Social Determinants of Juvenile Mental Health: 5 Things Providers Should Know

Mental health concerns in juveniles can be complex. Oftentimes, youth mental health concerns are attributed to hormones, stress at school, or just a “normal” teenage attitude. With military children, mental health concerns can sometimes be exacerbated by parental deployment or repeated relocations. It can be hard for these children to find support when their support systems are constantly changing.

The Department of Defense identifies, that “access to quality and affordable youth and education programs will be met through a comprehensive and robust series of planned and self-directed programs” under DoD Instruction” (DoDI 606004). Though military youth have access to healthcare, housing, and education through the DoD Military Health System, many military youth live off base. Military children are also impacted by health and well-being stressors, such as food insecurity. Thus, they navigate many life changes and challenges within civilian institutions and social systems, as well as with civilian counterparts, schoolmates, and friends.

As providers, it is essential to notice the vulnerability factors that our clients and their families are exposed to and to do our best to equip them with resources to better protect them from negative mental health outcomes. Though active service members can utilize housing, healthcare, and educational benefits, these factors are important to remember when families transition or are preparing to transition to civilian life.

What are the vulnerability factors?

According to Johnson, et al. (2023), five key factors have been identified as determinants of youth mental health.

• Economic Stability: Research has shown that even before COVID-19, almost one-fourth of children were living in homes that did not have a parent with a full-time income. Following the pandemic, these numbers rose even higher. A lack of stable household income has been linked to housing instability, healthcare inaccessibility, unaffordable childcare, and food insecurity (Johnson, et al. 2023).
• Educational Access: Of the nearly 900,000 military-connected children worldwide, more than 20,000 are enrolled in U.S. DoDEA schools (DoDEA, n.d.). Children living in households that are experiencing financial insecurity often attend lower-quality schools. At these schools, they are likely to have lower performance in math and reading, which is attributed to lower educational attainment. Lower educational attainment is linked to lesser future income, increasing the possibility of continuing the cycle of poverty (Johnson, et al. 2023).
• Healthcare Access: Lack of access to quality healthcare has been linked to negative long-term health outcomes. Families with children who have disabilities are especially at risk due to the inaccessibility of necessary accommodations (Johnson, et al. 2023).
• Physical Environment: Concerns in the physical environment can range from neighborhood violence to air and water quality. Children who live in unsafe environments are more likely to experience trauma, teenage pregnancy, and youth violence (Johnson, et al. 2023).
• Social/Community Context: Children’s relationships with direct family members living in their households, neighbors, and peers have a great influence on their mental health. Having healthy relationships with these individuals has been shown to serve as a protective factor against mental health-related issues (Johnson, et al. 2023).

These social determinants of mental health are often experienced simultaneously by families. The integration of these factors creates the potential for negative developmental outcomes and increased risk of mental health concerns, such as trauma and other ACEs (Adverse Childhood Experiences). Physical health outcomes may also be negatively influenced by these factors (Johnson, et al. 2023).

What can we do?

Though the impacts of these risk factors are tremendous and we as providers cannot solve them in one session, we can keep in mind the influence they have on our clients. Military families already experience more relocation, change, and parental absence than other families. When we acknowledge these already existing circumstances and consider other findings in our view of juvenile mental health as well, we are utilizing necessary preparation in doing our best work with these families.

Knowing that youth are at a greater risk for negative mental and physical health outcomes when they experience one or more of these determinants will help us to be better informed. As providers for diverse family groups, we can help these clients become more informed about their mental health. We can also provide resources to help equip our clients with the tools they need to care for their mental and physical health.

References

• Department of Defense. (2019). Youth Services Policy. DoD Instruction 606004. Retrieved from: https://www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/606004p.pdf?ver=2019-12-04-064421-733.
• Johnson, K. F., Cunningham, P. D., Tirado, C., Moreno, O., Gillespie, N. N., Duyile, B., Hughes, D. C., Goodman Scott, E., & Brookover, D. (2023). Social determinants of mental health considerations for Counseling Children and Adolescents. Journal of Child and Adolescent Counseling, 9(1), 21–33. https://doi.org/10.1080/23727810.2023.2169223.
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