Children can be more vulnerable in the heat. Here’s how to protect them this summer

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Extreme heat is increasingly common in Australia and around the world and besides making us uncomfortable, it can harm our health. For example, exposure to extreme heat can exacerbate existing medical conditions, or cause problems such as heat stroke.

Due to a combination of physiology and behaviour, children are potentially more vulnerable to severe heat-related illness such as heat stroke or heat exhaustion.

But these are not the only heat-related health issues children might experience on a very hot day. In a new study, we looked at emergency department (ED) visits and unplanned hospital admissions among children in New South Wales on heatwave days.

We found a significant increase in children attending hospital compared to milder days – with a range of health issues.

maxim ibragimov/Shutterstock

Why are children more vulnerable in the heat?

Sweating is the main way we lose heat from our bodies and cool down.

Children have a greater skin surface area to body mass ratio, which can be an advantage for sweating – they can lose more heat through evaporation for a given body mass. But this also means children can lose fluids and electrolytes faster through sweating, theoretically making them more susceptible to dehydration.

Meanwhile, younger children, particularly babies, can’t sweat as much as older children and adults. This means they can’t cool down as effectively.

Children in general also tend to engage in more outdoor physical activity, which might see them more exposed to very hot temperatures.

Further, children may be less in-tune to the signals their body is giving them that they’re overheating, such as excessive sweating or red skin. So they might not stop and cool down when they need to. Young children especially may not recognise the early signs of heat stress or be able to express discomfort.

A boy drinking from a drink bottle, appears hot and bothered.
Children may not easily be able to communicate that they’re hot and bothered. christinarosepix/Shutterstock

Our study

We wanted to examine children’s exposure to extreme heat stress and the associated risks to their health.

We measured extreme heat as “heatwave days”, at least two consecutive days with a daily maximum temperature above the 95th percentile for the relevant area on a universal thermal climate index. This ranged from 27°C to 45°C depending on the area.

We assessed health outcomes by looking at ED visits and unplanned hospital admissions among children aged 0–18 years from NSW between 2000 and 2020. This totalled around 8.2 million ED visits and 1.4 million hospital admissions.

We found hospital admissions for heat-related illness were 104% more likely on heatwave days compared to non-heatwave days, and ED visits were 78% more likely. Heat-related illness includes a spectrum of disorders from minor conditions such as dehydration to life-threatening conditions such as heat stroke.

But heat-related illness wasn’t the only condition that increased on heatwave days. There was also an increase in childhood infections, particularly infectious enteritis possibly related to food poisoning (up 6% for ED visits and 17% for hospital admissions), ear infections (up 30% for ED visits and 3% for hospital admissions), and skin and soft tissue infections (up 6% for ED visits and 4% for hospital admissions).

A boy standing in front of a sprinkler.
Kids can be more vulnerable in the heat because of their behaviour and physiology. K-FK/Shutterstock

We know many infectious diseases are highly seasonal. Some, like the flu, peak in winter. But heat and humidity increase the risk of certain infections caused by bacterial, viral and fungal pathogens.

For example, warmer weather and higher humidity can increase the survival of bacteria, such as Salmonella, on foods, which increases the risk of food poisoning.

Hot weather can also increase the risk of ear infections. Children may be at greater risk during hot weather because they often swim or play at the beach or pool. Water can stay in the ear after swimming and a moist environment in the ear canal can cause growth of pathogens leading to ear infections.

Which children are most vulnerable?

During heatwaves, we found infants aged under one were at increased risk of ED visits and hospital admission for any reason compared to older children. This is not surprising, because babies can’t regulate their body temperature effectively and are reliant on their caregivers to keep them cool.

Our study also found children from the most disadvantaged areas were more vulnerable to heat-related illness on heatwave days. Although we don’t know exactly why, we hypothesised families from poorer areas might have limited access to air-conditioning and could be more likely to live in hotter neighbourhoods.

Keeping kids cool: tips for parents

The highest levels of heat exposure on hot days for young children is usually when they’re taken outside in prams and strollers. To protect their children from direct sunlight, parents often instinctively cover their stroller with a cloth such as a muslin.

However, a recent study from our group showed this actually increases temperatures inside a stroller to as much as 3–4˚C higher than outside.

But if the cloth is wet with water, and a small fan is used to circulate the air close to the child, stroller temperatures can be 4–5˚C lower than outside. Wetting the cloth every 15–20 minutes (for example, with a spray bottle) maintains the cooling effect.

When young children are not in a stroller, and for older children, there are a few things to consider to keep them cool and safe.

Remember temperatures reported on weather forecasts are measured in the shade, and temperatures in the sun can be up to 15˚C higher. So sticking to the shade as much as possible is important.

Exercise generates heat inside the body, so activities should be shortened, or rescheduled to cooler times of the day.

Sunscreen and hats are important when outdoors, but neither are especially effective for keeping cool. Spraying water on the child’s skin – not just the face but arms, legs and even the torso if possible – can help. Wetting their hats is another idea.

Proper hydration on hot days is also essential. Regular water breaks, including offering water before, during and after activity, is important. Offering foods with high water content such as watermelon and orange can help with hydration too.

Wen-Qiang He, Research Fellow in Biostatistics and Epidemiology, Faculty of Medicine and Health, University of Sydney; James Smallcombe, Post-doctoral Research Associate, Faculty of Medicine and Health, University of Sydney; Natasha Nassar, Professor of Paediatric and Perinatal Epidemiology and Chair in Translational Childhood Medicine, University of Sydney, and Ollie Jay, Professor of Heat & Health; Director of Heat & Health Research Incubator; Director of Thermal Ergonomics Laboratory, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • California Is Investing $500M in Therapy Apps for Youth. Advocates Fear It Won’t Pay Off.

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    With little pomp, California launched two apps at the start of the year offering free behavioral health services to youths to help them cope with everything from living with anxiety to body acceptance.

    Through their phones, young people and some caregivers can meet BrightLife Kids and Soluna coaches, some who specialize in peer support or substance use disorders, for roughly 30-minute virtual counseling sessions that are best suited to those with more mild needs, typically those without a clinical diagnosis. The apps also feature self-directed activities, such as white noise sessions, guided breathing, and videos of ocean waves to help users relax.

    “We believe they’re going to have not just great impact, but wide impact across California, especially in places where maybe it’s not so easy to find an in-person behavioral health visit or the kind of coaching and supports that parents and young people need,” said Gov. Gavin Newsom’s health secretary, Mark Ghaly, during the Jan. 16 announcement.

    The apps represent one of the Democratic governor’s major forays into health technology and come with four-year contracts valued at $498 million. California is believed to be the first state to offer a mental health app with free coaching to all young residents, according to the Department of Health Care Services, which operates the program.

    However, the rollout has been slow. Only about 15,000 of the state’s 12.6 million children and young adults have signed up for the apps, school counselors say they’ve never heard of them, and one of the companies isn’t making its app available on Android phones until summer.

    Advocates for youth question the wisdom of investing taxpayer dollars in two private companies. Social workers are concerned the companies’ coaches won’t properly identify youths who need referrals for clinical care. And the spending is drawing lawmaker scrutiny amid a state deficit pegged at as much as $73 billion.

    An App for That

    Newsom’s administration says the apps fill a need for young Californians and their families to access professional telehealth for free, in multiple languages, and outside of standard 9-to-5 hours. It’s part of Newsom’s sweeping $4.7 billion master plan for kids’ mental health, which was introduced in 2022 to increase access to mental health and substance use support services. In addition to launching virtual tools such as the teletherapy apps, the initiative is working to expand workforce capacity, especially in underserved areas.

    “The reality is that we are rarely 6 feet away from our devices,” said Sohil Sud, director of Newsom’s Children and Youth Behavioral Health Initiative. “The question is how we can leverage technology as a resource for all California youth and families, not in place of, but in addition to, other behavioral health services that are being developed and expanded.”

    The virtual platforms come amid rising depression and suicide rates among youth and a shortage of mental health providers. Nearly half of California youths from the ages of 12 to 17 report having recently struggled with mental health issues, with nearly a third experiencing serious psychological distress, according to a 2021 study by the UCLA Center for Health Policy Research. These rates are even higher for multiracial youths and those from low-income families.

    But those supporting youth mental health at the local level question whether the apps will move the needle on climbing depression and suicide rates.

    “It’s fair to applaud the state of California for aggressively seeking new tools,” said Alex Briscoe of California Children’s Trust, a statewide initiative that, along with more than 100 local partners, works to improve the social and emotional health of children. “We just don’t see it as fundamental. And we don’t believe the youth mental health crisis will be solved by technology projects built by a professional class who don’t share the lived experience of marginalized communities.”

    The apps, BrightLife Kids and Soluna, are operated by two companies: Brightline, a 5-year-old venture capital-backed startup; and Kooth, a London-based publicly traded company that has experience in the U.K. and has also signed on some schools in Kentucky and Pennsylvania and a health plan in Illinois. In the first five months of Kooth’s Pennsylvania pilot, 6% of students who had access to the app signed up.

    Brightline and Kooth represent a growing number of health tech firms seeking to profit in this space. They beat out dozens of other bidders including international consulting companies and other youth telehealth platforms that had already snapped up contracts in California.

    Although the service is intended to be free with no insurance requirement, Brightline’s app, BrightLife Kids, is folded into and only accessible through the company’s main app, which asks for insurance information and directs users to paid licensed counseling options alongside the free coaching. After KFF Health News questioned why the free coaching was advertised below paid options, Brightline reordered the page so that, even if a child has high-acuity needs, free coaching shows up first.

    The apps take an expansive view of behavioral health, making the tools available to all California youth under age 26 as well as caregivers of babies, toddlers, and children 12 and under. When KFF Health News asked to speak with an app user, Brightline connected a reporter with a mother whose 3-year-old daughter was learning to sleep on her own.

    ‘It’s Like Crickets’

    Despite being months into the launch and having millions in marketing funds, the companies don’t have a definitive rollout timeline. Brightline said it hopes to have deployed teams across the state to present the tools in person by midyear. Kooth said developing a strategy to hit every school would be “the main focus for this calendar year.”

    “It’s a big state — 58 counties,” Bob McCullough of Kooth said. “It’ll take us a while to get to all of them.”

    So far BrightLife Kids is available only on Apple phones. Brightline said it’s aiming to launch the Android version over the summer.

    “Nobody’s really done anything like this at this magnitude, I think, in the U.S. before,” said Naomi Allen, a co-founder and the CEO of Brightline. “We’re very much in the early innings. We’re already learning a lot.”

    The contracts, obtained by KFF Health News through a records request, show the companies operating the two apps could earn as much as $498 million through the contract term, which ends in June 2027, months after Newsom is set to leave office. And the state is spending hundreds of millions more on Newsom’s virtual behavioral health strategy. The state said it aims to make the apps available long-term, depending on usage.

    The state said 15,000 people signed up in the first three months. When KFF Health News asked how many of those users actively engaged with the app, it declined to say, noting that data would be released this summer.

    KFF Health News reached out to nearly a dozen California mental health professionals and youths. None of them were aware of the apps.

    “I’m not hearing anything,” said Loretta Whitson, executive director of the California Association of School Counselors. “It’s like crickets.”

    Whitson said she doesn’t think the apps are on “anyone’s” radar in schools, and she doesn’t know of any schools that are actively advertising them. Brightline will be presenting its tool to the counselor association in May, but Whitson said the company didn’t reach out to plan the meeting; she did.

    Concern Over Referrals

    Whitson isn’t comfortable promoting the apps just yet. Although both companies said they have a clinical team on staff to assist, Whitson said she’s concerned that the coaches, who aren’t all licensed therapists, won’t have the training to detect when users need more help and refer them to clinical care.

    This sentiment was echoed by other school-based social workers, who also noted the apps’ duplicative nature — in some counties, like Los Angeles, youths can access free virtual counseling sessions through Hazel Health, a for-profit company. Nonprofits, too, have entered this space. For example, Teen Line, a peer-to-peer hotline operated by Southern California-based Didi Hirsch Mental Health Services, is free nationwide.

    While the state is also funneling money to the schools as part of Newsom’s master plan, students and school-based mental health professionals voiced confusion at the large app investment when, in many school districts, few in-person counseling roles exist, and in some cases are dwindling.

    Kelly Merchant, a student at College of the Desert in Palm Desert, noted that it can be hard to access in-person therapy at her school. She believes the community college, which has about 15,000 students, has only one full-time counselor and one part-time bilingual counselor. She and several students interviewed by KFF Health News said they appreciated having engaging content on their phone and the ability to speak to a coach, but all said they’d prefer in-person therapy.

    “There are a lot of people who are seeking therapy, and people close to me that I know. But their insurances are taking forever, and they’re on the waitlist,” Merchant said. “And, like, you’re seeing all these people struggle.”

    Fiscal conservatives question whether the money could be spent more effectively, like to bolster county efforts and existing youth behavioral health programs.

    Republican state Sen. Roger Niello, vice chair of the Senate Budget and Fiscal Review Committee, noted that California is forecasted to face deficits for the next three years, and taxpayer watchdogs worry the apps might cost even more in the long run.

    “What starts as a small financial commitment can become uncontrollable expenses down the road,” said Susan Shelley of the Howard Jarvis Taxpayers Association.

    This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. 

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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  • Galveston Diet Cookbook for Beginners – by Martha McGrew

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    We recently reviewed “The Galveston Diet”, and here’s a cookbook (by a nutritionist) to support that.

    For the most part, it’s essentially keto-leaning, with an emphasis on protein and fats, but without quite the carb-cut that keto tends to have. It’s also quite plant-centric, but it’s not by default vegan or even vegetarian; you will find meat and fish in here. As you might expect from an anti-inflammatory cookbook, it’s light on the dairy too, though fermented dairy products such as yogurt do feature as well.

    The recipes are quite simple and easy to follow, with suggestions of alternative ingredients along the way, making for extra variety as well as convenience.

    If you are going to buy this book, you might want to take a look at the buying options, to ensure you get a full-color version, as recent reprints have photos in black and white, whereas older runs have color throughout.

    Bottom line: if you’d like to cook the Galveston Diet way, this is as good a way to start as any.

    Click here to check out the Galveston Diet Cookbook for Beginners, and get cooking!

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  • The Counterintuitive Dos and Don’ts of Nail Health

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    It’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝I take a vitamin supplement for strengthening my nails (particularly one of my big toes!) – but they are running out! What do you recommend for strengthening nails? What is/are the key ingredient(s)?❞

    Vitamin-wise, biotin (vitamin B7) is an underrated and very important one. As a bonus, it’s really good for your hair too (hair and nails being made of fundamentally the same “stuff”. Because it has exceptionally low toxicity, it can be taken up to 10,000% of the NRV, so if shopping for supplements, a high biotin content is better than a low one.

    A lot of products marketed as for “skin, hair, and nails” focus on vitamins A and E, which are good for the skin but aren’t so relevant for nails.

    Nutritionally, getting plenty of protein (whatever form you normally take it is fine) is also important since keratin (as nails are made of) is a kind of protein.

    Outside of nutritional factors, a few other considerations:

    • Testosterone strengthens nails, and declining testosterone levels (as experienced by most men over the age of 45) can result in weaker nails. So for men over 45 especially, a diet that favors testosterone (think foods rich in magnesium and zinc) is good.
    • Because estrogen doesn’t do for women’s nails what testosterone does for men’s nails, increasing our magnesium and zinc intake won’t help our nails (but it’s still good for other things, including energy levels in the day and good sleep at night, and most people are deficient in magnesium anyway)
    • Those of us who enjoy painted nails would do well to let our nails go without polish sometimes, as it can dry them out. And, acrylic nails are truly ruinous to nail health, as are gel nails (the kind that use a UV lamp to harden them—which is also bad for the skin)
    • When nails are brittle, it can be tempting to soak them to reduce their brittleness. However, this is actually counterproductive, as the water will leech nutrients from the nails, and by the time you’ve been out of the footbath (for example) for about an hour, your nails will bemore brittle than before you soaked them.
      • Use a moisturizing lotion or nail-oil instead—bonus if it contains biotin, keratin, and/or other helpful nutrients.
      • Keep yourself hydrated, too! Hydration that comes to your nails from the inside will deliver nutrients, rather than removing them.

    About those supplements: we don’t sell them (or anything else) but for your convenience, here are some great ones (this writer takes pretty much the same, just a different brand because I’m in a different country):

    Magnesium Gummies (600mg) & Biotin Gummies (10,000µg)

    Enjoy!

    ❝I was wondering whether there were very simple, clear bullet points or instructions on things to be wary of in Yoga.❞

    That’s quite a large topic, and not one that lends itself well to being conveyed in bullet points, but first we’ll share the article you sent us when sending this question:

    Tips for Avoiding Yoga Injuries

    …and next we’ll recommend the YouTube channel @livinleggings, whose videos we feature here from time to time. She (Liv) has a lot of good videos on problems/mistakes/injuries to avoid.

    Here’s a great one to get you started:

    !

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  • Life After Death? (Your Life; A Loved One’s Death)

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The Show Must Go On

    We’ve previously written about the topics of death and dying. It’s not cheery, but it is important to tackle.

    Sooner is better than later, in the case of:

    Preparations For Managing Your Own Mortality

    And for those who are left behind, of course it is hardest of all:

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    But what about what comes next? For those who are left behind, that is.

    Life goes on

    In cases when the death is that of a close loved one, the early days after death can seem like a surreal blur. How can the world go ticking on as normal when [loved one] is dead?

    But incontrovertibly, it does, so we can only ask again: how?

    And, we get to choose that, to a degree. The above-linked article about grief gives a “101” rundown, but it’s (by necessity, for space) a scant preparation for one of the biggest challenges in life that most of us will ever face.

    For many people, processing grief involves a kind of “saying goodbye”. For others, it doesn’t, as in the following cases of grieving the loss of one’s child—something no parent should ever have to face, but it happens:

    Dr. Ken Druck | The Love That Never Dies

    (with warning, the above article is a little heavy)

    In short: for those who choose not to “say goodbye” in the case of the death of a loved one, it’s more often not a case of cold neglect, but rather the opposite—a holding on. Not in the “denial” sense of holding on, but rather in the sense of “I am not letting go of this feeling of love, no matter how much it might hurt to hold onto; it’s all I have”.

    What about widows, and love after death?

    Note: we’ll use the feminine “widow” here as a) it’s the most common and b) most scientific literature focuses on widows, but there is no reason why most of the same things won’t also apply to widowers.

    We say “most”, as society does tend to treat widows and widowers differently, having different expectations about a respectful mourning period, one’s comportment during same, and so on.

    As an aside: most scientific literature also assumes heterosexuality, which is again statistically reasonable, and for the mostpart the main difference is any extra challenges presented by non-recognition of marriages, and/or homophobic in-laws. But otherwise, grief is grief, and as the saying goes, love is love.

    One last specificity before we get into the meat of this: we are generally assuming marriages to be monogamous here. Polyamorous arrangements will likely sidestep most of these issues completely, but again, they’re not the norm.

    Firstly, there’s a big difference between remarrying (or similar) after being widowed, and remarrying (or similar) after a divorce, and that largely lies in the difference of how they begin. A divorce is (however stressful it may often be) more often seen as a transition into a new period of freedom, whereas bereavement is almost always felt as a terrible loss.

    The science, by the way, shows the stats for this; people are less likely to remarry, and slower to remarry if they do, in instances of bereavement rather than divorce, for example:

    Timing of Remarriage Among Divorced and Widowed Parents

    Love after death: the options

    For widows, then, there seem to be multiple options:

    • Hold on to the feelings for one’s deceased partner; never remarry
    • Grieve, move on, find new love, relegating the old to history
    • Try to balance the two (this is tricky but can be done*)

    *Why is balancing the two tricky, and how can it be done?

    It’s tricky because ultimately there are three people’s wishes at hand:

    • The deceased (“they would want me to be happy” vs “I feel I would be betraying them”—which two feelings can also absolutely come together, by the way)
    • Yourself (whether you actually want to get a new partner, or just remain single—this is your 100% your choice either way, and your decision should be made consciously)
    • The new love (how comfortable are they with your continued feelings for your late love, really?)

    And obviously only two of the above can be polled for opinions, and the latter one might say what they think we want to hear, only to secretly and/or later resent it.

    One piece of solid advice for the happily married: talk with your partner now about how you each would feel about the other potentially remarrying in the event of your death. Do they have your pre-emptive blessing to do whatever, do you ask a respectable mourning period first (how long?), would the thought just plain make you jealous? Be honest, and bid your partner be honest too.

    One piece of solid advice for everyone: make sure you, and your partner(s), as applicable, have a good emotional safety net, if you can. Close friends or family members that you genuinely completely trust to be there through thick and thin, to hold your/their hand through the emotional wreck that will likely follow.

    Because, while depression and social loneliness are expected and looked out for, it’s emotional loneliness that actually hits the hardest, for most people:

    Longitudinal Examination of Emotional Functioning in Older Adults After Spousal Bereavement

    …which means that having even just one close friend or family member with whom one can be at one’s absolute worst, express emotions without censure, not have to put on the socially expected appearance of emotional stability… Having that one person (ideally more, but having at least one is critical) can make a huge difference.

    But what if a person has nobody?

    That’s definitely a hard place to be, but here’s a good starting point:

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    Take care!

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  • Here’s how to help protect your family from norovirus

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    What you need to know

    • Norovirus is a very contagious infection that causes vomiting and diarrhea.
    • The best way to help protect against norovirus is to wash your hands often with soap and warm water, since hand sanitizer may not be effective at killing the virus.
    • If someone in your household has symptoms of norovirus, isolate them away from others, watch for signs of dehydration, and take steps to help prevent it from spreading.

    If you feel like everyone is sick right now, you’re not alone. Levels of respiratory illnesses like COVID-19, flu, and RSV remain remain high in many states, and the U.S. is also battling a wave of norovirus, one of several viruses that cause a very contagious infection of the stomach and intestines. 

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    You can get sick with norovirus even if you’ve had it before, since there are many different strains.

    How can families help protect against the spread of norovirus at home?

    If someone in your household has symptoms of norovirus, isolate them away from others and watch for signs of dehydration. If you are sick with norovirus, do not prepare food for others in your household and use a separate bathroom, if possible.

    When cleaning up after someone who has norovirus, wear rubber, latex, or nitrile gloves. Then wash your hands thoroughly.

    Clean surfaces using a solution containing five to 25 tablespoons of bleach (that’s 12.5 fluid ounces, or just  over ¾ cup), per gallon of water. Leave the bleach-water mix on surfaces for at least five minutes before wiping it off.

    For more information, talk to your health care provider.

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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    Learn to Age Gracefully

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  • Lost for words? Research shows art therapy brings benefits for mental health

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    Creating art for healing purposes dates back tens of thousands of years, to the practices of First Nations people around the world. Art therapy uses creative processes, primarily visual art such as painting, drawing or sculpture, with a view to improving physical health and emotional wellbeing.

    When people face significant physical or mental ill-health, it can be challenging to put their experiences into words. Art therapists support people to explore and process overwhelming thoughts, feelings and experiences through a reflective art-making process. This is distinct from art classes, which often focus on technical aspects of the artwork, or the aesthetics of the final product.

    Art therapy can be used to support treatment for a wide range of physical and mental health conditions. It has been linked to benefits including improved self-awareness, social connection and emotional regulation, while lowering levels of distress, anxiety and even pain scores.

    In a study published this week in the Journal of Mental Health, we found art therapy was associated with positive outcomes for children and adolescents in a hospital-based mental health unit.

    An option for those who can’t find the words

    While a person’s engagement in talk therapies may sometimes be affected by the nature of their illness, verbal reflection is optional in art therapy.

    Where possible, after finishing an artwork, a person can explore the meaning of their work with the art therapist, translating unspoken symbolic material into verbal reflection.

    However, as the talking component is less central to the therapeutic process, art therapy is an accessible option for people who may not be able to find the words to describe their experiences.

    Art therapy has supported improved mental health outcomes for people who have experienced trauma, people with eating disorders, schizophrenia and dementia, as well as children with autism.

    Art therapy has also been linked to improved outcomes for people with a range of physical health conditions. These include lower levels of anxiety, depression and fatigue among people with cancer, enhanced psychological stability for patients with heart disease, and improved social connection among people who have experienced a traumatic brain injury.

    Art therapy has been associated with improved mood and anxiety levels for patients in hospital, and lower pain, tiredness and depression among palliative care patients.

    A person painting.
    Studies suggest art therapy could support people with a range of health conditions. mojo cp/Shutterstock

    Our research

    Mental ill-health, including among children and young people, presents a major challenge for our society. While most care takes place in the community, a small proportion of young people require care in hospital to ensure their safety.

    In this environment, practices that place even greater restriction, such as seclusion or physical restraint, may be used briefly as a last resort to ensure immediate physical safety. However, these “restrictive practices” are associated with negative effects such as post-traumatic stress for patients and health professionals.

    Worryingly, staff report a lack of alternatives to keep patients safe. However, the elimination of restrictive practices is a major aim of mental health services in Australia and internationally.

    Our research looked at more than six years of data from a child and adolescent mental health hospital ward in Australia. We sought to determine whether there was a reduction in restrictive practices during the periods when art therapy was offered on the unit, compared to times when it was absent.

    We found a clear association between the provision of art therapy and reduced frequency of seclusion, physical restraint and injection of sedatives on the unit.

    We don’t know the precise reason for this. However, art therapy may have lessened levels of severe distress among patients, thereby reducing the risk they would harm themselves or others, and the likelihood of staff using restrictive practices to prevent this.

    A black tree sculpture made of clay, with pink and purple dots in the centre.
    This artwork was described by the young person who made it as a dead tree with new growth, representing a sense of hope emerging as they started to move towards their recovery. Author provided

    That said, hospital admission involves multiple therapeutic interventions including talk-based therapies and medications. Confirming the effect of a therapeutic intervention requires controlled clinical trials where people are randomly assigned one treatment or another.

    Although ours was an observational study, randomised controlled trials support the benefits of art therapy in youth mental health services. For instance, a 2011 hospital-based study showed reduced symptoms of post-traumatic stress disorder among adolescents randomised to trauma-focussed art therapy compared to a “control” arts and crafts group.

    A painting depicting a person crying.
    Artwork made by a young person during an art therapy session in an in-patient mental health unit. Author provided

    What do young people think?

    In previous research we found art therapy was considered by adolescents in hospital-based mental health care to be the most helpful group therapy intervention compared to other talk-based therapy groups and creative activities.

    In research not yet published, we’re speaking with young people to better understand their experiences of art therapy, and why it might reduce distress. One young person accessing art therapy in an acute mental health service shared:

    [Art therapy] is a way of sort of letting out your emotions in a way that doesn’t involve being judged […] It let me release a lot of stuff that was bottling up and stuff that I couldn’t explain through words.

    A promising area

    The burgeoning research showing the benefits of art therapy for both physical and especially mental health highlights the value of creative and innovative approaches to treatment in health care.

    There are opportunities to expand art therapy services in a range of health-care settings. Doing so would enable greater access to art therapy for people with a variety of physical and mental health conditions.

    Sarah Versitano, Academic, Master of Art Therapy Program, Western Sydney University and Iain Perkes, Senior Lecturer, Child and Adolescent Psychiatry, UNSW Sydney

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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