China has a population of 1.36 billion, 302 million of which are children under the age of 15. The rapid economic development and social reforms that have taken place in the last decades have all greatly influenced child and adolescent mental health. The One Child Policy was successful in maintaining a stable population, but also resulted in new challenges. The 4-2-1 family structure (4 refers to the grandparents, 2 to the parents, and 1 to the child) put a stressful responsibility on the parents and a tremendous amount of pressure on the single child to perform at high levels in all academic subjects.
Students often get out-of-hours private tuition to prepare for the National Higher Education Entrance Examination, commonly known as Gaokao. This examination determines one’s place at university, and indeed in life. Years of schooling and constant stress takes a toll on Chinese children’s mental health. Prevalence of suicidal ideations is high among college students in China. A stressful psychosocial school environment in terms of effort-reward imbalance predicts depressive symptoms, suicidal ideation and attempts in adolescence, especially in low socio-economic families. Poor academic performance predicts higher level of depression, externalized problems, and suicidal ideations, especially when child-parent relationship becomes more conflictual. Therefore, children with neurodevelopmental challenges, especially with externalized behaviours (most often with a diagnosis of Attention Deficit Hyperactivity Disorder or ADHD), represent a very vulnerable group in the context of modern China.
The project will implement a four step ADHD pathway, learning from lessons in Canada, based on shared experience and the description of other published ADHD care pathways.
Dr. Philippe Robaey (University of Ottawa) has experience in implementation research, especially the use of information technology to support patient engagement in treatment, and in the development of shared care pathways for ADHD.
Dr. Kathleen Pajer (University of Ottawa) is the chief of the Department of Psychiatry at CHEO in Ottawa. She has experience in implementing new model of care in outpatient services (CAPA). She is also leading a project of collaborative model of education and care management (Project ECHO®).
Dr. William Gardner’s (University of Ottawa) is an expert in the areas of pediatric mental health services research, outcomes measurement, quality measurement, ethics, and health policy.
Dr. Alice Charach’s (University of Toronto) research interests include long-term outcomes for young children with ADHD and collaborative networks to improve access to care for children and youth with mental health disorders.
Dr. André Samson (University of Ottawa) is an expert in qualitative studies and has studies the psychosocial adaptation to chronic disease especially in children.
Dr. Karen Courtney (University of Victoria) is an expert in health systems research, telehealth tools to enhance the delivery of care and clinical decision making.
Dr. Penny Corkum (Dalhousie University) is leading the Teacher Help program in Canada, and will be responsible for its adaptation and implementation in China.
Dr. Yuanyuan Jiang (University of Alberta) focuses on parenting in ADHD, and Dr. Zhaorui Liu focuses on the economic and social factors impacting mental health, and is in charge of the cost-effectiveness study.