Connectedness: The Strategy to Combat Anxiety & Depression

Executive Summary

Youth mental health is a local crisis. There is rising rates of anxiety and depression among British Columbia youth, yet service provision continues to struggle to keep up with this demand. The harm these disorders carry both to the individual and to our economy support the need for further societal investment in preventative ‘upstream’ approaches. The capital region’s Child & Youth Health Network aims to improve health and wellbeing of children and youth, with an initial focus on youth mental health. Currently, 1 in 5 Canadians suffer from a mental illness; however these rates are expected to increase to 1 in 2 experiencing a mental ailment by 2041. This is based on extremely high rates of mental disorders in those aged 20-29 years (The Mental Health Commissions of Canada, n.d.). Nationally and locally the two most prevalent mental ailments are mood and anxiety disorders, with 10% of South Island youth (Grades 7-12) reporting anxiety, and 10% reporting depression (McCreary Centre Society, 2013). The goal of this report is to support the Network’s initial priority focus to address local youth mental health (anxiety and depression), while demonstrating the need for a preventative response (i.e., connectedness strategies).

Connectedness Strategy

Connectedness is a strategy to address anxiety and depression. Connectedness is the subjective experience of one’s feeling and perceptions about their social environment (family, school, peers, and community) and attachment to others. Connections to family, school and community are important for youth resilience and overall wellbeing. This reports key findings outline several evidence-informed family and school connectedness strategies that can be used to prevent and combat youth anxiety and depression. Family connectedness yields the greatest potential, as it protects against emotional distress and a wide range of health risk behaviours. Family connectedness provides both current and long-term reduction in youth depressive symptoms (Boutelle et al, 2009). Youth who reported being disconnected from parents conveyed a greater value in peer opinions over parental opinions for serious decision making, and experienced increase prevalence of health risk behaviours (Ackard et al, 2006). Depression and anxiety symptoms are on average three times higher among girls and four times higher among boys with an overall feeling of low connection to their mothers (Skrove et al, 2013). Additionally, youth with high parental connections suffering from social anxiety had a lower probability of growing anxiety over time (Van Zalk et al, 2015).

School Connectedness strongly correlates with youth mental health symptoms of anxiety and depression. Similar to family connectedness low school connectedness predicts 1-year later depressive symptoms in youth (aged 12-14 years), and anxiety symptoms in girls (Shochet et al, 2006). An increased level of school connectedness was found to protect youth with risk of moderate to high depression (Langille et al, 2012). A high level of school connectedness was also a protective factor against suicidality across adolescents, including those at risk of depression (Langille et al, 2015). Historically, school-based initiatives have been criticized for their inability to reach the masses (i.e., high risk groups – street involved youth). However, recent data on social connectedness in homeless youth found 71% (aged 14-18 years) attended school regularly, and relied on school connections over family connectedness (Dang, 2014).

The evidence examined within this report has allowed us to pinpoint areas for C&YHN
consideration while we develop our strategic plan to tackle youth mental health and connectedness.

Key Items for C&YHN Consideration

  • Family and school connectedness has the most literature for evidence-informed strategies.
  • Scholar’s state family connectedness has the strongest protective ability, with school
    connectedness coming in second. Both are due to their ability to reach a wide-ranging population.
  • Broad awareness and prevention strategies are the most cost effective, therefore creating
    awareness of family and school connectedness strategies could have a population level impact.
  • Evidence-informed connectedness strategies: supporting and investing in family rituals (i.e., eating regular family meals); enhancing parent-child relationships with public awareness of study results and youth’s value in parental opinions; school connectedness consultants can support and educate staff; interdisciplinary school care teams can focus on connecting with youth; and four school-associated factors to improve connectedness (administrative structure, school operational aspects, school built environment, & relational support).
  • Mental health approaches should address both culture and gender. Current literature lacks a deep understanding of how connectedness strategies work across different racial and cultural groups.
  • There is little evidence around community connectedness strategies and their impact on anxiety and depression in youth; this may be an area for network investment and network piloting.
  • Future research and any potential strategies need to examine how the broader
  • determinants of health impact connectedness.