The Mental Health of Australian Children and Adolescents

OVERVIEW

YoungMindsMatter.

The second Australian Child and Adolescent Survey of Mental Health and Wellbeing

How to obtain a copy of the main reportA copy of the report The Mental Health of Children and Adolescents: Report on the second Australian Child and Adolescent Survey of Mental Health and Wellbeing can be downloaded in PDF format from our web site:

www.youngmindsmatter.org.au

Additional informationThis booklet contains a brief summary of findings from Young Minds Matter. Further information about the survey including some short videos, detailed papers on specific topics, and an interactive Survey Results Query Tool can also be accessed through our web site.

If you would like any additional information about Young Minds Matter, please email us at:

youngmindsmatter.smb@telethonkids.org.au

About the surveyYoung Minds Matter was funded by the Australian Government Department of Health. The survey was conducted in 2013-14 by the Telethon Kids Institute at The University of Western Australia in partnership with Roy Morgan Research.

1

Foreword

Mentaldisordersareoneofthelargestcausesofdisabilityandhealthburdeninchildrenandadolescents.Theycanbepersistentanddisabling.Theycanimpactchildren’slearninganddevelopment,andtheycanalsosignificantlyimpactfamilylife.Manyadultswithmentaldisordershavefirstonsetoftheirproblemsinchildhoodoradolescence,andpreventionandearlyinterventionareimportantinreducingtheburdenofmentalhealthproblemsthroughoutthelifecourse.

ThisbookletpresentsanoverviewoftheresultsfromYoung Minds Matter: the second Child and Adolescent Survey of Mental Health and Wellbeing (Young Minds Matter).Thesurveywasconductedin2013-14anditisonlythesecondtimethatanationalsurveyofchildandadolescentmentalhealthandwellbeinghasbeenconductedinAustralia.Thefirstsurveywasrunin1998.FindingsfromYoung Minds Matter,incombinationwithfindingsfromotherNationalSurveyofMentalHealthandWellbeingprojectsandothernationalandinternationaldata,providevaluableinformationforplanningsupportservicesforchildrenandtheirfamilies,andforguidingcontinuingreformofmentalhealthprogramsandservices.

Many adults with mental disorders have fi rst onset of their problems in childhood or adolescence...

2

Key findings

• Inthefaceofmajorsocietaltransformation,theprevalenceofmostmentaldisordershasremainedstablesince1998.Mentaldisordersarestillcommoninchildrenandyoungpeople–oneinsevenor560,000childreninAustraliawereassessedashavingoneormorementaldisordersintheprevious12months.

• ThenumberofchildrenandadolescentswithAttention-Deficit/HyperactivityDisorder(ADHD)andconductdisorderhasdecreasedsince1998.

• Therehasbeenanincreaseinthenumberofadolescentswithmajordepressivedisorder.Basedonself-reportedinformation,oneinthirteen11-17year-oldshadmajordepressivedisorder.Theratewashighestingirlsaged16-17years,withoneinfivehavingmajordepressivedisorder.

• Majordepressivedisorderhadthegreatestimpactofanydisorder,with42.8%ofsufferersexperiencingasevereimpactontheirlives.

• Mentaldisordershavemajorimpactsonschooling.Thosewithmajordepressivedisorderhadthehighestaveragenumberofdaysabsentfromschool(20days).

• Adolescentsaremorelikelythanyoungerchildrentosufferfrommentaldisorderswithasevereimpact.

• Basedontheirself-reportedinformation,oneinfiveadolescentswereestimatedtobesufferingfromhightoveryhighlevelsofpsychologicaldistress.

• Oneintwelveadolescentsaged12-17yearshadself-harmedintheprevious12months.

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• Girlsaged16-17yearsexperienceveryhighratesofdistress,depression,self-harmingandsuicidalbehaviour.Aroundonein20hadattemptedsuicideintheprevious12months.

• Mentaldisordersaremorecommoninfamiliesalreadyfacingotherchallengessuchasunemploymentorfamilybreakup.

• Thenumberofchildrenandadolescentswithmentaldisorderswhohaveusedservicesinthehealthandeducationsectorshasincreasedsubstantiallyfrom1998to2013-14.

• Justoverhalf(56.0%)ofchildrenwithmentaldisordershadusedservicesintheprevious12months.

• Familiesofoneinfivechildrenwithamentaldisorder,andwhoreportedtheirchildwasadverselyimpactedbythedisorder,didnotfeeltheirchildneededformalhelp.

• Schoolsarefrontlineforidentifyingmentaldisorders,providingservices,andreferringchildrentoservices.

• Althoughmanyfamilieshadtheirserviceneedsmet(nearlythreequarters),thereremainedsubstantialnumberswhoseneedsforhelpwentunmet,eitherpartiallyorfully.

Introduction

5

Early detection and treatment is vital

Mentalillnessoftenstartsinchildhoodandadolescence,unlikemanyofthecommonchronicphysicalhealthconditionssuchascardiovasculardisease,cancers,musculoskeletalpainanddiabetes.EstimatesfromtheGlobalBurdenofDiseaseprojectshowthatin2013,acrossthedevelopedworld,mentalillnesswasoneofthemajorcontributorstooverallillhealth,particularlyamongyoungeragegroups.Accordingtoresultsfromthe2010adultSurveyofMentalHealthandWellbeing,overhalfofadultmentaldisorderscommencedbeforetheageof18years.Therefore,identifyingandtreatingmentaldisordersastheydevelopinchildhoodandadolescenceisanimportantcomponentinreducingtheoverallprevalenceofmentaldisordersinAustralianadults.

Itiscriticallyimportanttodetectandtreatmentaldisordersasearlyaspossibleinordertoreducetheimpacttheycanhaveonchildrenduringkeydevelopmentalstagesoftheirlives.Impactsfrommentaldisorderscanalterthecourseofachild’sentirelife,evenifthementalillnessdoesnotpersistintoadulthood.Forinstance,mentaldisordersduringtheschoolyearscanaffectchildren’sattendance,engagementandlearningatschool.Thereismuchevidencetoshowthatifchildrenfallsubstantiallybehindintheirschoolwork,itcanbeverydifficulttocatchup.Interruptedprogressinschoolcanresultinchildrenfailingtoachievetheirfullpotentialinlifeandlimitingchildren’schoicesinadulthood.

It is critically important to detect and treat mental disorders as early as possible in order to reduce the impact they can have on children during key developmental stages of their lives.

How many kids have mental health problems?

7

Information about Young Minds Matter

Young Minds Matter wasasurveyofthementalhealthandwellbeingofAustralianchildrenandadolescents.Some6,310familieswithchildrenandadolescentsaged4-17yearsparticipatedinthesurvey,whichincludedaface-to-facediagnosticinterviewwiththeparentsorcarersandaself-reportonatabletcomputerfrom2,967youngpeopleaged11-17years.

Survey aims

Themainaimsweretodetermine:

• Howmanychildrenandadolescentshadwhichmentalhealthproblemsanddisorders;

• Thenatureandimpactoftheseproblemsanddisorders;

• Howmanychildrenandadolescentshadusedservicesformentalhealthproblems;and

• Theroleoftheeducationsectorinprovidingtheseservices.

Assessing mental disorders

TheDiagnosticInterviewScheduleforChildrenVersionIV(DISC-IV)wasusedtoassessyoungpeopleagainsttheDiagnosticandStatisticalManualofMentalDisordersVersionIV(DSM-IV)criteria.

DISC-IVmodulesforsevendisorderswereassessedwithrespecttotheprevious12months,andtheyincluded:

• Anxietydisorders

o Socialphobia

o Separationanxietydisorder

o Generalisedanxietydisorder

o Obsessive-compulsivedisorder

• Majordepressivedisorder

• Attention-Deficit/HyperactivityDisorder(ADHD)

• Conductdisorder.

8

Key findings

WhilethemajorityofyoungpeopleinAustraliaenjoygoodmentalhealth,Young Minds Matterfoundthatmentaldisordersinyoungpeopleremainrelativelycommon,with560,000oroneinseven4-17yearoldsassessedashavinghadmentaldisordersintheprevious12months.

Basedonparent/carer-reportedinformation,ADHDwasthemostcommondisorder(7.4%),followedbyanxietydisorders(6.9%),majordepressivedisorder(2.8%),andconductdisorder(2.1%).Almostonethirdofchildrenandadolescentswithadisorderhadexperiencedtwoormoredisordersintheprevious12months.

PREVALENCEOFMENTALDISORDERSAMONG4-17YEAROLDSINTHEPAST

12MONTHSBYSEXANDAGEGROUP

16.5

10.6

15.912.8

4-11 years 12-17 years0

5

10

15

Prev

alen

ce (%

)

FemalesMales

one in seven

9

Separation anxiety is the most common anxiety disorder

Young Minds Matter measuredanxietydisorderswheretheaffectedchildexperiencedpersistent,excessiveworryorfearswhichtypicallyinterferedwiththeirabilitytocarryouttheirdailytasksortotakepleasureinday-to-daylife.Some278,000children(orhalfofall4-17yearoldswithmentaldisorders)experiencedananxietydisorder.Separationanxietydisorderwasthemostcommonanxietydisorderinyoungerchildren(4.9%ofthoseaged4-11years),whileamongadolescents,bothsocialphobiaandseparationanxietydisorderwereequallymostcommon(3.4%).

PREVALENCEOFDIFFERENTTYPESOFANXIETYDISORDERSINTHEPAST12MONTHS

IN4-17YEAROLDSBYSEX

Major depressive disorder has the greatest impact

Mentalhealthisanessentialpartofachild’swellbeingandakeyaimofYoung Minds Matter wastodeterminetheimpactofmentaldisordersonhowyoungpeoplefunctionintheirdailylives.Theimpactofmentaldisorderswasassessedinfourkeyaspectsoflife:school,friendsandsocialactivities,family,andimpactonself.Disorderswereclassifiedashavingamild,moderateorsevereimpact.Some8.3%(335,000)ofyoungpeopleaged4-17yearshaddisorderswithmildseverityofimpact,3.5%(142,000)hadmoderateseveritydisordersand2.1%(83,000)hadsevereimpactdisorders.

6.87.0

0.51.1

2.32.0

4.14.4

2.22.4

0 2 4 6

Prevalence (%)

Social phobia

Separation anxiety

Generalised anxiety

Obsessive-compulsive

Any anxiety disorder

FemalesMales

10

Majordepressivedisorderhadthegreatestimpactofanydisorder,with42.8%ofsufferersexperiencingasevereimpactontheirlivesanditwasalsoassociatedwiththehighestaveragenumberofdaysabsentfromschool(20days),withadolescentsabsentformoredaysonaveragethanyoungerchildren.

SEVERITYOFMENTALDISORDERSINPAST12MONTHSIN4-17YEAROLDS

Olderchildrenwerealsomorelikelytosufferfromseveredisorders.Almostthreetimesasmanyadolescentsaschildrenhaddisorderswithsevereimpact(23.1%for12-17yearoldscomparedwith8.2%for4-11yearolds).

SEVERITYOFMENTALDISORDERSEXPERIENCEDBYALL4-17YEAROLDSINTHEPAST

12MONTHSBYAGEGROUP

1.31.9

3.7

1.21.0

0.6

0.81.8

4.9

0.40.5

1.2

0 1 2 3 4 5

Prevalence (%)

disorderConduct

ADHD

disorderdepressive

Major

disordersAnxiety

SevereModerateMild

9.8

2.71.1

6.44.7

3.3

4-11 years 12-17 years

0

2

4

6

8

10

Prev

alen

ce (%

)

SevereModerateMild

What adolescents told us

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Earlypreventionandtreatmentofchildhoodmentaldisordersispredicatedonparentsandcarersrecognizingthesymptomsandthenseekingandprovidingappropriatehelp.Acknowledgingthatparentsdonotalwaysknowhowtheiradolescentsarefeeling,Young Minds Mattercollectedinformationaboutdepressivesymptomsbothfromyoungpeopleandfromtheirparentorcarer.Thesurveyidentifiedmoreadolescentsashavingmajordepressivedisorderbasedontheinformationreportedbyadolescentsthemselves(7.7%)thanwhenbasedontheinformationprovidedbytheirparents(4.7%).

Two-thirdsofadolescentsdiagnosedwithmajordepressivedisorderbasedontheirself-reportedinformation,butnotidentifiedassuchbytheirparentsorcarers,saidthattheirparentsorcarersknewonly‘alittle’or‘notatall’abouthowtheywerefeeling.Asyoungpeoplemaynotalwaysfeelcomfortablediscussingtheiremotionalwellbeingwiththeirparents,itisimportantforschoolsandpeerstobeabletoidentifysignsofdistressinyoungpeople.

Olderadolescentfemales(aged16-17years)experiencedthehighestrates(oneinfive)ofmajordepressivedisorderbasedonself-report.

Two-thirds of adolescents diagnosed with major depressive disorder based on their self-reported information, but not identified as such by their parents or carers, said that their parents or carers knew only ‘a little’ or ‘not at all’ about how they were feeling.

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PREVALENCEOFYOUTH-REPORTEDMAJORDEPRESSIVEDISORDERINTHEPAST12

MONTHSIN11-17YEAROLDSBYSEXANDAGEGROUP

Many teenagers are suffering very high levels of psychological distress

Fromtheirself-reportedinformation,oneinfive(19.9%)adolescentsaged11-17yearswereestimatedtosufferfromhighorveryhighlevelsofpsychologicaldistress,andthiswasfourtimeshigher(80.7%)forthosewithmajordepressivedisorder.

Self-harming and suicidal behaviour is associated with major depressive disorder

Young Minds Mattercapturedinformationfrom12-17yearoldsaboutself-harmingactivity,whichincludeddeliberatelyhurtingorinjuringthemselveswithouttryingtoendtheirlives.Inthepreviousyear,oneintwelve(137,000)youngpeopleaged12-17yearshadself-harmed.Self-harmwasmuchmorecommonamonggirlsandinolderadolescents.

SELF-HARMINTHEPAST12MONTHSFOR12-17YEAROLDSBYSEXANDAGEGROUP

3.1

7.2 8.2

19.6

11-15 years 16-17 years0

5

10

15

20

Prevalen

ce(%

)

FemmalesMMaales

3.0

9.8

6.2

16.8

11-15 years 16-17 years0

5

10

15

Prop

ortio

n (%

)

FemalesMales

14

Duringtheprevious12months,oneinthirteen(128,000)adolescentsaged12-17yearshadseriouslyconsideredsuicide,andonethirdofthose(41,000)hadactuallyattemptedsuicide.

Similartopatternsofself-harm,suicideattemptsweremorecommonamonggirlsandolderadolescents.Therewerenosignificantdifferencesinratesofsuicidalbehavioursbysocio-demographiccharacteristics.

SUICIDALBEHAVIOURSINTHEPAST12MONTHSAMONG12-17YEAROLDSBYSEX

ANDAGEGROUP

Whileself-harmingbehavioursandsuicidalbehavioursaresometimesconsideredtobedifferentphenomena,Young Minds Matter foundaveryhighoverlapbetweenyoungpeoplewhoself-harmedandyoungpeoplewhohadsuicidalthoughtsandbehaviours,suggestingthatthesearerelatedbehaviours.

3.42.0

0.8

6.84.9

2.9

8.15.9

2.7

15.4

10.6

4.7

12-15 yearsMales

16-17 yearsMales

12-15 yearsFemales

16-17 yearsFemales

0

5

10

15

Prop

ortio

n (%

)

Suicideattempt

Suicideplan

Suicidalideation

one in thirteen

15

Young Minds Matterfoundthatself-harmingandsuicidalthoughtsandbehaviourswerestronglyassociatedwithmajordepressivedisorder.Basedoninformationcontainedintheirself-report,aquarterofmales(25.8%)andoverhalfoffemales(54.9%)withmajordepressivedisorderhadharmedthemselves(withoutsuicidalintent)inthe12monthspriortothesurvey.

Aboutone-half(48.6%)ofadolescentswithmajordepressivedisorderbasedonself-reportedinformationhadseriouslyconsideredendingtheirownlife,andaboutoneinfivehadattemptedsuicideinthepast12months(22.1%offemalesand13.8%ofmales).

Estimatesonself-harmandsuicidalbehavioursmaybeconservativebecausesomeyoungpeopleanswered“prefernottosay”.However,theseresultsareconsistentwithotherdataonself-harmingandsuicidalbehavioursinAustralianyoungpeoplewhichshowthatsuicideistheleadingcauseofyouthdeathinAustralia,withmentalillnessthoughttobelinkedtothemajorityofthesedeaths.Hospitalstatisticsshowanincreaseinhospitalpresentationsrelatedtoself-harminyoungpeople,highlightingthisasanemergingsocialissueofconsiderableconcern.

Based on information contained in their self-report, a quarter of males (25.8%) and over half of females (54.9%) with major depressive disorder had harmed themselves (without suicidal intent) in the 12 months prior to the survey.

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Older adolescent girls are at most risk

Veryhighratesofdistress,depression,andself-harmingandsuicidalbehavioursingirlsaged16-17yearsareofconcernandunderlinethechallengesfacedinthetransitiontoadulthood.Inalmostallinstances,theirratesofmentaldisordersandsuicidalorself-harmingbehavioursaretwicethatforboysofthesameage.

Mental illness is linked with socio-economic disadvantage

Theinequalitiesinmentalhealthforchildrenandadolescentshaveremainedunchangedsince1998.ThissuggeststhatthechangesinAustraliansocietythathaveoccurredsincethen,andthepoliciesandprogramsthathavebeenimplementedtoaddresshealthinequalitiesinAustralia,havenotbeeneffectiveinreducinginequalitiesinchildandadolescentmentalillness.Manyphysicalhealthproblemsoccurmorecommonlyinfamiliesthatexperiencesomeformofsocio-economicdisadvantage.However,comparedwithmanyphysicalhealthproblems,thedifferencesintheproportionsofchildrenwithmentaldisordersbetweendisadvantagedandadvantagedfamiliesarelarge.

Young Minds Matter foundstrongassociationsbetweentheprevalenceofmentaldisordersandkeyindicatorsofsocio-economicdisadvantage.Thereareasubstantialnumberoffamiliesdealingwithchildmentalillnesswhiledealingwithotherchallengesintheirlives.

Youngpeoplefromfamilieswithlowhouseholdincome,parentsandcarerswithloweducationlevels,higherlevelofunemployment,andthosefromstep,blendedandoneparentorcarerfamilieshadhigherratesofmentaldisorders

Step, blended or one parent

families

Families with low household

income

Parents and carers with low

educational levels

Families with higher level of

unemployment

Higher rates of mental disorders in the previous 12 months

17

intheprevious12months.Morethanoneinfivechildrenandadolescentshadamentaldisorderinfamilieswithhouseholdincomelessthan$1,000perweek,comparedwithoneintenchildreninfamilieswithhouseholdincomeover$2,000perweek.Almostathird(30.0%)ofchildrenwhosefamiliesliveinpublichousinghadamentaldisorder.Overoneinfivechildrenintwo-carerfamilieswherebothcarerswereunemployedhadamentalillnessandnearly30%ofchildrenlivinginsolecarerfamilieswherethesolecarerwasunemployedhadamentalillness,comparedwithoneintenchildreninfamilieswherebothcarerswereemployed.

Thesefindingshaveimplicationsforthedeliveryofsupportservices.Healthandeducationsupportservicesforchildrenwithmentaldisordersneedtoacknowledgethatasignificantproportionofchildrenneedinghelpwillbelivinginfamiliesthatmayrequireadditionalformsofsupport.Whilearangeofsocialprogramsandserviceshavebeenestablishedtoprovidesupportfor

familiesexperiencingvarioustypesofdisadvantage,notallofthesearegearedtohelpingchildrenwithmentalhealthproblems.Integrated,holisticsupportservicesaremostlikelytobeabletohelpfamilieswithmultipleneeds.

Integrated, holistic support services are most likely to be able to help families with multiple needs.

Service Use

19

Whenthefirstsurveywasconductedin1998onlyoneinfourchildrenandyoungpeoplewithemotionalorbehaviouralproblemshadreceivedanyformalhelpintheprevioussixmonths,eitherwithinthehealthsystemorinschool,andevenamongthosewiththemostsevereproblems,onlyhalfhadreceivedanyformofprofessionalhelp.

Thestigmaassociatedwithmentalillness,andalackofunderstandinginthecommunityaboutmentalillnesshashistoricallycontributedtothelownumbersofchildrenwithproblemsreceivinghelp.Young Minds Matter results,incombinationwithotherstudiessuchastheNational Survey of Mental Health Literacy and Stigma conductedbytheUniversityofMelbourne,identifyencouragingsignsofgreateropennessandawarenessofmentalhealthissuesinthecommunity,withmorefamilieswillingtodiscussmentalhealthissuesandtoseekhelpwhentheyneedit.However,thereisstillroomforimprovement.Young Minds Matter foundthatthefamiliesofapproximatelyoneinfivechildrenwhometalldiagnosticcriteriaforamentaldisorder,andwhoreportedthattheirchildwasadverselyimpactedbythesymptomsofmentaldisorder,feltthattheirchild

didnotneedformalhelp.Thereisstillaneedtoimproveunderstandinginthegeneralcommunityaboutthetypesofhelpthatareavailableformentalhealthproblems,andatwhatstageitisappropriatetoseekhelp.

SincethedevelopmentoftheNational Mental Health Strategytherehavebeensubstantialchangestotheservicesthatareavailabletochildrenwithmentalhealthproblemsandtheirfamilies.Forinstanceheadspacewasestablishedin2006andnowhasalmost100centresnationwide,aswellasprovidingonlineandtelephonesupportservices.Alsoin2006,theMedicareBenefits

There is still a need to improve understanding in the general community about the types of help that are available for mental health problems, and at what stage it is appropriate to seek help.

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SchedulewasexpandedthroughtheBetterAccessschemetoprovideaccesstopsychologicaltherapies.

Young Minds Matter foundthat,intheprevious12months,anestimated314,000or56.0%ofyoungpeopleaged4-17yearswithmentaldisorders(17.0%ofallchildren)hadusedservicesinthattime.

Althoughserviceuseinformationisnotdirectlycomparablebetweenthe1998and2013-14surveys,theincreaseinserviceuse(from31.2%to68.3%)forthoseaged6-17yearsishigherthanislikelytobeattributabletomethodologicalchangesalone.

Basedonself-reportedinformation,adolescentsalsousedavarietyofself-helpstrategiestodealwiththeirmentalproblemssuchas,doingmoreexercise,gettingsupportfromfriends,anddoingmoreofthethingstheyenjoy.

Schools provide a front-line role in servicing mental disorders

Schoolsalsoplayanimportantserviceroleforchildrenwithemotionalandbehaviouralproblems.Schoolservicesidentifymentaldisorders,referchildrentootherserviceswhennecessary,andin-schoolprogramssuchasKidsMatterandMindMatterspromotepositivementalhealthandwellbeing.

Young Minds Matter showedthatjustoveroneinten(11.5%)ofallstudentsoranestimated40.2%ofthosewithmentaldisordershadusedschoolservicesinthepreviousyear.

Amongmanyothernewinitiatives,manyjurisdictionshavedevelopednewpoliciesandprogramsaroundstudentwellbeing,andhaveprovidedadditionalcounsellingresourcesinschools,withYoung Minds Matter findingthat28.4%

one in ten

21

ofyoungpeoplewithdisordershadusedindividualcounsellingatschool.However,therelativelyhighrateofmentalhealthproblemsamongtheschoolpopulationandtheimpactthesecanhaveoneducationaloutcomessuggestapossibleroleforanational,coordinatedapproachtosocialandemotionalwellbeinginschools.

There still remain families whose need for services go unmet

Parentsandchildrenwereaskedabouttheirneedformentalhealthservicesandwhetherornottheyweremet,aswellaswhatbarrierstheyexperiencedtoseekingorreceivinghelp.

Whilenearlythreequartersofthoseneedinghelphadtheirneedsmet,eitherfullyorpartially,thereremainsubstantialnumbersoffamilieswhoseneedsforhelpwentunmetorwhoreceivedlesshelpthantheyfelttheyneeded.Aroundtwooutoffiveparentswerenotsurewheretogethelpfortheirchild’semotionalorbehaviouralproblems.

NEEDFORDIFFERENTTYPESOFHELPINTHEPAST12MONTHSFOR4-17YEAROLDS

WITHAMENTALDISORDER

Counsellingwasthemostneededserviceandtwothirdsofthoserequiringthisservicehadtheirneedsfullyorpartiallymet.Incontrast,twothirdsofthoserequiringlifeskillstrainingdidnothavetheirneedsmet.

Themostcommonreason(62.9%)fornotseekingorreceivinghelpreportedby13-17yearoldswithmajordepressivedisorder(basedonself-reportedinformation)wasworryoverwhatotherpeoplemightthinkorthattheydidnotwanttotalktoastranger.

41.7

22.3

68.1

36.0

0 20 40 60

Proportion (%) of those with a need for help

Life skills

Counselling

Medication

Information

Changes over time

23

In1998,Australiawasthefirstcountrytoconductanationalsurveyofmentalhealthandwellbeingofitschildren.In2013-14,Young Minds Matterbuiltontheinformationcollectedinthe1998survey,butcoveredabroaderrangeofmentalillnesses,includingmeasuringtheprevalenceofanxietydisordersinAustralianchildrenandadolescentsforthefirsttime.AlthoughYoung Minds Matterwasdesignedtoallowforcomparisonswiththefirstsurvey,therearesomedifferencesinthementaldisordersassessedaswellastheserviceusetimeframeandscope,allofwhichimpactcomparability.

Lookingatthedisordersthatweremeasuredinbothsurveys,forthe6-17yearoldagegroup(whichiscommonacrossbothsurveys),theoverallprevalenceofmentaldisordershasremainedrelativelystableovertime.WhiletherehavebeenmodestreductionsintheproportionsofchildrenandadolescentswithADHDandconductdisorder,therehasbeenanincreaseintheproportionofadolescentsexperiencingmajordepressivedisorder(upfrom2.9%in1998to5.0%in2013-14).

While there have been modest reductions in the proportions of children and adolescents with ADHD and conduct disorder, there has been an increase in the proportion of adolescents experiencing major depressive disorder...

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TWELVEMONTHPREVALENCEOFSELECTEDMENTALDISORDERSAMONG6-17YEAROLDS

IN1998AND2013-14

Whilethenumberofchildrenandfamiliesreceivinghelpformentaldisordershasincreasedsubstantiallysince1998,Young Minds Matter resultsshowtherehasbeenlittlechangeintheproportionofchildrenandadolescentswithamentaldisorder.Muchofthehealthandeducationsectorresourcesdevotedtomentalhealthproblemsaredirectedtowardsidentifyingandtreatingdisorders,ratherthanatpreventingdisordersfromoccurring.Improvedavailabilityofservicesmaydecreasetheoverallseverityanddurationofdisordersratherthanreducingtheonsetofdisorders.Therehavebeenseveralprogramsintroducedoverthelast15yearswiththeaimofreducingbehaviouralproblemsinchildrenandadolescents.TheseincludeparentingprogramssuchasIncredibleYearsandthe

PositiveParentingProgram,whichareexplicitlydesignedtoreducebehaviouralproblems.ProgramssuchasthesemayhavehadsomeeffectasthesurveyresultssuggestthatADHDandconductdisorderhavereducedinprevalencesince1998.

Resultsfromtwopointsintime,15yearsapart,arenotsufficienttoformjudgementsaboutwhetherserviceshavehadanimpactonreducingtheburdenofmentaldisorders.Whiletherehavebeenmanychangestotheprovisionofsupportservicesduringthattime,therehavebeenmanychangesinoursocietythatmayalsohaveanimpactonthewellbeingofchildrenandadolescents.Oneparticularlyvisiblechangehasbeenintheuseoftechnology,communicationsandthedevelopmentofsocialmedia.Thesetoolshave

3.22.1

7.89.8

2.12.7

11.112.2

0 2 4 6 8 10 12 14

Prevalence (%)

3 disordersAny of these

Conduct disorder

ADHD

disorderMajor depressive

2013-141998

One particularly visible change has been in the use of technology, communications and the development of social media.

25

creatednewenvironmentsinwhichchildrencanbebulliedandcyber-bullied.Cyber-bullyingcanclearlyhaveanegativeimpactonyoungpeople.Thesetoolshavealsochangedthewayinwhichyoungpeopleformandmaintainsocialrelationships,whichmaypresentbothnewchallengesandnewopportunitiesininteractingwithothers.Therehavealsobeensignificantstructuralchangesin

thelabourmarketandinexpectationsforperformanceatschool.NowahigherproportionofavailablejobsrequireadvancededucationandtheproportionofadolescentscompletingYear12,andparticipatinginpost-schooleducation,hasincreasedsubstantially.Thismayhaveincreasedthenumberofyoungpeoplefeelingpressuretoperformatahighlevelacademically.

Thecontinuedhighprevalenceandburdenofmentaldisordersinchildrenandadolescentspointstotheneedforcontinuedinvestmentintreatmentandprevention,continuingmentalhealthservicesreformatalllevels,andfurtherprioritisingresearchintomentaldisordersinchildhoodandadolescence.

Implicationsfor thefuture

27

Whileprovidingadequateearlyinterventionandtreatmentservicesisimportantinreducingtheimpactofmentaldisorders,preventingmentaldisordersinthefirstplacehasthepotentialtobothreducetheburdenofmentaldisordersandthecostoftreatingthem.Thereisstillmuchtobediscoveredaboutthecausesofthesedisorders,andresearchintotheirdevelopmentisanimportantsocialgoal.Thereisanemergingbodyof

evidenceregardingthepreventionofmentaldisorders.TherecentreviewofmentalhealthprogramsandservicesbytheNationalMentalHealthCommissionhasrecommendedgreaterinvestmentinprevention,withthepotentialtosaveinthelongertermonthecostsofserviceprovision.Achallengewithmovingresourcestopreventionhaslongbeenthatresultingfinancialsavingswouldaccrueoveraperiodofyears,anditisdifficulttotakefundingoutofservicesthatarecurrentlynotfullymeetingdemand.

Preventionofmentalhealthproblemsisdemandingbecauseofthedifficultiesinaddressingmanyofthefactorsknowntobeassociatedwiththeirdevelopment,suchasexposuretochildabuseanddomesticviolence,theexperienceofdysfunctional

familyenvironmentsduetoalcoholordrugproblemsorotherfamilydiscord,harshoraversiveparenting,familydisruptionduetoseparationordivorce,ortheexperienceofotheradverseeventsduringchildhood.Whilemanyoftheseissuesremainchallengingtosociety,itiscriticaltocontinuetodiscusshowtheycanbeaddressedorhowchildrencanbebufferedfromtheireffects.

Preventing mental disorders in the first place has the potential to both reduce the burden of mental disorders and the cost of treating them.

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Conclusion

Mentaldisordersareoneofthemostcommonhealthconditionsaffectingchildrenandyoungpeople.Theycanhavesignificantimpactsonchildren’seducationanddevelopment.Willingnesstodiscussmentalissues,seekhelpanduseserviceshasbeenincreasing.Manymorefamiliesarenowreceivinghelpthanwasthecase15yearsago,butthereremainsignificantopportunitiestoincreasetheavailabilityanduseofserviceswhenproblemsarefirstdevelopingandservicesaremostneeded.Whileitispositivethatmostchildrenwithseveredisordersarereceivinghelp,thelowernumbersseekinghelpamongchildrenwithmilddisordersmayrepresentsomemissedopportunitiestointerveneatatimewheninterventionsarelikelytobemosteffective.Mostmentalillnessesdevelopoveraperiodoftime.Whilenotallchildrenwithamildmentaldisorderwillgoontoexperienceamoreseveredisorder,earlyinterventionhasthepotentialtoreducetheburdenofseveredisorders.Effectivetreatmentsarenowavailableformostmentaldisorders,andearlyaccesstotreatmentcanresultinshorterdurationofdisordersandreducedseverityofdisorder.

Theemerginghighratesofdistress,majordepressivedisorder,self-harmingbehaviourandsuicidalthoughtsandbehavioursinteenagers,particularlyin16-17yearoldgirls,areissuesthatfamilies,schoolsandcommunitiesneedtobeawareof,andrespondto,withurgency.

If you or your child needs help with a mental health problem, you can visit your regular GP or

contact any of the following services:

Lifeline: 24/7 crisis support service

13 11 14 or online text chat at www.lifeline.org.au

Kids Helpline: 24/7 crisis support service for young people

1800 55 1800 or online text chat at www.kidshelp.com.au

headspace: 24/7 support service for young people

1800 650 890 or online text chat at www.headspace.org.au

Reach Out: online youth mental health service

www.reachout.com

beyondblue: online information on depression and anxiety

1300 22 4636 or www.behondblue.org.au

Relationships Australia: 1300 364 277 or www.relationships.org.au

Discover. Prevent. Cure.

www.youngmindsmatter.org.au

Young Minds Matter was funded by the Australian Government Department of Health

and conducted by the Telethon Kids Institute at The University of Western Australia

in partnership with Roy Morgan Research.

oung Minds Matter was funded by the Australian Government Department of Health

and conducted by the Telethon Kids Institute at The University of Western Australia

in partnership with Roy Morgan Research.

Young Minds Matter Young Minds Matter Ythe Australian Government Department of Health

and conducted by the Telethon Kids Institute at The University of Western Australia

in partnership with Roy Morgan Research.