Child and Adolescent Mental Health Research Shows Significant Global Imbalance

What's new

An editorial in the Journal of Child Psychology and Psychiatry (JCPP) highlights a significant imbalance in global child and adolescent mental health research [1]. A review of empirical studies published in JCPP over the past three decades (1990s, 2000s, 2010s) found that a disproportionate amount of research originates from and focuses on a small subset of high-income countries. Specifically, 95% of the research samples were drawn from the United States, United Kingdom and Western Europe, Canada, Australia, or New Zealand, with almost half from the UK or US alone. This concentration has remained consistent over the three decades analyzed.

The analysis also revealed that authors from these same high-income regions predominantly held first or senior authorship positions, even for studies conducted in other parts of the world. More than half of the studies conducted outside these core regions were still led by researchers from the US, UK, Western Europe, Canada, Australia, or New Zealand, rather than researchers from the countries where the samples were collected. This suggests a lack of global diversity not only in study populations but also in research leadership.

The science behind it

The authors reviewed 1,375 articles published in JCPP, encompassing 1,601 independent samples, to quantify the geographic distribution of research [1]. They examined both the countries where the research was conducted and the affiliations of the study authors. Despite the JCPP's long-standing mission to be internationally oriented, the data showed that research was conducted in only 76 countries, with 95% concentrated in five major regions. Most countries in Africa, Asia, and South America had no representation in the published research.

This geographic bias is particularly notable given that mental health conditions in children and adolescents are prevalent worldwide, with comparable rates across different regions. The vast majority of the world's population (85%) resides in Africa, Asia, Central and South America, and the Caribbean, and approximately 90% of children and adolescents live in low- and middle-income countries. The existing research frameworks and models for understanding child and adolescent mental health have largely been developed based on populations from high-income economies, potentially limiting their applicability and relevance to diverse global contexts.

What it means in practice

The findings suggest that current understandings of child and adolescent mental health, including its expression, development, risk factors, protective factors, and effective interventions, are heavily influenced by a narrow demographic [1]. This raises questions about the generalizability of research findings to the majority of the world's children and adolescents, particularly those in low- and middle-income countries who experience different sociocultural and geopolitical contexts.

For practitioners and policymakers, this means that evidence-based practices and guidelines derived from this concentrated research may not be optimally suited for diverse global populations. There is a critical need for research that is more representative of the global population to ensure that mental health interventions are culturally sensitive and effective for children and adolescents worldwide. The editorial calls for leading journals like JCPP to actively promote and support research from a broader range of countries and researchers, fostering a more inclusive and globally informed understanding of child and adolescent mental health.

Caveats

This article is an editorial, which means it presents the opinions and analysis of the journal's editors based on a review of past publications, rather than new primary research [1]. While the review of JCPP's publication history provides quantitative data on geographic distribution, the interpretation of its implications is inherently part of the editorial perspective. The analysis is limited to studies published within one specific journal, JCPP, which, while a leading publication, does not represent the entirety of global child and adolescent mental health research. However, the authors suggest that similar patterns may exist across the field.

Source: [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC13450272/