Name
Chamberlain University
NR-326: Mental Health Nursing
Prof. Name
Date
Psychiatric disorders among children are becoming increasingly complex, with approximately 15 million children estimated to be affected by some form of mental illness. Several risk factors contribute to this rise, including genetic predispositions within families and the growing problem of bullying in schools and communities. Diagnosing mental health disorders in children is especially challenging due to differences in their physical, emotional, and intellectual development. This challenge is evident in the case of anxiety, the most common mental disorder among children. Parents often misinterpret anxiety symptoms, which may lead to frustration and conflict. As children grow and enter more social environments, their awareness of personal differences can lead to increased emotional stress (Stewart, 2020).
Stewart (2020) emphasizes the importance of early identification of mental health disorders in children. Research suggests that between 30% and 50% of children with intellectual disabilities also experience a mental disorder. Without timely detection, these children are at greater risk for poor outcomes in adulthood. Unfortunately, in Canada, fewer than 75% of children with mental disorders receive treatment, and wait times often range from six months to one year.
To address these challenges, the interRAI Child and Youth Instruments were developed. Designed for children from birth to age 18, this tool uses a holistic, dimensional framework to evaluate mental health. By considering both patient factors and environmental influences, healthcare providers can achieve a more comprehensive assessment.
The interRAI instrument was compared with other existing tools, such as the CBCL-Internalizing Scale. The interRAI anxiety scale consists of six items that measure the frequency of anxiety symptoms. These symptoms include anxious complaints, unrealistic fears, obsessive and intrusive thoughts, panic episodes, and nightmares. Higher scores on the scale indicate greater severity of anxiety. Unlike many other tools, the interRAI system is versatile across service sectors and enables longitudinal monitoring of children’s mental health, which assists in effective care planning and prioritization (Stewart, 2020).
Comparison of interRAI Anxiety Scale with Other Tools
| Feature/Aspect | interRAI Anxiety Scale | CBCL-Internalizing Scale |
|---|---|---|
| Target Age Group | Birth–18 years | 6–18 years |
| Items Measured | 6 anxiety-specific items | Multiple internalizing symptoms |
| Symptom Examples | Anxiety, fears, obsessive & intrusive thoughts, panic, nightmares | Depression, anxiety, withdrawal |
| Framework | Dimensional & holistic | Symptom-based |
| Usage Across Service Sectors | Yes | Limited |
| Longitudinal Tracking | Yes | Limited |
The article clearly identifies the significant challenges surrounding children’s mental health, offering statistics on the high prevalence of untreated disorders. It also provides an in-depth explanation of the interRAI assessment instrument, highlighting its advantages in diagnosing pediatric mental disorders.
One limitation, however, lies in the geographic focus. The research draws heavily on Canadian data, limiting its applicability in other countries. Stewart (2020) reports that around 15 million children remain undiagnosed globally, but U.S. statistics from the Centers for Disease Control and Prevention (CDC) present additional insight into the scope of the issue.
U.S. Statistics on Children’s Mental Health (Ages 2–17)
| Condition | Estimated Cases (Millions) |
|---|---|
| ADHD | 6.1 |
| Behavior Problems (Ages 3–17) | 4.5 |
| Anxiety | 4.4 |
| Depression | 1.9 |
(Data source: Centers for Disease Control and Prevention, 2020)
The article’s greatest strength is its evidence-based support for the interRAI tool. However, further studies incorporating U.S. or global data would enhance the relevance of its findings for broader healthcare contexts.
Mental health disorders can manifest in early childhood and, if undiagnosed or untreated, may persist into adulthood. Early detection is therefore critical to improving outcomes. The interRAI instruments present a promising solution, offering a holistic and continuous assessment from birth to adolescence. The six-item anxiety scale measures critical symptoms such as unrealistic fears, obsessive and intrusive thoughts, panic episodes, and nightmares. Furthermore, its adaptability across service sectors strengthens its value for healthcare providers and mental health professionals, ultimately improving accuracy, efficiency, and prioritization in care planning (Stewart, 2020).
Centers for Disease Control and Prevention. (2020). Children’s mental health. https://www.cdc.gov/childrensmentalhealth/data.html
Stewart, S. L., et al. (2020). A psychometric evaluation of the interRAI child and youth mental health instruments (ChYMH) anxiety scale in children with and without developmental disabilities. BMC Psychiatry. https://doi.org/10.1186/s12888-020-02785-9
