Young Minds The Mental Health of Australian Children and ... · with their ability to carry out...
32
The Mental Health of Australian Children and Adolescents OVERVIEW Young Minds Matter. The second Australian Child and Adolescent Survey of Mental Health and Wellbeing
Transcript of Young Minds The Mental Health of Australian Children and ... · with their ability to carry out...
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:
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.
3
• 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
12
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.
13
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.
16
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.
20
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...
24
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.
28
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.
