In a 2005 study by the University of Manitoba, having poor perceived health or physical health conditions caused anxiety and depression in adolescents (Afifi 427). Just one children’s hospital in Portland, Oregon has 150 beds. Approximately 20 children are admitted to Doernbecher Children’s hospital each day. While the average length of a hospital stay in the United States is 5.5 days, children with chronic conditions may stay weeks or even months in hospital isolation.These long stays are documented to cause anxiety and depression (Snaith), a phenomenon discussed in medical contexts as “psychiatric morbidity”. This is shocking, especially combined with the fact that children with chronic conditions are up to 2.8 times as likely to develop psychiatric disorders as their healthy peers (Mullick).

Unfortunately, as a 2013 research team of the Carlos Haya University Hospital found: “symptoms of depression and anxiety were significant predictors of health-related quality of life,” while studying patients with chronic bronchiectasis (Olveira 597), meaning that mental trauma tends to lengthen or worsen the symptoms of the illness. These findings hold true when examining other patient groups, including those with somatic disease (Webb 340) and other disabilities (Perrin 153). The health correlation to depression and anxiety in adolescents and children is even more significant, as “mental disorders are likely to be accompanied by
significant functional impairments… (That) are likely to continue into adulthood”
(Afifi 427).

According to the World Health Organization, “The impact of a child’s disability on their quality of life is very much dependent on the way other individuals treat them,” stresses Dr. Mark Bellis, Director of the Centre for Public Health at Liverpool John Moores University, a WHO Collaborating Centre for Violence Prevention, and lead researcher. “This research establishes that the risk of violence to children with disabilities is routinely three to four times higher than that to non-disabled children. It is the duty of government and civil society to ensure that such victimization is exposed and prevented.” This higher risk of violence, neglect and abuse is also a great detriment to a disabled or chronically ill child’s mental state.

The medical community has known about the correlation between mental well-being and physical health for decades. In the American Academy of Political and Social Science archives, a research document from 1980 reads:

“Chronic illness encompasses a variety of disorders and includes any impairment of bodily function over a period of time. Contrasted to an acute illness which is of limited duration, the patient is faced with longstanding conflicts, adjustments and psychological situations to which he must adapt. How the patient accepts this loss (of bodily integrity) and the personal meaning of the loss to him become of prime importance. The illness affects the interpersonal aspects of his life and his relationship with the world about him. Life style often must change, and the illness or its treatment may place restrictions on the patient. These changes and restrictions frequently become pivotal in the patient’s overall mental adaptation.”

This understanding is communicated, along with other factors, in the metric known as quality of life (QoL). As it is put by James Pirrin of Princeton University, “The Institute of Medicine, the health arm of the National Academy of Sciences, defines quality as ‘the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge’… Quality of life reflects an individual’s perception of how (s)he is doing in several key life areas, such as school activities, peer relationships, emotions and play… These measures provide a more substantial and relevant indicator of disability in most cases than biological measures.”

According to that research, play and peer relationships are regularly the most important factors in quality of life to children. Engaging in fun and fulfilling play time with family and friends was the single most significant factor to improving the QoL of a child with chronic illness. Having a high QoL can improve the effectiveness of medical attention and prevent the precipitation of mental disorders into adulthood.

The Michigan State University Pediatric Hematology Oncology team states from anecdotal evidence that toys may seem like a small donation, but they often have a lasting impact. Children can remember getting a toy years later, but the act of normal play and the relief it provides from the sometimes grueling treatment protocols can restore a child’s will to continue to fight the disease (Jegla). It is of the utmost importance that children facing chronic illness be provided with tools that have a measurable impact on their quality of life.


Abram, Harry S. “The Psychology of Chronic Illness.” The Annals of the American Academy of Political and Social Science, vol. 447, 1980, pp. 5–10. JSTOR, JSTOR,

Afifi, Tracie O., et al. “Investigating Health Correlates of Adolescent Depression in Canada.” Canadian Journal of Public Health / Revue Canadienne De Sante’e Publique, vol. 96, no. 6, 2005, pp. 427–431. JSTOR, JSTOR,

Jegla, Melissa. “Toys Help Kids Heal at MSU Pediatric Clinic.” MSUToday, Michigan State University Pediatric Hematology Oncology Team, 26 June 2017,

Mullick, Mohammad S.I., et al. “Psychiatric Morbidity, Stressors, Impact, and Burden in Juvenile Idiopathic Arthritis.” Journal of Health, Population and Nutrition, vol. 23, no. 2, 2005, pp. 142–149. JSTOR, JSTOR,

Olveira, Casilda, et al. “Depression and Anxiety Symptoms in bronchiectasis: Associations with Health-Related Quality of Life.” Quality of Life Research, vol. 22, no. 3, 2013, pp. 597–605. JSTOR, JSTOR,

Perrin, James M. “How Can Quality Improvement Enhance the Lives of Children with Disabilities?” The Future of Children, vol. 22, no. 1, 2012, pp. 149–168. JSTOR, JSTOR,

Snaith, R. P., and A. S. Zigmond. “The Hospital Anxiety and Depression Scale.” British Medical Journal (Clinical Research Edition), vol. 292, no. 6516, 1986, pp. 344–344. JSTOR, JSTOR,

Webb, Bryn D., et al. “Determinants of Quality of Life in Children with Chronic Somatic Disease: Pilot Data from the GapS Questionnaire.” Quality of Life Research, vol. 22, no. 2, 2013, pp. 339–349. JSTOR, JSTOR,

“Violence against Adults and Children with Disabilities.” World Health Organization, World Health Organization, 11 July 2012,