Majority of Australian children with mental health disorders not accessing care, study finds

A new study has found the vast majority of Australian children with mental health disorders are not getting professional help with girls, young children and families from non-English-speaking backgrounds the least likely to access services.

The research, led by the Murdoch Children's Research Institute and published in the Australian Journal of Psychology, looked at the mental health of 4,983 children from the ongoing Longitudinal Study of Australian Children.

"We found that fewer than one in four children with mental health problems saw a health professional in the 18 months after they were identified as having a problem," said lead author Professor Harriet Hiscock.

The research found:

• Girls were less likely to receive care than boys (30 percent of children who received support for emotional problems at ages 8/9 and 10/11 were female despite 50 percent of those needing help being girls).
• Families from non-English speaking backgrounds are unlikely to receive help (14 percent of children with emotional problems came from a non-English speaking background but only 2 percent received help)
• Younger children were less likely to access services than older children (Parents filled out the questionnaires when their child was aged 8/9, 10/11 and 12/13 years.)

Prof Hiscock said families may delay getting help for young children in the hope that they will 'grow out' of the mental disorder, but as the situation worsens they seek treatment.

"The gradual onset and increase in severity over time of many mental health problems means that children and their parents are more likely to seek services when the symptoms become severe or impact significantly on the child's ability to function, typically as they grow older," she said. "However, left untreated, problems can become more entrenched and in turn harder to treat."

Prof Hiscock said boys are more likely to access health support than females, particularly paediatrician services, despite having similar levels of mental health symptoms.

"Boys are more likely to externalise problems, whereas girls are more likely to have emotional problems, which are harder to detect," she said.

Prof Hiscock said the reluctance of parents from non-English speaking backgrounds to get help may be because of different cultural norms and they may struggle to find services for their child in their own language.

"Their quietness in the classroom may also be mistaken for a language issue rather than a mental health issue," she said.

For the research, parents reported on their children's emotional problems in a Strength and Difficulties Questionnaire. The results were then linked with Medicare Benefits Schedule data to see which families had accessed help.

Dr. Melissa Mulraney, from the Murdoch Children's Research Institute, said to the best of her knowledge, no study has previously examined the mental health of Australian children and used prospective, objective, Medicare-linked data.

"The aim of this study was to enhance our understanding of how many children and which children are missing out on care," Dr. Mulraney said. "We hope our findings will help better target child mental health interventions and improve service use."

Prof Hiscock said it was also important to acknowledge that mental health disorders don't just start in adolescence but can begin in early childhood.

Prof Hiscock

Additional study findings:

• Children with emotional problems were more likely to receive mental health support than those with externalising problems.
• The factors most consistently associated with getting support were symptom severity and parent perception that the child needed help.
• A larger proportion of children received mental health services from a paediatrician (13-28 percent) than a psychologist (1-20 percent) or a psychiatrist (0-5 percent). Between 12-17 percent of children are estimated to be seeing a paediatrician for their mental health.

2016-17 Medicare data reveals that children under the age of 15 years had the lowest use of Medicare- rebated mental health services (5.1 percent) of any Australian age group.

Previous research has found that 14 percent of four to 17 year olds or 580,000 Australian children and adolescents meet diagnostic criteria for at least one mental health disorder over 12 months, and 50 percent of all adult mental disorders begin before the age of 14 years.