Sport is a regular fixture for most kids around Australia and injuries like concussion can be common. With philanthropic support, researchers have discovered links between the initial injury and mental health problems in young people.
A concussion is a mild form of head injury which can occur when the head gets bumped, causing a short-term change in how the brain works. According to the Murdoch Children’s Research Institute (MCRI), a third of children may experience a head injury before 13 years of age.
Led by MCRI researcher and Monash University PhD candidate Alice Gornall, the research involved a comprehensive literature review of the case studies of 90,000 children across nine countries.
The data revealed that a third of children who had a concussion developed a mental health problem after the incident. Of those children, 36.7 per cent experienced internalised problems such as withdrawing, anxiety, depression and post-traumatic stress. 20 per cent experienced externalised problems such as aggression, attention problems and hyperactivity.
Mental health improvements emerged between three to six months post-injury, with a minority experiencing persistent symptoms for several years afterwards.
“Despite the high incidence of concussion among children and adolescents, identifying those at risk of ongoing difficulties after concussion remains a prominent challenge for clinicians,” said Alice.
“On top of this, children take twice as long to recover from concussion than adults, with one in four children experiencing symptoms beyond one-month post-injury.”
Emma, age 17, has been seeking mental health support after suffering two concussions, a year apart.
In 2019 while playing netball she knocked her head on a goal post and last March she was hit with a ball in the back of the head.
Emma said after the second concussion she developed anxiety, headaches, a sense of hopelessness and had trouble concentrating.
“After my last concussion I found it very hard to be motivated for school and everyday life. Doing the simplest of tasks such as a walk was difficult for me, not being able to complete these tasks got me quite disheartened which impacted on my mental health,” she said.
Emma’s dad Bruce Henry said he welcomed the push for mental health to be part of paediatric concussion assessment and management as many cases would be going untreated.
“When a child has a concussion they might look fine but you can’t see the underlying impact,” he said.
“It’s so important for mental health to form part of concussion management, which has been essential to Emma’s recovery process.”
With the support of the RCH Foundation, MCRI researchers are also trialling an intervention program, Concussion Essentials, to prevent children suffering long term post-concussion symptoms.
The eight session intervention combines physiotherapy and psychology treatments that target presenting symptoms with education around common concerns such as headache, fatigue and return to exercise, school and sports. Early data shows that the intervention is effective in accelerating recovery.
MCRI Professor Vicki Anderson said assessment, prevention and intervention of mental health difficulties after concussion should be integrated into standard concussion management.
“Mental health is central to concussion recovery. Concussion may both precipitate and exacerbate mental health difficulties, impacting delayed recovery and psychosocial outcomes,” she said.
“Incorporating mental health risk into post-injury management represents an opportunity to engage children and adolescents with mental health services to either prevent unnecessary problems emerging or to treat already existing issues.”