{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T23:33:32Z","timestamp":1793662412175,"version":"4.5.1"},"reference-count":50,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2021,7,19]],"date-time":"2021-07-19T00:00:00Z","timestamp":1626652800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"British Columbia Ministry of Children and Family Development","award":["BCMCFD#SL00444S01"],"award-info":[{"award-number":["BCMCFD#SL00444S01"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Evid Based Mental Health"],"accepted":{"date-parts":[[2021,6,17]]},"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec>\n                    <jats:title>Question<\/jats:title>\n                    <jats:p>Mental disorders typically start in childhood and persist, causing high individual and collective burdens. To inform policymaking to address children\u2019s mental health in high-income countries we aimed to identify updated data on disorder prevalence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified epidemiological studies reporting mental disorder prevalence in representative samples of children aged 18 years or younger\u2014including a range of disorders and ages and assessing impairment (searching January 1990 through February 2021). We extracted associated service-use data where studies assessed this. We conducted meta-analyses using a random effects logistic model (using R metafor package).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      Fourteen studies in 11 countries met inclusion criteria, published from 2003 to 2020 with a pooled sample of 61 545 children aged 4\u201318 years, including eight reporting service use. (All data were collected pre-COVID-19.) Overall prevalence of any childhood mental disorder was 12.7% (95% CI 10.1% to 15.9%; I\n                      <jats:sup>2<\/jats:sup>\n                      =99.1%). Significant heterogeneity pertained to diagnostic measurement and study location. Anxiety (5.2%), attention-deficit\/hyperactivity (3.7%), oppositional defiant (3.3%), substance use (2.3%), conduct (1.3%) and depressive (1.3%) disorders were the most common. Among children with mental disorders, only 44.2% (95% CI 37.6% to 50.9%) received any services for these conditions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An estimated one in eight children have mental disorders at any given time, causing symptoms and impairment, therefore requiring treatment. Yet even in high-income countries, most children with mental disorders are not receiving services for these conditions. We discuss the implications, particularly the need to substantially increase public investments in effective interventions. We also discuss the policy urgency, given the emerging increases in childhood mental health problems since the onset of the COVID-19 pandemic (PROSPERO CRD42020157262).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/ebmental-2021-300277","type":"journal-article","created":{"date-parts":[[2021,7,19]],"date-time":"2021-07-19T20:00:26Z","timestamp":1626724826000},"page":"36-44","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":211,"title":["Prevalence of childhood mental disorders in high-income countries: a systematic review and meta-analysis to inform policymaking"],"prefix":"10.1136","volume":"25","author":[{"given":"Jenny Lou","family":"Barican","sequence":"first","affiliation":[{"name":"Children's Health Policy Centre, Simon Fraser University, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna","family":"Yung","sequence":"additional","affiliation":[{"name":"Children's Health Policy Centre, Simon Fraser University, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Children's Health Policy Centre, Simon Fraser University, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yufei","family":"Zheng","sequence":"additional","affiliation":[{"name":"Children's Health Policy Centre, Simon Fraser University, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katholiki","family":"Georgiades","sequence":"additional","affiliation":[{"name":"Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2036-4472","authenticated-orcid":false,"given":"Charlotte","family":"Waddell","sequence":"additional","affiliation":[{"name":"Children's Health Policy Centre, Simon Fraser University, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,7,19]]},"reference":[{"key":"2025082623502505000_25.1.36.1","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1001\/jamapsychiatry.2015.0730","article-title":"Adult functional outcomes of common childhood psychiatric problems: a prospective, longitudinal study","volume":"72","author":"Copeland","year":"2015","journal-title":"JAMA Psychiatry"},{"key":"2025082623502505000_25.1.36.2","first-page":"168","article-title":"Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization's world mental health survey initiative","volume":"6","author":"Kessler","year":"2007","journal-title":"World Psychiatry"},{"key":"2025082623502505000_25.1.36.3","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291714002888"},{"key":"2025082623502505000_25.1.36.4","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.60.7.709"},{"key":"2025082623502505000_25.1.36.5","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0b013e32816ebc8c"},{"key":"2025082623502505000_25.1.36.6","doi-asserted-by":"crossref","first-page":"92","DOI":"10.24095\/hpcdp.28.3.02","article-title":"A new population-based measure of the economic burden of mental illness in Canada","volume":"28","author":"Lim","year":"2008","journal-title":"Chronic Dis Can"},{"key":"2025082623502505000_25.1.36.7","doi-asserted-by":"publisher","DOI":"10.1177\/0269881113495118"},{"key":"2025082623502505000_25.1.36.8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2011.03590.x"},{"key":"2025082623502505000_25.1.36.9","doi-asserted-by":"publisher","DOI":"10.1007\/s10940-008-9057-3"},{"key":"2025082623502505000_25.1.36.10","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1093\/phe\/phx018","article-title":"Making children\u2019s mental health a public policy priority: for the one and the many","volume":"11","author":"Waddell","year":"2018","journal-title":"Public Health Ethics"},{"key":"2025082623502505000_25.1.36.11","unstructured":"United Kingdom (UK) Office for National Statistics . Healthcare expenditure, UK health accounts, 2020. Available: https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/healthandsocialcare\/healthcaresystem\/bulletins\/ukhealthaccounts\/2018 [Accessed Feb 2021]."},{"key":"2025082623502505000_25.1.36.12","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1377\/hlthaff.2020.02022","article-title":"National health care spending in 2019: steady growth for the fourth consecutive year","volume":"40","author":"Martin","year":"2021","journal-title":"Health Aff"},{"key":"2025082623502505000_25.1.36.13","unstructured":"Canadian Institute for Health Information (CIHI) . National health expenditure trends, 2020. Ottawa, ON: CIHI, 2021."},{"key":"2025082623502505000_25.1.36.14","unstructured":"United Nations General Assembly . Convention on the rights of the child, 1989. Available: https:\/\/www.unicef.org\/child-rights-convention\/convention-text [Accessed Apr 2021]."},{"key":"2025082623502505000_25.1.36.15","doi-asserted-by":"publisher","DOI":"10.1136\/eb-2017-102862"},{"key":"2025082623502505000_25.1.36.16","doi-asserted-by":"publisher","DOI":"10.1136\/ebmental-2019-300096"},{"key":"2025082623502505000_25.1.36.17","unstructured":"Schwartz C , Yung D , Barican J . Preventing and treating childhood mental disorders: effective interventions. Vancouver, BC: Children\u2019s Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, 2020."},{"key":"2025082623502505000_25.1.36.18","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-199311000-00002"},{"key":"2025082623502505000_25.1.36.19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7610.2008.01927.x"},{"key":"2025082623502505000_25.1.36.20","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2016.303485"},{"key":"2025082623502505000_25.1.36.21","doi-asserted-by":"crossref","first-page":"97","DOI":"10.2105\/AJPH.2016.303557","article-title":"Systematic reviews for policymaking: muddling through","volume":"107","author":"Greenhalgh","year":"2017","journal-title":"Am J Public Health"},{"key":"2025082623502505000_25.1.36.22","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2009.102467"},{"key":"2025082623502505000_25.1.36.23","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1017\/S2045796015001158","article-title":"The global coverage of prevalence data for mental disorders in children and adolescents","volume":"26","author":"Erskine","year":"2017","journal-title":"Epidemiol Psychiatr Sci"},{"key":"2025082623502505000_25.1.36.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2011.07.018"},{"key":"2025082623502505000_25.1.36.25","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.12381"},{"key":"2025082623502505000_25.1.36.26","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1176\/appi.ps.201700145","article-title":"Prevalence of serious emotional disturbance among U.S. children: a meta-analysis","volume":"69","author":"Williams","year":"2018","journal-title":"Psychiatr Serv"},{"key":"2025082623502505000_25.1.36.27","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (APA) . Diagnostic and statistical manual of mental disorders: DSM-5. Washington, DC: APA, 2013.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"2025082623502505000_25.1.36.28","unstructured":"World Health Organization . Classification of diseases (ICD), 2020. Available: https:\/\/www.who.int\/standards\/classifications\/classification-of-diseases [Accessed Feb 2021]."},{"key":"2025082623502505000_25.1.36.29","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60827-1"},{"key":"2025082623502505000_25.1.36.30","unstructured":"World Health Organization . Mental health atlas 2017, 2018. Available: https:\/\/www.who.int\/publications\/i\/item\/mental-health-atlas-2017 [Accessed Sep 2020]."},{"key":"2025082623502505000_25.1.36.31","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"2025082623502505000_25.1.36.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.06.005"},{"key":"2025082623502505000_25.1.36.33","unstructured":"American Psychiatric Association . DSM history, 2020. Available: https:\/\/www.psychiatry.org\/psychiatrists\/practice\/dsm\/history-of-the-dsm [Accessed Sep 2020]."},{"key":"2025082623502505000_25.1.36.34","unstructured":"World Bank Group . High income, 2021. Available: https:\/\/data.worldbank.org\/country\/XD [Accessed Jun 2021]."},{"key":"2025082623502505000_25.1.36.35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2010.05.017"},{"key":"2025082623502505000_25.1.36.36","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2011.11.014"},{"key":"2025082623502505000_25.1.36.37","doi-asserted-by":"publisher","DOI":"10.1023\/A:1014573708569"},{"key":"2025082623502505000_25.1.36.38","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v036.i11"},{"key":"2025082623502505000_25.1.36.39","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.14.3.147"},{"key":"2025082623502505000_25.1.36.40","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.61.3.241"},{"key":"2025082623502505000_25.1.36.41","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201100518"},{"key":"2025082623502505000_25.1.36.42","doi-asserted-by":"publisher","DOI":"10.1177\/0004867415622562"},{"key":"2025082623502505000_25.1.36.43","doi-asserted-by":"crossref","first-page":"9","DOI":"10.7870\/cjcmh-2013-003","article-title":"Creating comprehensive children\u2019s mental health indicators for British Columbia","volume":"32","author":"Waddell","year":"2013","journal-title":"Can J Commun Ment Health"},{"key":"2025082623502505000_25.1.36.44","unstructured":"Waddell C , Schwartz C , Barican J . COVID-19 and the impact on children\u2019s mental health. Vancouver, BC: Children\u2019s Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, 2020."},{"key":"2025082623502505000_25.1.36.45","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(20)30570-8"},{"key":"2025082623502505000_25.1.36.46","doi-asserted-by":"publisher","DOI":"10.1177\/070674370204700903"},{"key":"2025082623502505000_25.1.36.47","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1176\/ajp.155.6.715","article-title":"Prevalence of psychopathology among children and adolescents","volume":"155","author":"Roberts","year":"1998","journal-title":"Am J Psychiatry"},{"key":"2025082623502505000_25.1.36.48","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1177\/0706743719830033","article-title":"2014 Ontario child health study findings: policy implications for Canada","volume":"64","author":"Waddell","year":"2019","journal-title":"Can J Psychiatry"},{"key":"2025082623502505000_25.1.36.49","first-page":"88","article-title":"Measuring children's mental health in Ontario: policy issues and prospects for change","volume":"27","author":"Duncan","year":"2018","journal-title":"J Can Acad Child Adolesc Psychiatry"},{"key":"2025082623502505000_25.1.36.50","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.12663"}],"container-title":["Evidence Based Mental Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/ebmental-2021-300277","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:50:39Z","timestamp":1756277439000},"score":1,"resource":{"primary":{"URL":"https:\/\/mentalhealth.bmj.com\/lookup\/doi\/10.1136\/ebmental-2021-300277"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,19]]},"references-count":50,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1,20]]},"published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1136\/ebmental-2021-300277"],"URL":"https:\/\/doi.org\/10.1136\/ebmental-2021-300277","relation":{},"ISSN":["1362-0347","1468-960X"],"issn-type":[{"value":"1362-0347","type":"print"},{"value":"1468-960X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,19]]}}}