Abstract
Paving the way for early mental health support in children
Building mental health and wellbeing in Australia and New Zealand starts with early support for infants, children and their families. Yet a recent report by the Royal Australian and New Zealand College of Psychiatrists’ Faculty of Child and Adolescent Psychiatry shows that most young children with social, emotional and behavioural difficulties do not receive professional help that could avoid a lifetime of disease burden.
For this year’s Children’s Mental Health Week 13 – 20th February 2024, the RANZCP is shining a light on the need to support our children to establish lifelong patterns of mental health and wellbeing, allowing them to be safe, healthy and ready to thrive. The critical period from conception to age 5 presents a unique opportunity to shape lifelong patterns of mental health and wellbeing. Early intervention, especially in priority populations, can significantly impact the trajectory of mental health outcomes.
As the college of psychiatrists, our responsibility extends beyond crisis management to proactively advocating for prevention and early intervention through timely access to mental health support for children.
Our starting point is confronting. In New Zealand, approximately 11% of children aged 3–4 years have emotional difficulties and in Australia, an estimated 16% of Australian children aged 2–3 years have social-emotional problems and almost 25% have behavioural problems.
These challenges are often linked to adverse childhood experiences such as child abuse and neglect, hostile parenting, caregiver mental health issues, and severe poverty. Recognising these risk factors, the report calls for a comprehensive, integrated approach to support infant and child mental health.
The report has identified that preventing or reducing exposure to adverse childhood experiences (ACEs) could reduce the rate of common mental disorders in the population by an estimated 30%.
This means over the course of their life, 3 in 10 Australians can avoid developing mental health conditions or can manage their conditions in a way that is conducive to their wellbeing and participation in society, if given specialist support early on.
The key strategies outlined in the report by members emphasise the need for a responsive, integrated, sustainable, and equitable (RISE) framework.
This includes lobbying governments and policy makers to break cycles of poverty and inequality, engaging and empowering families and communities, and embedding screening and case-finding within well-functioning referral pathways. Crucially, the co-location of mental health services within routine family visits is proposed to enhance accessibility and reduce stigma.
The shortage of child and adolescent psychiatrists is glaring, especially in rural areas. Imagine the children in those underserved regions — their struggles, their unmet needs. We know that youth in these areas are at greater risk of suicidality than those in metropolitan areas.
As we mark Children’s Mental Health Week, this timely report could mark the start of a turning point in how we design and plan our services, train our workforce, and provide equity and excellence in mental healthcare for our youngest community members.
Your role as psychiatrists is pivotal in these circumstances. Early psychiatric support is identified as crucial for vulnerable infants and children. By integrating mental health care into the broader spectrum of children's care, including collaboration with GPs, nurses, paediatricians, psychologists, and allied health professionals, we can create a non-stigmatising environment that fosters early and timely psychosocial intervention for children at risk.
The shortage of child and adolescent psychiatrists poses a stark challenge, and we have our part to play in helping bridge this gap, ensuring every child, regardless of location, has access to quality mental health care.
Let us stand together in our commitment to building a healthier and happier future for the children of Australia and New Zealand.