Three-quarters of Australian children with mental health disorders aren’t getting professional help, according to new Australian research. Girls, younger children and families from non-English-speaking backgrounds are the least likely to access mental health services.
A study published by the Australian Journal of Psychology looked at the mental health of just under 5,000 Australian children aged eight to 13 via parental surveys of their child’s emotional and mental health. It then linked the results with Medicare data to see which families had accessed help. Fewer than one in four children we identified as having a mental health problem saw a health professional in the 18 months after we surveyed them.
Left unaddressed, mental health problems can become more entrenched and harder to treat. And mental health problems in childhood can have lifelong ramifications including increased risk of mental health problems in adulthood, poor educational attainment, unemployment, and contact with the criminal justice system. So ensuring children and adolescents who experience mental health problems receive access to timely and effective care is essential.
What types of mental health problems do kids have?
Around 14 per cent of children and adolescents aged four to 17 meet diagnostic criteria for at least one mental health disorder. The most common mental health disorders in Australian children in this age group are anxiety disorders, which affect 6.9 per cent of children, and attention deficit hyperactivity disorder (ADHD), which affects 7.4 per cent of children.
Around 50 per cent of all adult mental disorders begin before the age of 14. Yet in 2017-18, children under the age of 15 had the lowest use of Medicare-rebated mental health services (5.1 per cent) of any Australian age group.
Younger children were less likely to access services than older children. Some 20-27 per cent of children aged 12-13 years accessed services, compared to 9-15 per cent of children aged eight to nine years. Young children respond to and process emotional experiences and traumatic events in ways that are very different from adults and older children. Consequently, it can be more difficult to recognise problems in early childhood.
Girls were less likely to receive care than boys. Though 50 per cent of girls were diagnosed with mental health problems in the study, they accounted for just 30 per cent of children who received support for emotional problems at ages eight to 11. This may have something to do with the fact that mental health conditions can be more difficult to recognise in girls as boys are more likely to externalise problems.
Culturally and linguistically diverse backgrounds
Around 14 per cent of children with emotional problems came from a non-English speaking background, but they only accounted for 2 per cent who received help.
The reluctance of parents from non-English speaking backgrounds to get help may be related to different cultural understandings of mental health and illness. They may also struggle to find services for their child in their own language.
Mental health conditions may also be more difficult to recognise among children from non-English speaking backgrounds, where quietness in the classroom may be mistaken for a language issue rather than a mental health issue.
READ MORE: The road to equality and mental health
Change is needed
Over the past 20 years there has been little change in the prevalence of child and adolescent mental disorders in Australia despite increased investment in resources. This is likely in part because the quality and the intensity of services provided have not improved.
Children may not be receiving sufficient treatment sessions or treatment sustained over a long enough period to meaningfully impact on their symptoms. It’s recommended that children receive at least eight sessions of cognitive behavioural therapy for the treatment of anxiety, for example, but many children will require more.
Australia’s health system rewards discharging patients from care within a set number of appointments rather than once they have improved. The Medicare Better Access scheme allows for a maximum of ten subsidised appointments with a psychologist in a calendar year. But again, many children require more.
The study concluded that a system-level shift was needed to funding based on measured symptom improvement rather than a capped number of appointments both in hospital settings and in the community.
The research suggests we need to better understand parent and child drivers of why children miss out on care, particularly girls, younger children, and those from diverse backgrounds. Doing so and ensuring access to high-quality care will benefit not only the child and their family now but also the adult they will become.
* Crisis support services can be reached 24 hours a day: Lifeline 13 11 14; Suicide Call Back Service 1300 659 467; Kids Helpline 1800 55 1800; MensLine Australia 1300 78 99 78; Beyond Blue 1300 22 4636.