Protective Factors for Children Who Experience a Death in Their Household: Examining Comprehensive Systems to Promote Mental Health in High-Risk Contexts

With high rates of poverty, HIV and consequently high rates of death of in households, children in the South African province KwaZulu-Natal (KZN) face several threats to mental health and well-being. It is estimated that approximately 13% of children have experienced the death of one or both parents with approximately half of those due to HIV-related causes (Human Sciences Research Council, 2013). Children who have been orphaned often experience mental health difficulties including depression, anxiety, and post-traumatic stress (e.g., Cluver, Orkin, Gardner, & Boyes, 2012). In an area with high rates of HIV and HIV-related illness and death, an understanding of the potential impact of a death in the household on children’s mental health is critical. Further, identifying potential protective processes will be central to ensuring quality preventive efforts for reducing mental health difficulties in South African children.

Several studies have begun to explore protective factors of the vulnerable child population in South Africa (e.g., Meinck, Cluver, & Boyes, 2010), but there is a need for a better understanding of processes that buffer the impact of experiencing a death in the household. For children who have been orphaned, Cluver and Gardner (2007) identified several protective factors for mental health at household, community, and educational levels. The current study will explore the extent to which a positive school environment moderates the relationship between experiencing recent death and children’s mental health.

The sample is composed of 1961 Zulu households from 24 communities in KZN. Communities were selected based on urbanity and high school graduation rates. Measures were chosen based on international validity and cultural appropriateness. Using hierarchical linear regression, preliminary analyses found that children who had experienced a recent death in their household had higher levels of mental health difficulties, β=.060, t(1893) = 2.602, p < .05. However, positive school environment significantly moderated the relationship, β= -.075, t(1893) = -2.882, p < .05, so that in the presence of a positive school environment, the relationship between experiencing a recent death and mental health outcomes was dampened. These findings suggest that in a high-risk area, a positive school environment may be an important mental health protective factor for children who have recently experienced a death in their household. Final analyses will further explore the moderation relationship of school environment on mental health outcomes and will also examine other potential moderators across contests including family processes and community factors.