4 Mental health terms

Bio-medical terms can be like a different language and, as with any language, learning it can help us to understand what is happening. This section gives definitions and explanations about some of the language associated with children’s mental health. There are many definitions for some of these terms.

Mental health: We all have mental health and, in a similar way to physical health, it can fluctuate in response to a range of factors. The World Health Organization defines mental health as:

If we are not able to cope with the stresses of life and can’t do the things that make us feel we are achieving something positive, we can start to lack confidence and motivation. This is the same for children as it is for adults. Imagine being a child who is overwhelmed by events that are beyond their control, but must still attend school and be tested, or participate in activities that they have no motivation for.

Mental illness or a mental health condition: A disorder of the mind, which seriously affects a child’s functioning as well as their behaviour or thinking over an extended period of time. There are a number of mental health conditions, the most common in children being depression, anxiety and trauma-related problems as well as issues to do with poor conduct. There will be more about these conditions later in the course.

Wellbeing: A concept that has many definitions, but is usually associated with being ‘comfortable’, happy, well-adjusted and healthy. Other definitions make reference to the quality of an individual’s life. In relation to children, their level of wellbeing can often be judged in relation to their behaviour. A child who is experiencing a poor sense of wellbeing is more likely to be unhappy, have difficulty in concentrating and be unable to engage adequately with everyday activities.

Figure _unit2.4.1 Figure 9 Children’s wellbeing is to do with the quality of their lives

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This is a photograph of a child chasing a bubble.

Figure 9 Children’s wellbeing is to do with the quality of their lives

Diagnosis: The identification of the nature of an illness or other problem by examination of the symptoms. Medical doctors are the professionals that usually diagnose mental health conditions, including among children. A diagnosis is helpful to enable a person to access appropriate and evidence-informed treatments, as well as for advocacy purposes (e.g. where parents who have a child with the same mental health condition can support each other). However, a diagnosis is not always welcome, as unfortunately mental health conditions, even in children, can be stigmatised.

Developmental norms: A sound knowledge about developmental norms is essential in terms of ‘making sense’ of children and mental health conditions. For example, a young child that has an imaginary friend that they speak to in primary school is perfectly normal (and is thought to be associated with being intelligent), whereas talking to an imaginary friend for older teens is seen as unusual and often problematic. Hence, children with a mental health condition will present in ways that are outside of the norm, but determining what is within the ‘normal range’ is vital in terms of establishing if a problem is really a problem.

Risk factors: A risk factor in terms of child mental health is any attribute, characteristic or exposure of an individual that increases the likelihood of developing a condition. In relation to younger children, salient risk factors that can impact on their mental health include a clear lack of routine, not having their physical and emotional needs met, or living in a family where there is domestic violence.

Adverse Childhood Experiences (ACE): Stressful events that can occur in childhood including, but not limited to, the following:

• domestic violence
• parental abandonment (e.g. through an acrimonious separation or divorce)
• having a parent with a mental health condition where this is poorly supported
• abuse (physical, sexual and/or emotional)
• neglect (physical and/or emotional)
• growing up in a household in which there are adults experiencing alcohol and drug use problems.

Protective factors: Conditions or attributes in individuals, families, communities or wider society that mitigate or eliminate risk in families and communities, thereby increasing the health and wellbeing of children and families. For example, communities that have plenty of green open spaces and well-equipped schools are associated with enhanced health and wellbeing for children.

Nature and nurture: In the ‘nature versus nurture’ debate, ‘nurture’ refers to personal experiences ‘growing up’ and the impact of a person’s context or environment. Nurture is therefore directly related to a person’s childhood or upbringing. However, nature is to do with a person’s biology, including their genes. A person’s physical ‘make up’ (e.g. their potential to grow to a certain height) and aspects to do with their personality traits are determined by their genes. The person has little control over certain aspects or features of themselves, irrespective of where they were born or how they were raised. It is now generally accepted that children grow and develop as a result of a complex interplay between both nature and nurture.

Child and Adolescent Mental Health Services (CAMHS): CAMHS are a form of specialist mental health services, primarily delivered by the National Health Service in the UK. CAMHS provide a range of services for children and young people who have difficulties with their emotional or behavioural wellbeing. CAMHS vary depending on the catchment area they serve – with many having waiting lists, and struggling to meet the demands for their services.