiety disorders were the main outcomes. Results were stratified by migration category (immigrant, refugee, nonimmigrant), generation status (first-and second-generation), age, and sex. RESULTSA total of 470 464 children and youth in British Columbia were included in the study (227 217 [48.3%] female). Nonimmigrant children and youth represented 65.5% of the total study population (307 902 individuals). Among those who migrated, 142 011 (87.8%) were first-or secondgeneration immigrants, and 19 686 (12.2%) were first-or second-generation refugees. Diagnostic prevalence of mental disorders varied by migration category, generation status, age, and sex.Children and youth from immigrant and refugee backgrounds (both first-and second-generation), compared with nonimmigrant youth, generally had a lower prevalence of conduct disorder (eg, age

A Review of Canadian Diagnosed ADHD Prevalence and Incidence Estimates Published in the Past Decade

“…A total of ten papers are included in the review [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ], all of which were published from 2012 to 2022 (see Table 1 ). Ten papers included prevalence estimates of ADHD in Canada [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. Out of these papers, one also examined the incidence of ADHD in Canada [ 15 ].…”

“…This group of studies based estimates on data collected from 1999 [ 11 , 20 ] to 2015/6 [ 12 , 17 , 20 ]. The range for data collection was similar for papers that focused on ADHD prevalence in children and/or adolescents (1999–2015/6) [ 11 , 15 , 17 , 18 , 20 ] and those that examined prevalence in adults (1999–2018) [ 13 , 14 , 15 , 16 , 19 ].…”

“…This group of studies based estimates on data collected from 1999 [ 11 , 20 ] to 2015/6 [ 12 , 17 , 20 ]. The range for data collection was similar for papers that focused on ADHD prevalence in children and/or adolescents (1999–2015/6) [ 11 , 15 , 17 , 18 , 20 ] and those that examined prevalence in adults (1999–2018) [ 13 , 14 , 15 , 16 , 19 ]. With regard to data collection methods used to derive estimates, some papers used primary care EMR data [ 12 ] and health administrative databases [ 15 , 16 , 17 , 18 , 20 ], whereas others used national/provincial surveys [ 11 , 13 , 14 , 19 ].…”

Global burden of mental health problems among children and adolescents during COVID-19 pandemic: A systematic umbrella review

“…In Ireland, a qualitative study showed that adolescents and children experienced increased rates of social isolation, maladaptive behavior, anxiety, and depression during the pandemic [32]. Moreover, the pandemic resulted in a significant psychosocial impact on Chinese adolescents and children in terms of emotional distress, with a prevalence of 24.9% for anxiety, 19.7% for depression, and 15.2% for stress [33]. Another systematic review of Chinese studies showed that the prevalence of COVID-19 related posttraumatic stress, sleep disorders, anxiety, and depression were 48%, 44%, 26%, and 29%, respectively [34].…”

“…Another study that was published in 2010 reported that 1 in 5 US children experience a serious or debilitating mental health problem in their lifetime [17]. Similar studies from Canada [18, 19], Europe [20, 21], and Australia [22, 23] suggest comparative high burden of child and adolescent mental health (CAMH) problems. Moreover, countries with limited resources, mostly those in the global south, often lack high-quality evidence on mental health epidemiology.…”