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The COVID-19 pandemic arrived with significant hardship. The secondary impacts of the pandemic and our response with respect to pediatric mental health has been a subject of significant discussion in the lay public, media, and decision-maker groups. The initiatives to control SARS-CoV-2 have become politicized. A narrative emerged early that strategies to mitigate the spread of the virus were harming children’s mental health. Position statements from professional organizations in Canada have been used to support this claim. The aim of this commentary is to provide a reanalysis of some of the data and research methodology used to support these position statements. Some of the direct claims such as “online learning is harmful,” should be supported by a strong evidence base with significant consensus that speaks directly to causality. We find that the quality of the studies and the heterogeneity of the results does not support the strength of the unequivocal claims made by these position statements. In a sample of the current literature examining the issue, we find that outcomes range from improvements to deteriorations. Earlier studies relying on cross-sectional surveys typically have shown stronger negative effects than longitudinal cohort studies, which often have also shown groups of children experiencing no changes to measured mental health characteristics or groups that have experienced improvements. We argue it is imperative that policymakers use the highest quality evidence in making the best decisions. We as professionals must avoid discussing only one side of heterogeneous evidence.

Background: The prevalence of reported mental health concerns is rising among post-secondary students. Screening instruments can help identify these concerns and connect students to appropriate care. However, most existing instruments are limited to certain diagnoses, have varying levels of psychometric evidence, do not measure a wide range of psychological and social stressors, or have not been developed in partnership with students. The goal of this dissertation was to adapt the clinician- and self- administered pediatric psychosocial screening tools, MyHEARTSMAP and HEARTSMAP respectively, to be suitable for use by post-secondary students. Methods: The HEARTSMAP-U tool was adapted and evaluated over three years in partnership with post-secondary students, administration, and clinical experts. A scoping review was conducted to identify validation practices and gaps with existing instruments. In a multi-phase, multi-method process, HEARTSMAP-U was adapted from existing HEARTSMAP instruments through consensus-driven meetings, student focus groups, and a survey with post-secondary mental health professionals. A preliminary evaluation study was conducted to assess HEARTSMAP-U’s validity evidence with University of British Columbia (Vancouver) students. Results: The scoping review revealed a need for screening tools developed with, by, and for diverse post-secondary students. The student-centred HEARTSMAP-U instrument consists of ten psychosocial sections and generates urgency and severity-specific resource recommendations based on students' scoring patterns. Students and post-secondary mental health professionals found the tool content to be acceptable and relevant to end-users. HEARTSMAP-U demonstrated evidence of predictive validity in identifying students with psychiatric concerns and evidence of convergent validity as scores were highly correlated with other instruments measuring similar concerns and general quality of life (PedsQL-YA) and strength-based psychosocial assessments (MHC-SF). A small proportion of piloted students followed up with tool-recommended resources, but a large number reported their intent to access them in the future. Conclusion: HEARTSMAP-U was adapted and evaluated through a multi-method, student-centered approach, resulting in a tool that is deemed acceptable and suitable for use in the post-secondary education setting. Currently, HEARTSMAP-U is undergoing larger-scale validation to further assess its predictive validity and utility. Future studies may explore its implementation potential in post-secondary institutions and how it can be integrated within existing mental health strategies.

Supplemental material, sj-pdf-1-ccp-10.1177_13591045211017619 for The utility of universal screening for somatization in a pediatric emergency department: A prospective evaluation by Punit Virk, Jacob Ellis, Amrit Dhariwal, Andrea Chapman and Quynh Doan in Clinical Child Psychology and Psychiatry