interRAI Child and Youth Mental Health Screener (ChYMH-S) among Chinese migrant children: A validation study

Abstract

Summary: Youth mental health has become an emerging issue in Chinese society, yet internationally validated instruments for assessment among this population are lacking. This study applies the interRAI Child and Youth Mental Health Screener (ChYMH-S) to the high-risk rural-to-urban migrant youth in China, and examines the applicability of this instrument. Youth mental health has become an emerging issue in Chinese society. The young population in China (age 0–14) totals 233 million, representing 12% of the world’s youth population. Growing up under China’s one-child policy, massive rural-to-urban migration, and increasing divorce rate, many Chinese youth live in migrant, left-behind, and single-parent families that impose mental health risks. Amongst them, 85% (197 million) are at school age (6–18 years), who face even higher mental health risks due to high family expectations for the only child and academic stress. Research has reported high mental health problems in Chinese school-age children, ranging 11%–28%; one in ten Chinese school-age children is estimated to have psychiatric disorders that warrant treatment. Despite the urgent mental health needs of school-age children in China, current research lacks internationally validated instruments for assessment among this population, which impedes global comparison and professional mental health early assessment. This study applies the interRAI Child and Youth Mental Health Screener (ChYMH-S) to Chinese school-age youth. We focus on a high-risk population—rural-to-urban migrant youth, a population that amount to 35.81 million in China, face multi-dimensional vulnerabilities (such as low family income and exclusion from social resources), and present higher mental health problems than their peers. Our objectives are to: 1) examine the cross-cultural applicability and suggest necessary adaptations of ChYMH-S; 2) provide initial recommendations for comprehensive mental health assessment in Chinese youth. A total of 157 4th-5th-grade migrant students were recruited in Beijing. Each participant was interviewed by trained assessors during school hours using the interRAI ChYMH-S instrument. To test convergent validity, 115 randomly selected parents were invited to complete Child Behavior Checklist, 62 participants also completed Strengths and Difficulties Questionnaire, and other participants completed Revised Children’s Anxiety and Depression Scale. The implementation process of ChYMHS in Chinese schools and the results suggest initial evidence that the ChYMH-S instrument appears to be applicable and valid for Chinese youth. Our findings provide implications for promoting early detection of mental health issues in Chinese youth, which is particularly relevant for those at high risk.