In this section
At any point
in time, one in seven Australian children will experience a mental health
problem and half of all adult mental health problems are known to begin before
the age of 14 years. However, many Australian children are
missing out on mental health care.
these problems can persist into adolescence and into adulthood with adverse consequences
including early school dropout, peer relationship issues, drug and alcohol
offending, and lost productivity in the workforce. Early prevention and
intervention is therefore essential.
Potential causes of this include:
It is well recognised that children with a chronic illness
are at greater risk of developing mental health problems such as anxiety or depression,
than their healthy peers. However, many children with a chronic illness are not
routinely asked about their mental health and wellbeing in health care
settings. Working in partnership with RCH, we are conducting a project to
determine if a single item asking parents about their child’s mental health and
wellbeing can be incorporated into the admission process for children attending
the day medical unit. We will also see how this single question compares with
validated measures of child mental health and whether offering support and
referrals to those children who are struggling with their mental health can
make a difference to their mental health, over time.
Using data from the Victorian
Emergency Minimum Dataset, we examined seven year trends (2008/09-2014/15) in
children’s presentations to EDs across Victoria. Specifically, we examined the number
of children presenting for mental health versus physical health concerns; the
characteristics of mental health presentations in comparison to physical health
(e.g. length of stay, triage category, and admission patterns); and the range
of mental health diagnoses resulting in ED presentations. We found that children’s
presentations for mental health were growing more quickly than those for
physical health problems, and that mental health presentations pose a
relatively greater burden on ED resources than physical health presentations.
Our findings were published in the Medical Journal of Australia with an
accompanying editorial and podcast. Findings informed a successful MRFF Million
Minds grant ($5 million) examining how to better manage and support children
coming to EDs with mental health problems.
Sawyer SM, Patton GC. Why are so many more adolescents
presenting to our emergency departments with mental health problems? MJA
In this project,
we sought to determine the types of services used by families for their child’s
sleep problems; whether service use was associated with family geographical
location or socioeconomic status; and to estimate the out-of-pocket costs
associated with service use. We found that the majority of children with ADHD
and sleep problems were not accessing help for their sleep problems. Help-seeking
did not differ by geographical location or SES, although low income families
were more likely to seek help than high income families. Lower SES families
paid a similar amount per visit compared to high SES families however, the more
disadvantaged group spent more overall across a three-month period due to a
higher number of visits over the period.
Victoria are increasingly presenting to emergency departments (EDs) with
anxiety and depression. We interviewed families who presented to four EDs
across Victoria with these problems. Families describe what brought them to the ED; what other
services they tried before the ED; any barriers/enablers of accessing other
services; whether there are any family factors that may have prevented them
seeking help through another source; and what their ‘ideal’ would look like for
the help they were seeking. Outcomes of this study have been published and will
inform new models of care to reduce child mental health presentations to the ED
and strengthen mental healthcare in the community.
Prof Hiscock is conducting related projects through the Health Services research group at MCRI. You can read more about these projects here.
National: RCH; MCRI; University of Melbourne; Monash Children’s
Hospital; Sunshine Hospital; Ballarat Hospital.
International: USA - University of Michigan, Child Health
Evaluation and Research Center (Prof Gary Freed); Ireland- Trinity College, School
of Nursing and Midwifery (A/Prof Maria Brenner); Denmark, University of
Southern Denmark, Centre for Global Health (Ms Stine Lundstroem).
Victorian Emergency Minimum
Dataset (VEMD); Young Minds Matter Survey (YMMS); Longitudinal Study of
Australian Children (LSAC); The Royal Children’s Hospital (RCH; Epic);
Australian Paediatric Research Network (APRN).
RCH Foundation; NHMRC Project
Grant (‘Towards an evidence-based and
equitable mental health system for children in Australia’)