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Mental health difficulties across childhood and mental health service use: findings from a longitudinal population-based study

  • Melissa Mulraney (a1), Harriet Hiscock (a2), Emma Sciberras (a3), David Coghill (a4) and Michael Sawyer (a5)...

Abstract

Background

Over the past 20 years the prevalence of child and adolescent mental disorders in high-income countries has not changed despite increased investment in mental health services. Insufficient contact with mental health services may be a contributing factor; however, it is not known what proportion of children have sufficient contact with health professionals to allow delivery of treatment meeting minimal clinical practice guidelines, or how long children experience symptoms prior to receiving treatment.

Aims

To investigate the level of mental healthcare received by Australian children from age 4 years to 14 years.

Method

Trajectories of mental health symptoms were mapped using the Strengths and Difficulties Questionnaire. Health professional attendances and psychotropic medications dispensed were identified from linked national Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme records.

Results

Four trajectories of mental health symptoms were identified (low, high-decreasing, moderate-increasing and high-increasing). Most children with mental health symptoms had few MBS mental health attendances, and only a minority received care meeting study criteria for minimally adequate treatment. Children in the high-increasing and moderate-increasing trajectories were more likely to access care, yet there was no evidence of improvement in symptoms.

Conclusions

It is important that children and adolescents with mental health problems receive treatment that meets minimal practice guidelines. Further research is needed to identify the quality of care currently provided to children with mental health difficulties and how clinicians can be best funded and supported to provide care meeting minimal practice guidelines.

Declaration of interests

None.

Copyright

Corresponding author

Correspondence: Melissa Mulraney, Health Services, Murdoch Children's Research Institute, 50 Flemington Rd, Parkville, Victoria 3052, Australia. Email: melissa.mulraney@mcri.edu.au

References

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1Jorm, AF, Patten, SB, Brugha, TS, Mojtabai, R. Has increased provision of treatment reduced the prevalence of common mental disorders? Review of the evidence from four countries. World Psychiatry 2017; 16: 90–9.
2Jorm, AF. Why Hasn't the Mental Health of Australians Improved? The Need for a National Prevention Strategy. Sage Publications, 2014.
3Johnson, SE, Lawrence, D, Hafekost, J, Saw, S, Buckingham, WJ, Sawyer, M, et al. Service use by Australian children for emotional and behavioural problems: findings from the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry 2016; 50: 887–98.
4Harris, MG, Hobbs, MJ, Burgess, PM, Pirkis, JE, Diminic, S, Siskind, DJ, et al. Frequency and quality of mental health treatment for affective and anxiety disorders among Australian adults. Med J Aust 2015; 202: 185–9.
5Wang, PS, Berglund, P, Kessler, RC. Recent care of common mental disorders in the United States: prevalence and conformance with evidence-based recommendations. J Gen Intern Med 2000; 15: 284–92.
6Wang, PS, Lane, M, Olfson, M, Pincus, HA, Wells, KB, Kessler, RC. Twelve-month use of mental health services in the United States: results from the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62: 629–40.
7Soloff, C, Lawrence, D, Johnstone, R. LSAC Technical Paper No. 1: Sample Design. Australian Institute of Family Studies, 2005.
8Australian Government Department of Human Services. Medicare Statistics. Australian Government Department of Human Services , 2018 (https://www.humanservices.gov.au/organisations/about-us/statistical-information-and-data/medicare-statistics).
9Hiscock, H, Danchin, MH, Efron, D, Gulenc, A, Hearps, S, Freed, GL, et al. Trends in paediatric practice in Australia: 2008 and 2013 national audits from the Australian Paediatric Research Network. J Paediatr Child Health 2017; 53: 5561.
10Goodman, R. Psychometric properties of the Strengths and Difficulties Questionnaire. J Am Acad Child Adolesc Psychiatry 2001; 40: 1337–45.
11Blakemore, T, Strazdins, L, Gibbings, J. Measuring family socioeconomic position. Austr Soc Policy 2009; 8: 121–68.
12Pink, B. Technical Paper: Socio-Economic Indexes for Areas (SEIFA) 2011. Australian Bureau of Statistics, 2013.
13Furukawa, TA, Kessler, RC, Slade, T, Andrews, G. The performance of the K6 and K10 screening scales for psychological distress in the Australian National Survey of Mental Health and Well-Being. Psychol Med 2003; 33: 357–62.
14Muthen, L, Muthen, B. Mplus User's Guide. Muthen & Muthen, 1998–2011.
15Ryan, SM, Jorm, AF, Toumbourou, JW, Lubman, DI. Parent and family factors associated with service use by young people with mental health problems: a systematic review. Early Interv Psychiatry 2015; 9: 433–46.
16Lawrence, D, Hafekost, J, Johnson, SE, Saw, S, Buckingham, WJ, Sawyer, MG, et al. Key findings from the second Australian child and Adolescent Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry 2016; 50: 876–86.
17Lawrence, D, Johnson, S, Hafekost, J, Boterhoven de Haan, K, Sawyer, M, Ainley, J, et al. The Mental Health of Children and Adolescents: Report on the Second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Department of Health, Canberra, 2015.
18Kessler, RC, Berglund, P, Demler, O, Jin, R, Merikangas, KR, Walters, EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62: 593602.

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Supplementary materials

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Mental health difficulties across childhood and mental health service use: findings from a longitudinal population-based study

  • Melissa Mulraney (a1), Harriet Hiscock (a2), Emma Sciberras (a3), David Coghill (a4) and Michael Sawyer (a5)...

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Mental health difficulties across childhood and mental health service use: findings from a longitudinal population-based study

  • Melissa Mulraney (a1), Harriet Hiscock (a2), Emma Sciberras (a3), David Coghill (a4) and Michael Sawyer (a5)...
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