Mental Health
Gender matters for thriving: preserving young people’s mental health despite poor family support Afshin Vafaei* Afshin Vafaei William Pickett Susan Phillips
Youth sometimes avoid or overcome mental health issues despite having limited access to family, peer, or community supports. In keeping with intersectionality theories, we explored circumstances that might override known social determinants of depression.
Methods: We used 2018 Canadian Health Behaviours in School-aged Children data. The outcome was self-reported good mental health i.e. no depressive symptoms. Inputs were resilience (the ability to thrive despite individual/social difficulties), subjective body image, spiritual health, food security, and life satisfaction. Via Chi-square automatic interaction detection (CHAID) decision tree models we identified key covariates that described subgroups at higher risk of depressive symptoms. A series of empty logistic multilevel regression models was constructed to evaluate clustering of depressive symptoms associated with covariates emerging from CHAID analyses (done by calculating intraclass correlation coefficient values and median odds ratios). Finally, we developed binomial regression models to quantify beneficial effects of these protective variables in high-risk populations, e.g.., those reporting low family support as the first split in CHAID.
Results: According to the CHAID model (Figure) beyond family support, teacher support, resilience and body image were the most important covariates for all, while level of social capital was important only for boys. These findings were mirrored in cluster effects. Findings from binominal multivariate regression modelling varied by sex. Among boys, only teacher support and positive body image were protective. Girls who reported normal body image had an OR of reporting good mental health of 1.36 (95%CI:1.24-1.50), whereas this effect in boys was only 6% (OR=1.06; 95%CI:1.01-1.12). Resilience was protective only among girls. Findings have clinical and policy implications for the protection of youth mental health.
