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Children’s mental health is influenced by many factors

Some of the important infl uences include children’s physical, social and emotional development, family circumstances, sense of belonging to school, and access to resources and support services. The infl uences that have been found to increase the likelihood that children will experience mental health problems are known as ‘risk factors’. Other influences have been found to decrease the likelihood of children developing mental health difficulties, even when risk factors are present. These are called ‘protective factors’. This overview provides information about the kinds of risk factors that can affect children’s mental health, and also about protective factors that can support children and help to reduce the risk of mental health difficulties.

What are mental health risk factors?

The idea that certain risk factors make it more likely that children will experience poor mental health is based on research findings that show how frequently, and under what conditions, children’s mental health difficulties occur. Knowing what kinds of factors put children at risk of mental health difficulties helps health experts plan and develop the kinds of support and resources needed to be able to intervene early to improve children’s mental health. It also helps to guide efforts to prevent mental health problems developing. The following table shows examples of risk factors (identified by researchers and mental health professionals) that often contribute to the development of mental health diffi culties in children. It is important to note that the presence of a risk factor does not mean that an individual child will necessarily develop a mental health difficulty.
Risk factors
Who is affected Risk factor
Child
  • Complications during birth and early infancy
  • Difficult temperament (overly shy or aggressive)
  • Low self esteem
  • Low intelligence
  • Poor bonding with parents and carers
Family
  • Family disharmony, instability or breakup
  • Harsh or inconsistent discipline style
  • Parent/s with mental illness or substance abuse
  • Siblings with a serious illness or disability
School
  • Peer rejection and/or bullying
  • Academic failure
  • Poor attendance
  • Poor connection between family and school
Life events
  • Difficult school transition
  • Death of a family member
  • Emotional trauma
  • Experience of physical or sexual abuse
Society
  • Discrimination
  • Isolation
  • Socioeconomic disadvantage
  • Lack of access to support services

How risk factors affect children

While risk factors often indicate circumstances that may severely challenge children’s mental and emotional wellbeing, predicting whether or not an individual child develops a mental health diffi culty is not straightforward. For example, whether or not a child develops a mental health difficulty after experiencing a death in the family will depend on such things as the age and emotional temperament of the child; the closeness of the relationship between the child and the person who has died; the support available through relatives, friends and others; whether the death was sudden or anticipated; and the effects of any previous experiences of loss. Sometimes risk factors result from isolated events, such as a death in the family. Often, however, several risk factors are related to one another, and it is their combined effect that leads to diffi culties. For example, Denise, a sole parent, has been struggling to look after three children on her own. She has been sick and had to give up her part time job and the family has had to move. There has been disruption, economic hardship and parental illness, each of which is a risk factor for children’s mental health. When several risk factors are present there is a greater likelihood that children will experience mental health diffi culties.

Children and grief contains more information on children's experience of grief and loss.

Protective factors for children’s mental health

Protective factors can help to reduce the likelihood of developing a mental health problem. The kinds of things found to be protective of children’s mental health are presented in the table to the right. Not all protective factors work in the same way. Some protective factors may help by shielding the child from experiencing a risk factor. For instance, a child who has an easy temperament (protective factor) cannot simultaneously have a diffi cult temperament (risk factor). More commonly, protective factors operate to reduce children’s exposure to risk. For example, a child with good social and emotional skills is able to make friends easily and is consequently less likely to experience social isolation (risk factor). Positive connections 
between family and school support children’s academic achievement and reduce the likelihood of failure. Other protective factors serve to reduce the impact of risk factors. For example, a caring relationship with a parent, carer and/or teacher provides children with a source of support to help them cope with difficulties. Similarly, when children have a strong sense of cultural identity it can help to buffer the negative effects of discrimination and increase resilience. It is important to note that while the factors listed have been found to be associated with a reduction in the risk of mental health difficulties, this does not mean that a particular factor or combination of factors will necessarily be protective for all children. The impacts of any of these factors may vary widely for different children and in different situations.
Examples of key protective factors that influence children’s mental health
Who is affected Protective factor
Child
  • Easy temperament
  • Good social and emotional skills
  • Positive coping style
  • Optimistic outlook on life
  • Good attachment to parents or carers
Family
  • Family harmony and stability
  • Supportive parenting
  • Strong family values
  • Consistency (firm boundaries and limits)
School
  • Positive school climate
  • Sense of belonging and connectedness between family and school
  • Opportunity for participation in a range of activities
  • Academic achievement
Life events
  • Involvement with a caring adult
  • Support available at critical times
Society
  • Participation in community networks
  • Access to support services
  • Economic security
  • Strong cultural identity and pride

Resilience: The capacity to bounce back

Though risk factors increase the likelihood of experiencing mental health diffi culties, some people who are exposed to signifi cant risk factors do not develop difficulties. Instead they fi nd ways to overcome the particular challenge and, as a result, increase their ability to cope with diffi culties. Research into resilience has sought to identify the kinds of things that allow children (and adults) to overcome risk or adversity and ‘bounce back’ in this way. This has led to a range of approaches that aim to build resilience by promoting the things that strengthen children’s mental health and 
enhance their ability to cope with difficulties. Many approaches to resilience emphasise the development of social and emotional skills, as 
advocated by KidsMatter Primary. However, it is important to recognise that resilience is most effectively promoted when (in addition to learning 
personal social and emotional skills) children are also connected through supportive relationships with family, friends, school and community, and have access to the resources needed to help them succeed and thrive. The factors found to be protective of children’s mental health are therefore critical for helping to build resilience.

Responding to risk

Since children have different reactions to adversity and different ways of coping, it is important to take an individual approach when assessing whether a child is at risk of developing a mental health diffi culty. The impacts on the child of both risk and protective factors, including any culturally-specifi c factors, should be taken into account when developing strategies for building resilience.

1. Reduce exposure to risk

Recognising the kinds of mental health risk factors children are exposed to can help to eliminate or reduce those able to be addressed. For example, by taking steps to address bullying and racism, schools can work to minimise this risk for their students.
 
Child abuse, neglect and exposure to violence represent very serious mental health risks for children’s development, and frequently cause ongoing trauma and disadvantage that extend into adulthood. Action to stop abuse is critical to protect children’s mental and physical health. Even when the immediate trauma has stopped, the risk of mental health difficulties remains high for children who have experienced abuse or trauma. When children have been affected by abuse or trauma, extra effort is required to assist recovery and build resilience.

2. Build protective factors to reduce the effects of risk

In many situations, it will not be possible for parents, carers or school staff to eliminate the critical risk factors affecting children. For example, chronic illness or disability affecting parents or family members are diffi culties that place stress on children as well as families, particularly because they are chronic, demanding circumstances and are mostly not able to be solved. In such situations, a focus on identifying and building protective factors can help to reduce the effects of mental health risks. 
 
Ensuring that support is available outside the immediate family (eg extended family, friends and school), and that children know how to access it, can be a particularly helpful strategy. Preventive programs designed to assist children to develop coping skills for their situations can also help to build protective factors. Examples include programs for children of parents with a mental illness, siblings of children with special needs, and children experiencing loss or family breakdown.

Key points for supporting children who may be affected by mental health risk factors

Build caring relationships 
A caring relationship with at least one important adult – ideally a parent or carer – is a signifi cant protective factor that builds resilience to help children cope with difficulties. 
 
Be aware of risks and how your child is coping
Recognising when children are exposed to mental health risk factors and observing how well they cope can help you tune into children and provide support to meet their needs. 
 
Establish a support network
Children, parents, carers and families cope best when they have support. Support may be available through friends, extended family, schools, community organisations or professionals. Being able to draw on a network of support is especially necessary during challenging times.