Three-quarters of Australian children with mental disorders are not receiving professional help, according to new Australian research. Girls, younger children, and non-English-speaking families are the least likely to access mental health services.
A study published in the Australian Journal of Psychology examined the mental health of just under 5,000 Australian children aged 8 to 13 through parental surveys of their children's mental and emotional health. We then associate the results with the Medicare data to see which families accessed the help. Less than one in four children we identified with mental health problems consulted a health professional within 18 months of the research.
Left untreated, mental health problems can become more entrenched and more difficult to treat. And childhood mental health problems can have lifelong ramifications, including increased risk of mental health problems in adulthood, low levels of schooling, unemployment, and contact with the criminal justice system. Therefore, ensuring that children and adolescents suffering from mental health problems have access to timely and effective care is essential.
What kinds of mental health problems do children have?
About 14% of children and adolescents aged four to 17 years meet diagnostic criteria for at least one mental health disorder. The most common mental disorders in Australian children in this age group are anxiety disorders, which affect 6.9% of children, and attention deficit hyperactivity disorder (ADHD), which affects 7.4% of children.
About 50% of all mental disorders in adults begin before age 14. However, in 2017-18, children under the age of 15 had the lowest use of discounted mental health services in Medicare (5.1%) of any Australian age group.
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Younger children were less likely to access services than older children. Approximately 20% to 27% of children aged 12 to 13 accessed services, compared with 9% to 15% of children aged eight to nine years. Young children respond and process emotional experiences and traumatic events in very different ways from adults and older children. Consequently, it may be more difficult to recognize problems in early childhood.
Girls were less likely to receive care than boys. Although 50% of girls were diagnosed with mental health problems in the study, they accounted for only 30% of children who received support for emotional problems between the ages of eight and 11. This may have something to do with the fact that mental health conditions may be harder to recognize in girls as boys are more likely to voice problems.
Cultural and linguistically diverse backgrounds
About 14 percent of children with emotional problems came from non-English speaking backgrounds, but only accounted for 2 percent of those receiving help.
The reluctance of parents who do not speak English to get help may be related to different cultural understandings of mental health and illness. They can also strive to find services for their children in their own language.
Mental health conditions may also be harder to recognize among children from other non-English speaking backgrounds where silence in the classroom may be confused with a language issue rather than a mental health problem.
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Change is needed
In the last 20 years, there has been little change in the prevalence of mental disorders in children and adolescents in Australia, despite increased investment in resources. This is probably partly because the quality and intensity of the services provided have not improved.
Children may not be getting enough treatment sessions or prolonged treatment for a period long enough to have a significant impact on their symptoms. It is recommended that children receive at least eight sessions of cognitive-behavioral therapy for the treatment of anxiety, for example, but many children will need more.
Australia's healthcare system rewards the release of care patients within a set number of consultations, rather than once improved. The Medicare Better Access scheme allows a maximum of ten subsidized consultations with a psychologist in a calendar year. But again, many children require more.
The study concluded that a change in the system level was required for funding, based on measured improvement of symptoms, rather than a limited number of consultations, both in hospitals and in the community.
Research suggests that we need to better understand parents and children why children lose their care, particularly girls, children and people of diverse backgrounds. Doing this and ensuring access to high-quality care will not only benefit the child and his or her family, 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; Child Support Line 1800 55 1800; MensLine Australia 1300 78 99 78; In addition to blue 1300 22 4636.