Executive summary: The Health of Canada's Young People: a mental health focus

Executive summary

The Health Behaviour in School-aged Children study (HBSC) is a continuing, cross-national research project conducted in collaboration with the WHO Regional Office for Europe. There are now 43 participating countries and regions from North America and Europe. The study aims to contribute to new knowledge about the health, well‑being, and health behaviours of young people (aged 11 to 15 years). HBSC is Canada's only national-level health promotion database for this age group. The Federal Government has supported the Canadian HBSC study since 1988.

This report presents key findings from the 2010 cycle of HBSC. Current priorities for the public health system in Canada are particularly emphasized. As the HBSC study has traditionally focused upon the importance of social settings and conditions as potential determinants of health, this focus continues in the current report. In addition, this report examines the mental health of young Canadians as a primary theme.

In addition to our analysis of survey results from over 26,000 students, this report was informed by findings from a national youth engagement workshop. The purpose of this workshop was to obtain insights from a cross-section of young Canadians with respect to the key mental health findings. Efforts made to integrate the perspectives of young people directly into this report were driven by a philosophy that the opinions and insights of youth matter and the Federal Government's role in supporting youth engagement through its committment to the United Nations Convention on the Rights of the Child. This represents a new initiative for HBSC in Canada, with interpretation of the national report findings being enriched by this process.

Mental health of young Canadians

Key insights

• Many mental health issues are gender-specific, with important variations in mental health patterns existing between boys and girls.
• Many mental health issues are also age-specific, with important declines in mental health observed as young people get older.
• Whether one views mental health with a positive or negative lens, the same basic groups of young people requiring special attention are identified.
• It is clear that states of mental health in young people, either positive or negative, have many different potential causes. While the report findings cannot infer causal relationships, a diverse number of environmental factors and health behaviours were found to be associated with the four mental health outcomes of interest.
• Positive mental health outcomes are associated with environments that are supportive, and with good communication with adults and peers in those environments. Positive mental health outcomes also coincide with healthy choices in terms of risk behaviours, whether measured in individual young people or their peers.
• Negative mental health outcomes are associated with environments that are non-supportive or disadvantaged socially, and with poor levels of communication. Negative mental health outcomes also coincide with poor health behaviour choices.
• Overall, while relationships vary, the quality of social settings, behavioural choices and norms, and the quality of relationships are key factors in the occurrence of both positive and negative mental health outcomes.
• When it comes to mental health status in young people, interpersonal relationships make an important difference.

Positive messages about mental health status

• The majority of young Canadians rated their life satisfaction as "8 or higher" on a standard 10-point scale.
• Less than 10% of young people reported that engagement in a problem behaviour was "somewhat or definitely like them".
• Relatively few young people (about 25% for boys and 30% for girls) wish they were someone else.

Negative messages about mental health status

• Girls consistently report more negative emotional health outcomes than boys.
• Boys consistently report more negative behavioural mental health outcomes than girls.
• Mental health suffers as young people move through Grades 6 to 10, especially for girls, with positive indicators decreasing and negative indicators increasing.
• About one-fifth of boys and one-third of girls feel depressed or low on a weekly basis or more.

Relationships with mental health: positive messages

• The vast majority of young people, and particularly boys, have a positive home life that is associated with positive mental health.
• Positive school environments and higher levels of teacher support are associated with more positive mental health.
• Young people who report that their friends engage in positive behaviours are more likely to have higher levels of mental health.
• Economic characteristics do not necessarily relate to positive or negative indicators of mental health.
• Increased physical activity, reduced sedentary behaviour, and healthy diets are all positively related to improved mental health.

Relationships with mental health: negative messages

• As young people get older, they are less connected to school at a time when their emotional well‑being is most vulnerable.
• Having peers who engage in risky activities is associated with risks for several negative mental health outcomes.
• Young people who report that they find it difficult to talk to their friends are more likely to report emotional problems.
• Young people who go to schools in neighbourhoods troubled by social tensions are more likely to report higher levels of behavioural problems.
• Mental health problems are strongly associated with the occurrence of fighting injury.
• Physical inactivity, sedentary behaviour, and poor diets are all correlated with mental health problems.
• Overweight and obese young people, particularly young girls, are more likely to report mental health problems.
• Engagement in substance use and risky behaviours is associated with various mental health problems.
• Bullying and violence are strongly related to emotional and behavioural problems.

Social settings and health

Home

• Most young Canadians report positive relationships with their parents and have a happy home life.
• Three quarters or more of both boys and girls in all grade groups find it easy to talk to their mother about things that really bother them.
• There has been recent improvement in young people's relationships with their parents.
• About one-third of young people feel that their parents' expectations of them are too high both generally and at school.
• Adolescent girls are less positive than boys on many of the measures of relationships in home environments.

School

• A majority of young people feel supported by their schools, and have a sense of belonging to their school.
• Conversely, school is not a positive place for a small but important proportion of Canadian youth.
• Young people are increasingly reporting lower levels of achievement and poorer satisfaction with school.

Peers

• A strong majority of young people report having a best friend and being able to talk to their friends about things that are bothering them.
• Over 85% of young people report hanging out with friends who engage in positive activities such as sports, helping others, getting along with their parents, or doing well at school.
• A small but important proportion of young people report hanging around friends who engage in risky activities.

Neighbourhoods

• Highly urban and highly rural or remote environments pose unique challenges to the health of young people.
• Important proportions of school administrators, particularly those from mixed grade schools and from rural and remote communities, documented social tensions and safety issues as problems in the neighbourhoods where schools are located.
• While the majority of HBSC schools are within walking distance to parks, young people may not always use such facilities, sometimes due to their fears about personal safety.

Key issues surrounding the health of young people

Injury

• Injury remains a leading cause of poor health in populations of young Canadians from across the country.
• The leading activity associated with the occurrence of injury to young people remains "playing or training for a sport". Injuries are a negative side effect of a group of activities that generally have positive effects on the health of young people.
• Helmet use appears to be a normal behaviour among a majority of younger (Grade 6) children.
• Many young people report engagement in known risk-taking behaviours that can lead to major injury, despite widespread knowledge of the potential consequences of these behaviours.

Healthy living

• There have been some notable improvements in the food consumption patterns in recent cycles of the HBSC. In particular, the frequency of fruit consumption has gone up while the frequency of candy and sugared soft drink consumption has gone down.
• While many young people eat at fast food restaurants regularly, about one in three rarely or never do so.
• Less than one in five Canadian youth accumulate enough physical activity to meet Canada's new physical activity guidelines (i.e., 60 minutes of moderate-to-vigorous intensity physical activity every day).
• Screen time levels are extremely high, particularly for high school boys. More than half of these boys watch TV at least two hours per day, use the computer in their free time for at least two hours per day, and play video games for at least two hours per day.
• Approximately half of young people report that they do not consume fruits or vegetables at least once a day.

Healthy weights

• The prevalence of obesity did not increase between the 2006 and 2010 HBSC surveys, suggesting that increases in obesity observed over the past couple of decades may have reached a peak.
• Approximately one in four boys are either overweight or obese as determined from self-reported heights and weights. Approximately one in six girls are either overweight or obese by these criteria.
• A significant proportion of overweight (24%) and obese (30%) youth report that they are doing something to lose weight.
• Only two-thirds of young people with a healthy weight feel that their body is about the right size.

Substance use and risky behaviour

• Rates of smoking among Canadian youth are at historical lows. In 2010, 7% of boys and 6% of girls in Grade 10 reported smoking cigarettes every day.
• Alcohol and cannabis are the most commonly used substances among Canadian youth. A significant percentage of students have used alcohol and cannabis at least once by the time they reach Grade 10.
• Between 1990 and 2010, the lifetime prevalence of cannabis use among Grade 9 and 10 students increased from 25% to 38%.
• Although many youth have tried using cannabis, less than 20% of students in Grade 9 and 10 report using cannabis in the last 30 days.
• Most young people appreciate the major health risks associated with substance use and risky behaviour.

Bullying and violence

• The prevalence of young people reporting bullying others appears to be decreasing.
• The prevalence of fighting has decreased since the 2006 cycle of the HBSC.
• Higher proportions of young people reported being victims of violence in the form of bullying.