Research trends and hot spots of children’s and adolescent mental health education: a bibliometric analysis from 2000 to 2022

Abstract

Purpose:

The purpose of this study is to systematically review the research hotspots and frontiers in the field of international child and adolescent mental health education over the past 22 years. Furthermore, based on the changes in these hotspots, it aims to predict future research directions, providing valuable references for scholars engaged in subsequent research in this field. Methods: Using analytical tools such as CiteSpace, R-Tool, and VOSviewer, a quantitative analysis was conducted on 10,231 research papers in the field of children’s mental health education from the WoSCC database published between 2000 and 2022. Results: The results indicate that mental health problems among children and adolescents have become a global public health issue, with a continuous increase in related research publications over the years. The COVID-19 pandemic has exacerbated mental health problems among children and adolescents during periods of lockdown. The United States is a core research country in this field, and influential journals in this area include "Pediatrics" and "Social Science & Medicine." Ford, Tamsin is an authoritative author in this field. Popular research topics in this field include family education, children with disabilities, and substance abuse. Future research is likely to focus on the impact of physical activity on mental health.

Keywords

Children adolescent mental health visualisation analysis

1 Introduction

The prevalence of behavioral abnormalities and psychological disorders among children and adolescents has been increasing year by year. It has become one of the major factors affecting family well-being and posing a threat to the healthy development of children. Additionally, psychological state plays a dominant role in human behavior, and abnormal psychological states can affect various aspects of children and adolescents’ lives, including their learning and daily activities. According to the "2020 China Youth Development Statistics Report", at least 30 million children and adolescents under the age of 17 in China are troubled by various emotional and behavioral problems. Each year, one quarter of the total number of patients seeking mental or psychological counseling are teenagers [1]. Authoritative data released by the National Institute of Mental Health in the United States shows that about 46% of American teenagers aged 13 to 18 suffer from some form of mental or psychological disorder [2]. A survey report by the World Health Organization (WHO) shows that about 10% to 20% of teenagers worldwide have mental health problems, and the incidence of psychological problems among children and adolescents is on a continuous upward trend worldwide. The probability of mental health problems occurring during childhood and adolescence is as high as 50% [3, 4], with depression and anxiety being the most representative. There are various factors that contribute to psychological abnormalities. Direct factors include congenital defects, abuse, and neglect, while indirect factors include unhealthy lifestyle habits, changes in the social environment, parental conflicts, and substance abuse. Smartphone addiction leads to decreased social interaction, and during the COVID-19 pandemic lockdown, multiple factors such as increased academic pressure, reduced physical activity, and strained family relationships further exacerbate psychological abnormalities among children and adolescents [5, 6].

Childhood and adolescence are the most rapidly developing stages of human physical and mental development. It is another critical period of life development after infancy. During this period, children’s bodily structures, minds, cognition, and emotions will undergo significant changes [7]. In developing and underdeveloped countries, parents may neglect their children’s psychological changes due to work demands. This neglect, combined with accumulating academic pressure, negative emotions, and impaired social relationships, can exacerbate the development of mental health problems. However, providing psychological education to children and adolescents during their early years can enhance their awareness of inner emotional changes, leading them to proactively seek help when feeling down or experiencing negative stimuli. This approach can effectively prevent the occurrence of mental health issues among young people and ultimately reduce the overall incidence of mental health disorders. In existing mental health intervention programs, one representative example is the Mental Health First Aid (MHFA) program conducted in Australia. The MHFA training has been implemented in 25 countries, and multiple studies have demonstrated that adolescents who participate in MHFA training courses can effectively improve their attitudes towards mental illness, enhance their mental health levels, and benefit both themselves and others. This program has significant implications for maintaining mental health [8, 9]. The importance of mental health education lies in its provision of knowledge, skills, and resources about mental health for children and adolescents. It not only helps prevent and alleviate mental health problems but also cultivates positive mental qualities and overall development. Through mental health education, children and adolescents can better understand and manage their emotions and stress, establish healthy interpersonal relationships, develop confidence and self-esteem, cope with challenges, and pursue success.

In the past few decades, researchers have conducted effectiveness evaluations of various types of mental health education programs, including quantitative assessments of their impact on children and adolescents’ mental health knowledge, attitudes, skills, and behaviors [10]. Studies have shown that effective mental health education can significantly improve the mental health levels of children and adolescents and reduce the occurrence of mental health problems. In terms of intervention methods and strategies, researchers have explored various mental health education interventions and strategies, including classroom education, interactive games, psychological counseling, and social skills training [11, 12]. These studies help identify the most effective intervention methods and provide guidance for educators and professionals in practical implementation. With the continuous development of technology, researchers have begun to explore the use of emerging technologies and modern means, such as online platforms, mobile applications, and virtual reality, for children and adolescents’ mental health education [13]. These innovative approaches provide new avenues for the widespread dissemination of mental health education.

CiteSpace, R-Tool, and VOSviewer are scientific visualization tools commonly used in bibliometrics and knowledge network analysis. These tools have found widespread application in various disciplines such as education, psychology, computer science, and fuzzy theory [14, 15]. By integrating mathematics, statistics, and graphics, they provide a comprehensive research approach with a focus on quantitative analysis [16, 17]. The methodology involves filtering and processing a large amount of text using analysis software, which enables the exploration of potential connections among previously published papers and the extraction of latent knowledge value through computational techniques. However, issues related to the mental health of children and adolescents have consistently been subjects of concern and research for governments, psychologists, sociologists, and medical researchers worldwide due to their high prevalence and associated risks. It is worth noting that the search results indicate a gradual increase in the publication of papers in this research field. However, relying solely on manual reading and analysis is time-consuming, labor-intensive, and prone to subjective biases. Literature metrics tools play a crucial role in systematically analyzing valuable information, research hotspots, and development trends within a specific research field. By dynamically visualizing the findings in images, these tools offer data collectors numerous advantages, including high efficiency, ease of understanding, and high reproducibility. Moreover, they contribute to enhancing the analytical efficiency and scientific rigor of researchers when analyzing publicly published research. These tools have versatile applications, particularly in trend detection, identification of authoritative scholars, and the advancement of disciplinary development [18, 19]. With this in mind, the present study utilized visualization software to conduct a quantitative analysis of publications on child and adolescent mental health education research spanning from 2000 to 2022. The primary objectives were to systematically review the research frontiers in this field, assess the overall landscape of child and adolescent mental health education, and provide valuable references for future research.

2 Materials and methods

2.1 Data sources

This study analyzed text data from the Web of Science Core Collection (WoSCC), the most comprehensive database for published research. In WoSCC, TS represents the topic sentence. The search formula used in this study was “TS=children, child, adolescence, adolescent, teenager, youth And TS=mental health education, mental healthy education, psychological health education, psychologically healthy education, psychological healthy education”. The search period was from Janua, ry 1st, 2000 to December 31st, 2022. Only articles and reviews were selected as article types, and the language was limited to English. A total of 10730 articles were collected. According to the search formula on WoSCC, the results were exported as txt and CSV format text files. The search was completed on March 1st, 2023, to prevent data bias caused by database updates. Finally, the obtained data was imported into CiteSpace software to remove duplicate publications, leaving 10231 studies for quantitative analysis. The study design process is illustrated in Fig. 1.

Fig. 1

Flow chart of the study design

2.2 Data analysis and visualisation

CiteSpace, developed by Dr. Chaomei Chen from Drexel University in the United States, is a scientific literature analysis tool. For this study, CiteSpace version 6.1.R2 was used, with analytical functions that include national distribution and collaboration, centrality calculation, journal dual-map overlay, institutional distribution, subject area distribution, keyword timeline visualization, reference cooperation, and burst detection [20]. VOSviewer, developed by Nees Jan van Eck and Ludo Waltman, is commonly used for network analysis in bibliometrics. For this study, VOSviewer version 1.6.19 was used, with analytical functions that include national distribution, institutional distribution, author distribution and collaboration, and keyword co-occurrence [21]. Finally, the strategic coordinate plot was drawn using the Bibliometrix tool package in R-Studio’s R-Tool. In this study, the three tools mentioned above were used to analyze the annual publication quantity, growth trends, co-occurring clusters of keywords, and keywords with explosive citation frequency growth over time in the field of children and adolescent mental health education. These analyses were conducted to identify research hotspots and future research priorities.

3 Results

3.1 Annual volume of publications

Figure 2 illustrates the annual publication trend in the field of children and adolescent mental health education from 2000 to 2022. As shown in Fig. 2, the overall research output presents an increasing trend, which can be divided into three stages. The ① stage is the stage of stable development (2000-2009), with a total of 1257 publications in 10 years. The ② stage is the stage of rapid development (2010-2017), with 3066 publications in 8 years, which is 2.44 times that of the first stage. The ③ stage is the stage of research explosion (2018-2022), with 5908 publications in 5 years, which is 4.70 times that of the first stage. The citation frequency of related studies has increased year by year, particularly during the COVID-19 pandemic, the number of publications and citations has shown an explosive growth. The difference in the number of publications and citation frequency among the three stages may be due to various factors such as economic conditions, global population, parental attention, knowledge dissemination speed, scholars’ appeals, and global public health problems.

Fig. 2

Trend chart of annual publication and citations volume (2000-2022).

3.2 Leading countries distribution

Figures 4 depict the geographical distribution of the 149 countries/regions currently involved in CAMHE research, which is mainly concentrated in the northern hemisphere. It is noteworthy that collaborations among countries/regions are primarily concentrated between North America and Europe, North America and Oceania, and North America and East Asia, indicating close ties and collaboration between these regions. Table 1 and Fig. 3 display the top 10 countries/regions in terms of the number of publications, citation frequency, and centrality. A high centrality weight (≥0.1) implies a unique contribution by a country in the field of children’s mental health education research [22]. The United States has the highest number of CAMHE research publications (2948), accounting for 28.81% of the total research, followed by England (971) and Australia (778), which account for 9.49% and 7.60% of the total research, respectively. In the last 22 years, research publications from the United States have been cited the most (129493), followed by England (33928), and both countries have centrality values above 0.1.

Fig. 3

Trend chart of annual publication and citations volume (2000-2022).

Fig. 4

Frequency of country/region cooperation.

Table 1

Top 10 countries/regions in terms of number of publications, the corresponding frequency of citations and centrality

Rank	Countries/regions	Publications	Citations	Centrality
1	USA	2948	129493	0.23
2	England	971	39928	0.14
3	Australia	778	25105	0.10
4	Canada	628	19454	0.09
5	China	557	9238	0.01
6	Spain	245	6735	0.07
7	Germany	242	11021	0.07
8	Norway	225	5043	0.06
9	Netherlands	225	10437	0.05
10	Sweden	221	7555	0.04

3.3 Leading institutions

Each node in Figures 6 represents a research institution, with the size of the node representing the number of papers published and cited by the institution in the field of CAMHE. These highly productive research institutions are the authoritative figures in the field, serving as the hubs for knowledge creation and dissemination in the domain of CAMHE. Understanding these major research institutions is crucial for selecting research collaboration partners, visiting scholars, and tracking the focus of international cutting-edge research institutions in the field of children and adolescent mental health education. This study analyzed institutions that have published over 15 papers in the past 22 years, resulting in 296 nodes and 7 clusters. Cluster 1 comprises 120 research institutions, including high-impact institutions such as the University of Wisconsin, Harvard University, the University of North Carolina, Johns Hopkins University, and the University of Washington. These institutions primarily focus on interventions for children with autism, the psychological and emotional changes in foster children, the impact of adverse childhood experiences on behavior, socioeconomic status and the mental health of children and adolescents, and psychological therapy for mental health. Understanding these leading research institutions is crucial for researchers to select collaborative partners, conduct academic visits, and keep up-to-date with international research developments in child and adolescent mental health education. Cluster 2 covered 52 research institutions, with highly cited institutions including King’s College London, University College London, Cambridge University, and University of Exeter. The research institutions in cluster 2 mainly focused on interventions for the psychological and behavioral well-being of children with autism, the influence of family and social support on adolescent mental health, prevention of mental illness in children and adolescents, and the impact of parental behavior on the psychological health and behavior of their children. Cluster 3 included 37 research institutions, with highly cited institutions such as Karolinska Institute, University of Helsinki, and Stockholm University. The research institutions in cluster 3 mainly focused on the impact of physical activity on the mental health of children and adolescents, on-campus mental health education programs, the use of mental health services among children and adolescents, and intervention methods for improving the psychological well-being of children and adolescents. Cluster 4 covered 32 research institutions, with highly cited institutions such as the University of Melbourne, University of Queensland, and Murdoch Children’s Research Institute. The research institutions in cluster 4 mainly focused on the psychological state of children and adolescents with disabilities, the influence of exercise habits on mental health, the relationship between family and child/adolescent mental health, and prevention of mental illness in children and adolescents. Cluster 5 included 25 research institutions, with highly cited institutions such as Utrecht University, University of Groningen, and University of Amsterdam. The research institutions in cluster 5 mainly focused on the psychological well-being of children with autism, mental health services for children and adolescents, the impact of socioeconomic status on mental health, and case studies of intervention measures for improving the psychological well-being of children and adolescents. Cluster 6 covered 24 research institutions, including the University of Toronto, University of British Columbia, and Dalhousie University. The research institutions in cluster 6 mainly focused on the relationship between physical activity and adolescent mental health, the trajectory of mental health changes from adolescence to adulthood, the impact of internet and social media use on children and adolescent mental health, and changes in psychological status before and after starting school. Cluster 7 consisted of only six research institutions, including Tehran University of Medical Sciences and Islamic Azad University, with research primarily focused on pharmacotherapy for mental health.

Fig. 5

Collaborative network visualization of Institutions in VOSviewer.

Fig. 6

Collaborative network visualization of Institutions citations in VOSviewer.

Table 2 displays the number of publications and the top ten institutions ranked by citation frequency of the core research institutions. Among the most frequently cited institutions in the field of children and adolescent mental health education, Carolina University (9033) is the most cited, followed by Harvard University (7377) and Columbia University (6864). It is noteworthy that nine of the top 10 most frequently cited institutions are located in the United States and are concentrated in Cluster 1. This suggests that US research institutions have an absolute dominance in the field of children and adolescent mental health education, which may reflect the prominent issue of children and adolescent mental health in the US.

Table 2

Top 10 Cited Institutions

Rank	Institution	Citations	Publications
1	Carolina University	9033	129
2	Harvard University	7377	109
3	Columbia University	6864	167
4	University of Wisconsin	6746	75
5	Johns Hopkins University	6546	104
6	Melbourne University	5936	216
7	University of Minnesota System	5388	82
8	Arizona State University	5306	36
9	Washington University	5244	57
10	University of Pennsylvania	5158	108

3.4 Distribution of high-cited authors

Publication of papers is an essential indicator for evaluating research activities, and Price law is commonly used in bibliometrics to determine the minimum number of publications required to identify core authors [23]. This serves as an important reference for determining potential candidates for core authorship. The formula for determining core research authors is $N = 0.749 \sqrt{η_{max}}$ , where η_max = 216, after calculation and rounding, it has been determined that authors who have published 11 or more papers in the field of children and adolescent mental health education in the past 22 years are considered core researchers in this field. A total of 39,288 research authors were included in the analysis (Fig. 7), of which 24 were selected as core research authors, with the top 10 ranked authors listed in Table 3.

Fig. 7

Collaborative network visualization of authors in VOSviewer.

Table 3

Institutions ranked by number of publications and citations

Rank	Institution	Authors	Citations	Publications
1	University of Exeter	Ford, Tamsin.	1185	32
2	University of Bergen	Hysing, Mari.	456	18
3	Washington University	Lyon, Aaron R.	273	17
4	Norwegian Institute of	Sivertsen, Borge.	334	15
	Public Health
5	Charles R. Drew University	Assari, Shervin.	392	15
6	of Medicine and Science
7	Newcastle University	Lubans, David R.	1133	14
8	Erasmus Universiteit	Raat, Hein	233	14
10	Rotterdam	Reijneveld, Sijmen A.	298	14
	Stockholm University	Hjern, Anders	311	14

3.5 Distribution of journals

Over the past 22 years, a total of 10,231 studies on child and adolescent mental health education were published in 1,978 journals. As shown in Fig. 8, the distribution of contributions from the most important journals follows Bradford’s Law of Scattering [24]. To provide a more representative description of these highly influential journals, Table 4 presents the top ten ranked journals, which collectively published 1463 articles (14.30% of all publications in our bibliometric study). As expected, most research in the field of child and adolescent mental health education is published in renowned psychology or public health journals. Furthermore, the top three journals in the ranking published 48.19% of the articles listed in the table. According to the analysis of journal citation frequencies, the top 10 journals were cited a total of 31,267 times, and the research published in Pediatrics and Social Science & Medicine had the greatest impact, being cited 17,098 times, which accounts for 54.68% of the total citations.

Fig. 8

Analysis of collaborative network visualization of journals in VOSviewer.

Table 4

Institutions ranked by number of publications and citations

Rank	Journal	Publications	Citations	IF ( JCR 2021)	JCR quartile
1	International Journal of Environmental Research and Public Health	321	2473	4.614	Q2
2	BMC Public Health	206	3952	4.135	Q2
3	Children and Youth Services Review	178	2719	2.519	Q2
4	Frontiers in Psychology	145	1644	4.232	Q1
5	Pediatrics	134	12051	9.703	Q1
6	BMJ Open	133	1373	3.007	Q2
7	Social Science & Medicine	92	5048	5.379	Q2
8	Frontiers in Psychiatry	90	665	5.435	Q2
9	Journal of Adolescent Health	90	2840	7.898	Q1
10	Journal of Child and Family Studies	74	1221	2.784	Q2

3.6 Keyword analysis

The frequency of a word’s occurrence can reflect the hot topics within a research field. With a time slice set at 2, keywords with a frequency of ≥10 are used to create a Core Keyword Co-occurrence Map (Fig. 9) and a Timeline Map of Keyword Literature (Fig. 10). Table 5 lists the top 20 keywords ranked by frequency. The most commonly appearing keywords are "children" (2463) and "mental health" (2282). Noteworthy, "Covid-19" appears at the bottom of the list, indicating the significant impact of the pandemic on the mental health of children and adolescents. The co-occurrence network of these keywords is presented in Fig. 9, where the connecting lines between different keywords indicate their co-occurrence relationships. The keywords are categorized into six major clusters based on their research directions. The blue cluster includes keywords related to adolescent depression and anxiety. The red cluster includes keywords related to early prevention and intervention for children’s mental health. The purple cluster includes keywords related to experimental research and empirical summaries. The yellow cluster includes keywords related to disabled children and adolescents and daily behavior. The green cluster includes keywords related to drug abuse and living environment. Finally, the orange cluster includes keywords related to psychological symptoms.

Fig. 9

Core keyword co-occurrence map.

Fig. 10

Timeline map of keyword literature.

Table 5

Top 20 keywords in terms of frequency of occurrence and the corresponding total link strength

Rank	Keyword	Occurrences	Total link strength
1	Children	2463	19068
2	Mental Health	2282	18146
3	Adolescents	2055	16741
4	Education	1521	11907
5	Depression	1237	10704
6	Prevalence	1027	8539
7	Risk	692	5450
8	Impact	679	5278
9	Disorders	631	5367
10	Stress	615	5007
11	Anxiety	563	4854
12	Behavior	552	4567
13	Intervention	536	4510
14	Students	524	4225
15	Family	475	3825
16	School	455	3855
17	Childhood	436	3721
18	Prevention	399	3291
19	Parents	347	2825
20	Covid-19	325	2112

In CiteSpace, the timeline graph displays the most frequently occurring keywords for each cluster over time [25], to some extent reflecting changes in research hotspots and content. The graph formed 12 effective clusters (Fig. 10), which are #1 Refugee Children, #2 Mental Health Stigma, #3 Depression Literacy, #4 Physical Activity, #5 Sexual Orientation, #6 Adoptive Parent, #7 Domestic Violence, #8 Child Development, #9 Parental Education, #10 Intellectual Disability, #11 Being Neet, and #12 Cannabis Use. Among them, the clusters that have attracted the most attention are #1 Refugee Children, #2 Mental Health Stigma, #8 Child Development, #9 Parental Education, #10 Intellectual Disability, #11 Being Neet, and #12 Cannabis Use.

#1 Refugee Children, with main keywords such as prevalence, intervention, trauma, discrimination, and posttraumatic stress disorder, focuses on the changes in psychological health of refugee children. Studies have shown that refugee children and adolescents experience multiple adverse factors in their growth process, which put them at greater risk in education and employment, affecting their psychological health and well-being. When providing psychological health assistance to refugee children and adolescents, doctors need to understand their social experiences, educational backgrounds, and possible past psychological issues as much as possiblel [26, 27]. #2 Mental health stigma, the main keywords include depression, risk, health education, adolescent health, educational attainment, etc. This cluster of research mainly focuses on the psychological issues of patients with infectious and mental illnesses. Research suggests that the stigma associated with mental illness or infectious diseases may prevent children and adolescents from seeking help for mental and emotional distress, and may also make them more isolated as they face rejection from peers [28]. Accurate education on mental health knowledge and proactive response to existing psychological issues are necessary methods to combat stigma [29]. #8 Child development, the main keywords include outcome, mental health service, help seeking, and mental health literacy. This cluster focuses on the developmental trajectory of children. Research suggests that parents’ behavior can influence their children’s mental health, parenting can affect adolescent physical health, and parental mental illness can increase the risk of future illness in children [30]. Intergenerational transmission of mental disorders can affect the overall development of children [31]. #9 Parental Education, the main keywords include health, socioeconomic status, mental disorder, risk factor, etc. This cluster mainly focuses on the impact of parents on their children’s mental health. Studies have shown that early psychological education for children has multiple benefits, however, children of parents with lower educational levels have more psychological problems, and children of mothers with lower educational levels should be regarded as a high-risk group that needs attention [32]. #10 Intellectual Disability, the main keywords include developmental disability, perspective, community, schizophrenia, etc. This cluster focuses on the mental health of children and adolescents with disabilities. Research suggests that children with intellectual or physical disabilities are more likely to experience mental health problems due to their physical limitations. However, with an increase in education, the impact of disabilities on mental health can be mitigated [33]. #11 Being Neet (not in education, employment or training), the main keywords include unemployment, foster care, income, special education, etc. This clustering study mainly focuses on young people with low education levels and no vocational training. Research shows that young people classified as NEET may be out of the labor market for a long time and are more likely to have mental disorders, drug abuse, and alcohol addiction [35, 36]. #12 Cannabis Use, the main keywords include young people, substance use, disability, drug use, alcohol, and this cluster study mainly focuses on drug use and delinquent behavior in adolescents during puberty. Studies have shown that puberty is a critical transitional period, where leaving high school education may increase the use of drugs and alcohol due to exposure to family violence, peer influence, and negative environmental influences [36, 37].

3.7 Analysis of research hotspots

The burst of keywords provides evidence of a sudden increase in the frequency of a specific keyword, indicating that a potential topic has attracted unusual attention from researchers during a specific period [38]. Importing 10,231 records of literature for analysis in CiteSpace, with the minimum duration of burst units set to 2, a total of 20 burst keywords were obtained (Table 6). The burst strength of the keyword "psychiatric disorder” was the highest at 37.29 and also had the longest duration. According to the association analysis of burst keywords, the causes of childhood psychiatric disorders are diverse, and the mental health status is closely related to family happiness and happiness index [39]. However, this thorny issue seems to have no particularly good solution, and can only be prevented by popularizing mental health knowledge in families, schools, and communities and creating a good social environment to prevent the occurrence of bad behaviors. Recently emerged keywords in the past 3 years may be potential research hotspots, mainly including "physical education," "trauma," and "Covid-19." The most direct benefit of physical activity is to promote physical health and enhance cardiovascular and pulmonary functions. Engaging in team sports can also promote social interaction and increase confidence, thus positively promoting mental health. It is worth noting that the promotion of mental health through exercise has been a hot topic in sports science research in recent years, and multiple intervention plans should be provided when educating children on mental health. There is a strong association between trauma and Covid-19. During the Covid-19 pandemic, the mandatory lockdown led to a series of complex social and psychological pressures and mental health problems among young people. In addition, poverty, social and economic differences, and resource inequalities during the pandemic have led to a "double blow" to vulnerable groups and people who previously had or were susceptible to mental illness [40]. However, with the vaccination and reopening of countries, Covid-19 will gradually leave people’s vision, and the impact of Covid-19 on the mental health of children and adolescents will also fade over time.

Table 6
Top 20 keywords with strongest citation bursts in MHECA publications

Thematic analysis is based on clusters of authors’ keywords and their interconnections to obtain themes. The first quadrant (Q1) represents the driving themes that focus on the current hot research areas. The second quadrant (Q2) represents very specialized themes, where the research achievements in this field are more mature. The thirdquadrant (Q3) represents marginal themes, which are emerging or about to disappear research areas. The fourth quadrant (Q4) represents fundamental themes, which generally refer to basic concepts [41]. In Fig. 8A, we provide a thematic map of the field of children and adolescent mental health education, which is divided into four quadrants (Q1 to Q4). From Fig. 11, it can be observed that anxiety, COVID-19, and quality of life are located in Q1, focusing on recent hot research topics. In some countries and regions, the implementation of lockdown measures during the COVID-19 pandemic has placed a significant burden on them. The pandemic has led to worsened health behaviors, increased levels of mental health problems, and higher anxiety levels, severely impacting the quality of life for children [42, 43]. "Education" and "risk factors" in Q4 are fundamental themes, emphasizing the importance of education for children’s mental health and highlighting the screening of risk factors related to psychological abnormalities. The themes in Q2, namely "stress," "intervention," "social support," and "suicide," are closely related to children and adolescents in various countries. They are common problems faced by families, schools, and government agencies. Factors such as work pressure, expectations, misconduct, and economic disparities contribute to multiple stressors experienced by children. Improving family relationships, gaining friends, and receiving social support can help alleviate distress and enhance positive emotions [44, 45]. The themes in Q3, including "adolescent," "prevention," "pregnancy," and "parents," seem to be fading. Based on previous research in educational psychology, experts have repeatedly called for more attention to be given to children. Additionally, parents are increasingly concerned about their children’s misconduct, advocating for early intervention and correction of psychological abnormalities [46].

Fig. 11

Mental health education for children and adolescents thematic map.

4 Research perspectives

4.1 Promoting collaborative exchanges among research institutions

In future research, it is necessary to strengthen dialogue and cooperation among different countries, regions, and organizations to promote the development of research. From the research results, there are differences in research topics, methods, and pace among different research institutions, and the reasons for these differences are diverse. In this process, it is necessary to draw the attention of relevant researchers and balance and reduce the problems that may arise in this regard. Good cooperation and communication will provide a global think tank for the development of global children’s mental health education, bringing together research resources and hotspots from different regions and contributing to its development through collective wisdom.

4.2 Focus on emerging research hotspots

With the changing times, new issues and perspectives in children’s mental health education continue to emerge, which are closely related to the zeitgeist, such as the COVID-19 pandemic and children’s mental health education. Researchers must pay full attention to the emergence of new research hotspots. Systematically consider the relationship between them and the development of the times, and seek solutions to the current situation of children’s mental health education from a specific era. Moreover, the emergence of a research hotspot is likely to be a key topic for discussion in the coming years, which will have an important impact on the development of children’s mental health education. From a preventative perspective, it is extremely importantfor the research field to move its focus forward and for research institutions and personnel to be sensitive.

4.3 Strengthening basic research theory

Basic research theory is the foundation of all research, and fundamental theoretical research can provide more perspectives for relevant research. In future research, while paying attention to emerging research issues, it is necessary to strengthen basic theoretical research, inject new blood into it, and demonstrate the development of basic theory, so as to continuously empower the research topic. In particular, for the concept research of children’s mental health education, with the changes of the times, people’s cognitive level will also be constantly adjusted, and the correctness of cognition is the core issue of the entire research field, which is crucial for the development of the entire research field.

4.4 Highlighting distinctive research themes

Research has found that different research countries and institutions have different research topics and areas of focus, showing the humanistic color of research. Due to different environments, the problems that emerge in children’s mental health are also different. Research is conducted to better serve practical purposes, and from this perspective, different regions should conduct specific discussions on outstanding issues related to children’s mental health education in their own areas, analyze in-depth the coupling and mechanisms between the regional and personal issues of children’s mental health education (political, economic, cultural, racial, etc.), and at the same time provide targeted solutions for the world to prevent the global spread of such problems in children’s mental health education.

4.5 Bringing together multiple research efforts

Until now, children’s mental health education has increasingly become a global hot topic. Children’s mental health development must be fully considered, and with the continuous differentiation of issues in this field, the integration of research resources is particularly crucial. In terms of families, it is necessary to create a harmonious and relaxed family atmosphere from an early age, provide conditions for children’s mental health development, and parents need to pay attention to and observe the psychological issues of children’s growth, provide timely feedback and analysis, form an alliance organization with schools, society, and other institutions, and give early intervention to psychological and behavioral abnormalities; schools and society need to establish relevant organizations, set up relevant personnel and teams, and regularlycollect and guide children’s mental health problems. At the same time, relevant measures should be taken to prevent the occurrence of violence, drugs, sexual promiscuity, smoking, and alcohol consumption in schools, reduce the risk of mental health problems among students on campus, and pay attention to the psychological counseling of special groups of children. More care should be given to special groups of children such as left-behind children and disabled children. In addition to the linkage between family, school, and society, it is also necessary to have policy and regulatory guidance, participation of relevant hospital professionals, and reshaping of the psychological micro-environment for special groups. Meanwhile, it is also necessary to have specialized university and faculty construction for this purpose.

5 Discussion and conclusion

This study conducted a comprehensive investigation of the field of international mental health education for children and adolescents over the past 22 years using bibliometric analysis. Based on the increasing number of published studies over the years, it is evident that the issue of mental health education for children and adolescents has received attention from multiple countries, with a particular emphasis on mental health problems during the pandemic. Studies published from 2020 to 2022 accounted for 40.40% of the total research. Furthermore, children and adolescents in developed countries, led by the United States, face various external factors that contribute to mental health issues, such as substance abuse, bullying, and alcohol consumption, which can lead to abnormal behaviors or excessive stress among some children. Parents and schools should strengthen guidance and take preventive measures to address these external factors and prevent blind idolization and the pursuit of thrill-seeking behaviors. The collaboration between family education and school intervention is crucial for promoting the mental health of children and adolescents.

The main research institutions and highly cited scholars are predominantly located in developed countries such as the United States and Europe, indicating that scholars in these countries have long recognized the severity of mental health issues among children and adolescents. However, negative mental states such as anxiety, depression, and even suicidal behavior remain high, suggesting that the implementation of relevant measures or policies has encountered obstacles. This may be closely related to the local social and cultural background, parental education level, race, and religious beliefs.

Physical activity is not only crucial for mental health but also enhances metabolism, strengthens cardiovascular function, and promotes skeletal health. The long-term benefits of regular physical activity on the body are well-known. Researchers are now shifting their focus towards the short-term effects of 24-hour physical activity on both physical and mental well-being. They use accelerometers or other wearable devices to monitor the duration and intensity of physical activity, as well as sleep patterns, within a 24-hour period. Studies have reported a correlation between meeting recommended levels of physical activity and better mental health [47]. Due to the low cost of physical activities and their multiple benefits for physical, mental, and psychological health, it is possible for them to become a key focus of future research. In this study, we used three text analysis tools to review the trends, hotspots, and frontiers of research on children and adolescent mental health education over the past 22 years. The study found that children and adolescent mental health issues have become a global public health problem, and related research publications have been increasing year by year. The COVID-19 pandemic has exacerbated mental health problems among children and adolescents. The United States is the core research country in this field, and Pediatrics and Social Science & Medicine are influential journals. Ford, Tamsin is an authoritative author in this field. Family education, disabled children, and drug abuse are hot topics in this field. The influence of physical activity on mental health may be a future research focus.

Finally, this study is the first to use bibliometrics to analyze research on children and adolescents’ mental health education over the past 22 years. However, this study inevitably has some limitations. First, the data used in this study only came from the WOSCC database and did not include data from other databases. Second, due to language limitations, this study only analyzed English texts, and it cannot be ruled out that there are high-quality studies in other languages. Lastly, a total of 10,730 records were retrieved in this study, and a significant amount of time and effort were invested in data cleaning. However, due to the large volume of data, we cannot guarantee that errors or omissions of references did not occur during the cleaning process. Considering the limitations of the current research methods, it is recommended to incorporate multiple methods in future studies. The adoption of a combined approach of quantitative and qualitative analysis is advocated, which involves a comprehensive analysis of the presented data, reviewing, summarizing, and providing prospects regarding the factors, current status, and future developments of data origins. In future research, it is necessary to further strengthen the integration of cross-sectional surveys and longitudinal tracking studies for a specific cluster of research. This will help establish an integrated research framework and better analyze the causes and consequences of the evolutionary process of a particular cluster, in order to provide more accurate strategies for addressing it.

References

Liang Feng , Hu Lei and Shen Qingmin , Study on the promotion ofphysical exercise to adolescentmental health education under publichealth emergencies, Journal of Chongqing University ofTechnology (Social Science) 37(02) (2023), 130–136. doi: 10.3969/i.issn.1674-8425(s).2023.02.012.

Bitsko

R.H.

, Claussen

A.H.

, Lichstein

, Black

L.I.

, Jones

S.E.

, Danielson

M.L.

, Hoenig

J.M.

, Davis Jack

S.P.

, Brody

D.J.

, Gyawali

, Maenner

M.J.

, Warner

, Holland

K.M.

, Perou

, Crosby

A.E.

, Blumberg

S.J.

, Avenevoli

, Kaminski

J.W.

, Ghandour

R.M.

and Contributor, Mental Health Surveillance Among Children –United States, 2013-2019, MMWR Supplements 71(2) (2022), 1–42.

World Health Organization. Adolescent Mental Health. 2018. Available from; https://www.who.int/news-room/fact-sheetsdetail/adolescent-mental-health

World Health Organization. Adolescent Mental Health, 2020.Available from; https://www.who.intnews-roomfact-shets/detail/adolescent-mental-health.

Jean Twenge

, Thomas Joiner

, Megan Rogers

and Gabrielle Martin

, Increases in Depressive Symptoms, Suicide-Related Outcomes, and Suicide Rates Among U.S. Adolescents After and Links to Increased New Media Screen Time, Clinical Psychological Science 6(1) (2017), 3–17.

Fancourt

, Steptoe

and Bu

, Trajectories of anxiety and depressive symptoms during enforced isolation due to COVID-19 in England: a longitudinal observational study, The lancet. Psychiatry 8(2) (2021), 141–149.

Sawyer

S.M.

, Afifi

R.A.

, Bearinger

L.H.

, Blakemore

S.J.

, Dick

, Ezeh

A.C.

and Patton

G.C.

, Adolescence: a foundation for futurehealth, Lancet (London, England) 379(9826) (2012), 1630–1640.

Mohammadi

A.S.

, Panahi

, Sayarifard

and Ashouri

, Identifying the prerequisites, facilitators, and barriers in improving adolescents’ mental health literacy interventions: A systematic review, Journal of Education and Health Promotion 9(1) (2020), 322.

Kitchener

B.A.

and Jorm

A.F.

, Mental health first aid training for the public: evaluation of effects on knowledge, attitudes and helping behavior, BMC Psychiatry (2002), 2.

10.

Lilingling , Online mental health education teaching mode andempirical research based on Artificial intelligence, Journal ofIntelligent & Fuzzy Systems 40(2) (2021), 3467–3476.

11.

, The relationship between psychological quality education and mental health level of college students by educational psychology, Frontiers in Psychology (2022), 13.

12.

and Liu

, Intervention effect of the video health education model based on solution-focused theory on adolescents’ mental health during the COVID-19 pandemic, Iran J Public Health 50(11) (2021), 2202–2210.

13.

Verma

, Bhardwaj

, Aledavood

, De Choudhury

and Kumar

, Examining the impact of sharing COVID-19 misinformation online onmental health, Sci Rep 12(1) (2022).

14.

Wang

and Lv

, Hot topics and evolution of frontier research inearly education: a bibliometric mapping of the research literature (2001–2020), Sustainability 13(16) (2021), 9216.

15.

Yu Dejian , Xu Zehui and Wang Wanru , Bibliometric analysis of fuzzy theory research in china: a 30-year perspective, Knowledge-Based Systems 141 (2018), 188–199.

16.

Yu Dejian , Xu Zehui and Hamido Fujita , Bibliometric analysis on the evolution of applied intelligence, Applied Intelligence 49(2) (2019), 449–462.

17.

He Xiaorong , Wu Yingyu , Yu Dejian and Jose Merigo

, Exploring the ordered weighted averaging operator knowledge domain: a bibliometric analysis, International Journal of Intelligent Systems 32(11) (2017), 1151–1166.

18.

Zhu

, Shi

, Wang

, Cui

, Wang

, Tang

, Qian

, Wei

, Wang

, Zhou

and Xu

, Global research trends on in fertility and psychology from the past two decades: a bibliometric and visualized study, Frontiers in Endocrinology 13 (2022), 889845.

19.

Rashid

, Li

, Feng

, Ahmad

, Getaneh

, Yu

, Hu

, Abidi

S.H.

and Shao

, HIV-1 genetic diversity a challenge for AIDS vaccine development: a retrospective bibliometric analysis, Human Vaccines & Immunotherapeutics 18(1) (2022), 2014733.

20.

Chen

C.M.

, Citespace ii: detecting and visualizing emerging trendsand transient patterns in scientific literature, Journal of theAmerican Society for Information Science and Technology 57(3) (2006), 359–377.

21.

Nees Jan van Eck and Ludo Waltman , Software survey: VOS viewer, a computer program for bibliometric mapping, Scientometrics 84(2) (2010), 523–538.

22.

, Zheng

J.J.

, Wu

, Gao

and Liu

C.J.

, Postural control of Parkinson’s disease: A visualized analysis based on Citespace knowledge graph, Frontiers in Aging Neuroscience 15(2023), 1136177.

23.

De Solla Price

D.J.

, Networks of scientific papers, Science 149 (1965), 510–515.

24.

Brookes

B.C.

, Bradford’s law and the bibliography of science, Nature 224 (1969), 953–6.

25.

Wan

, Shen

, Ouyang

, Dong

, Hong

, Liang

and Liu

, Bibliometric and visual analysis of neutrophil extracellular trapsfrom 2004 to 2022, Frontiers in Immunology 13 (2022), 1025861.

26.

Ziaian Tahereh , de Anstiss Helena , Puvimanasinghe Teresa and Miller Emily , Refugee Students’ Psychological Wellbeing and Experiences inthe Australian Education System: A Mixed-methods Investigation, Australian Psychologist 53(4) (2017), 345–354.

27.

Mace Ariel Olivia , Mulheron Shani , Jones Caleb and Cherian Sarah , Educational, developmental and psychological outcomes of resettled refugee children in Western Australia: A review of School of Special Educational Needs: Medical and Mental Health input, Journal of Paediatrics and Child Health 50(12) (2014), 985–992.

28.

Bulanda

J.J.

, Bruhn

, Byro-Johnson

and Zentmyer

, Addressing mental health stigma among young adolescents: evaluation of ayouth-led approach, Health & Social Work 39(2) (2014), 73–80.

29.

Anita Chandra and Cynthia Minkovitz

, Factors that Influence Mental Health Stigma Among 8th Grade Adolescents, Journal of Youth and Adolescence 36(6) (2007), 763–774.

30.

Seum

, Meyrose

A.K.

, Rabel

, Schienkiewitz

and Ravens-Sieberer

, Pathways of parental education on children’s andadolescent’s body mass index: the mediating roles of behavioral andpsychological factors, Frontiers in Public Health 10(2022), 763789.

31.

Christiansen

, Anding

, Schrott

and Rãuhrle

, Children of mentally ill parents-a pilot study of a groupintervention program, Frontiers in Psychology 6 (2015), 1494.

32.

Meyrose Ann-Katrin , Klasen Fionna , Otto Christiane , GniewoszGabriela , Lampert Thomas and Ravens-Sieberer Ulrike , Benefits of maternal education for mental health trajectories across childhood and adolescence, Social Science & Medicine 202 (2018), 170–178.

33.

Mandemakers

J.J.

and Monden

C.W.S.

, Does education buffer the impact of disability on psychological distress?, Social Science & Medicine 71(2) (2010), 288–297.

34.

Benjet

, Hernãandez-Montoya

, Borges

, Mãl’ndez

, Medina-Mora

M.E.

and Aguilar-Gaxiola

, Youth whoneither study nor work: mental health, education and employment, Salud publica de Mexico 54(4) (2012), 410–417.

35.

Goldman-Mellor

, Caspi

, Arseneault

, Ajala

, Ambler

, Danese

, Fisher

, Hucker,

, Odgers

, Williams

, Wong

and Moffitt

T.E.

, Committed to work but vulnerable: self-perceptions and mental health in NEET 18-year olds from a contemporary British cohort, Journal of Child Psychology and Psychiatry, and Allied Disciplines 57(2) (2016), 196–203.

36.

Holmila Marja , Raitasalo Kirsimarja and Kosola Mikko , Mothers who abuse alcohol and drugs: Health and social harms among substance-abusing mothers of small children in three child cohorts, Nordic Studies on Alcohol and Drugs 30(5) (2013), 361–373.

37.

Jãd’ãd’skelãd’inen

, Holmila

, Notkola

I.L.

and Raitasalo

, Mental disorders and harmful substance use in children ofsubstance abusing parents: A longitudinal register-based study on acomplete birth cohort born in, Drug and Alcohol Review 35(6) (2016), 728–740.

38.

Li Xiao , Wu Peng , Shen Geoffrey Qiping , Wang Xiangyu and Teng Yue , Mapping the knowledge domains of Building Information Modeling (BIM): A bibliometric approach, Automation in Construction 84 (2017), 195–206.

39.

Nitka

, Richter

, Parzer

, Resch

and Henze

, Health-related quality of life among adolescents: A comparison between subjects at ultra-high risk for psychosis and healthy controls, Psychiatry Research 235 (2016), 110–115.

40.

Mahapatra

and Sharma

, Case series associated with COVID-19pandemic in causing psychiatric morbidity, General Psychiatry 34(1) (2021), e100343.

41.

Friday Joseph Agbo , Solomon Sunday Oyelere , Jarkko Suhonen and Markku Tukiainen , Scientific production and thematic breakthroughsin smart learning environments: a bibliometric analysis, SmartLearning Environments (8) (2021), 1.

42.

Ravens-Sieberer

, Kaman

, Erhart

, Devine

, Schlack

and Otto

, Impact of the COVID-19 pandemic on quality of life and mental health in children and adolescents in Germany, European Child & Adolescent Psychiatry 31(6) (2022), 879–889.

43.

Ravens-Sieberer

, Kaman

, Otto

, Adedeji

, Napp

A.K.

, Becker

, Blanck-Stellmacher

, Lãűffler

, Schlack

, ãűlling

H.H

, Devine

, Erhart

and Hurrelmann

, Seelische Gesundheit und psychische Belastungen von Kindern und Jugendlichenin der ersten Welle der COVID-19-Pandemie âAŞ Ergebnisseder COPSY-Studie [Mental health and psychological burden of childrenand adolescents during the first wave of the COVID-19pandemic-results of the COPSY study]. Bundesgesundheitsblatt,Gesundheitsforschung, Gesundheitsschutz 64(12) (2021), 1512–1521.

44.

Cheng

, Li

, Lou

, Sonenstein

F.L.

, Kalamar

, Jejeebhoy

, Delany-Moretlwe

, Brahmbhatt

, Olumide

A.O.

and Ojengbede

, The association between social support and mental health among vulnerable adolescents in five cities: findings from the study of the well-being of adolescents in vulnerable environments, The Journal of Adolescent Health 55(6 Suppl) (2014), S31–S38.

45.

Kleiman

E.M.

, Riskind

J.H.

and Schaefer

K.E.

, Social support andpositive events as suicide resiliency factors: examination ofsynergistic buffering effects, Archives of Suicide Research 18(2) (2014), 144–155.

46.

Sanders

M.R.

, Parenting interventions and the prevention of seriousmental health problems in children, The Medical Journal ofAustralia 177(S7) (2002), S87–S92.

47.

Viner

R.M.

, Gireesh

, Stiglic

, Hudson

L.D.

, Goddings

A.L.

, Ward

J.L.

and Nicholls

D.E.

, Roles of cyber bullying, sleep, and physical activity in mediating the effects of social media use on mental health and well being among young people in England: a secondary analysis of longitudinal data, The Lancet. Child & Adolescent Health 3(10) (2019), 685–696.

Research trends and hot spots of children’s and adolescent mental health education: a bibliometric analysis from 2000 to 2022

Abstract

Purpose:

Keywords

1 Introduction

2 Materials and methods

2.1 Data sources

3 Results

3.1 Annual volume of publications

Table 6 Top 20 keywords with strongest citation bursts in MHECA publications

4.1 Promoting collaborative exchanges among research institutions

4.2 Focus on emerging research hotspots

4.3 Strengthening basic research theory

4.4 Highlighting distinctive research themes

4.5 Bringing together multiple research efforts

5 Discussion and conclusion

References

Table 6
Top 20 keywords with strongest citation bursts in MHECA publications