Prevalence and correlates of mental health difficulties in young Ghanaian children

Background Although 90% of youth live in low- and middle-income countries, only 10% of child mental health research is conducted in these settings. We sought to shed light on the mental health of Ghanaian children by estimating the prevalence of socioemotional difficulties and examining associations with psychosocial risk and protective factors.

Methods Data come from the cross-sectional Mental Health in Ghana study. Mothers and fathers reported their depressive symptoms, positive mental health, parenting practices and sociodemographic and household characteristics. Mothers reported child (ages 6–60 months) characteristics, including mental health according to the Ages and Stages Questionnaire Social-Emotional (ASQ:SE-2) (administered for all children), Caregiver Reported Early Development Instruments (CREDI) (6–36 months old) and the Strength and Difficulties Questionnaire (SDQ) (37–60 months old). Receiver operating characteristic analysis was used to determine CREDI and SDQ cut-offs, with the ASQ;SE-2 as the gold standard. Multivariate linear regression analyses were used to examine associations with correlates.

Findings Out of 750 households, 748 with data on child mental health were included in analyses. According to the CREDI and ASQ:SE-2, 35.9% (95% CI 31.4% to 40.4%) of 6–36 months old were at risk of experiencing socioemotional difficulties. Prevalence rates in 37–60 months old were slightly lower at 26.3% (95% CI 21.2% to 31.4%). The prevalence of socioemotional difficulties in the whole sample was 47.1% (95% CI 43.5% to 50.6%), with higher rates in male (51.6% (95% CI 46.5% to 56.7%)) compared with female (42.5% (95% CI 37.5% to 47.6%)) children. Maternal and paternal positive mental health and maternal use of positive disciplinary strategies were significantly associated with fewer socioemotional difficulties in female children. Only maternal positive mental health was a significant protective factor for male children’s mental health.

Conclusion A high burden of socioemotional difficulties exists among young Ghanaian children. Parental positive mental health is a key protective factor, highlighting the importance of considering the full spectrum of parental mental health and its associations with child mental health.