Associations between ongoing COVID-19 lockdown and the financial and mental health experiences of Australian families

In 2020, Australia's successful COVID-19 public health restrictions comprised a national “initial lockdown” (March–May) and “ongoing lockdown” (July–November) for metropolitan Victorian residents only. We evaluated associations between ongoing lockdown and family finances and mental health. In the June and September 2020 Royal Children's Hospital National Child Health Polls, caregivers of children in Victoria and New South Wales (NSW) reported the following: job/income loss; material deprivation (inability to pay for essential items); income poverty; mental health (Kessler-6); perceived impact on caregiver/child mental health; and caregiver/child coping. Data from caregivers (N = 1207/902) in June/September were analysed using difference-in-difference modelling (NSW provided the comparator). During Victoria's ongoing lockdown, job/income loss increased by 11% (95%CI: 3%–18%); Kessler-6 poor mental health by 6% (95%CI: −0.3%–12%) and perceived negative mental health impacts by 14% for caregivers (95%CI: 6%–23%) and 12% for children (95%CI: 4%–20%). Female (vs. male) caregivers, metropolitan (vs. regional/rural) families, and families with elementary school-aged children (vs. pre-/high-school) were the most affected. The ongoing lockdown was associated with negative experiences of mental health, employment and income, but not deprivation or poverty, likely because of government income supplements introduced early in the pandemic. Future lockdowns require planned responses to outbreaks and evidence-informed financial and mental health supports.     

Development of a framework for classifying threat and neglect in childhood: A qualitative study

Quantification of childhood adversity has typically involved a cumulative risk approach in which total number of discrete adversities serves as an index of overall risk. However, this approach fails to account for the growing evidence of differential outcomes following exposure to childhood adversities. An alternative approach adopts a dimensional perspective, with growing evidence for distinct developmental impacts associated with exposure to threat (violence/abuse) and deprivation (neglect). This study developed a framework for the classification of these dimensions through a thematic analysis of health practitioners' views and accounts of different forms of childhood adversity. Ten health practitioners experienced in working with children with challenging behaviours and neurodevelopmental disorders participated in semi-structured interviews regarding definitions and examples of six categories of adversity: physical/emotional/sexual abuse, physical/emotional neglect, and domestic and family violence. The qualitative analysis identified 23 themes across the six categories of adversity, along with two overarching themes regarding ambiguity of classifying exposures and non-specific outcomes of exposures. Themes were integrated to provide a framework and checklist for classifying indicators of exposure to threat and deprivation. The findings offer a framework and checklist for the assessment of threat and deprivation that will allow for further testing of the dimensional risk model.