This week, decision makers, policy makers, service providers, young people and advocates will come together at a forum in Hobart to discuss how we might do things differently to better support the mental health of young Tasmanians aged 12-25 years.
I’ve been asked to come along to share what I’ve learnt about how children and young people, and those who support them in our communities, are feeling about mental health and access to mental health services.
This is a discussion we desperately need to have and one which I feel passionate about.
The importance of good mental health for children and young people and the need for improved access to mental health services are issues that have been consistently raised with me since I began my term as Commissioner for Children and Young People almost a year ago.
The World Health Organisation defines mental health as “a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”
For children and young people, mental health is a huge contributor to overall wellbeing. It can influence the way they think or feel about themselves and about the world around them.
Poor mental health, if left unchecked, can have a profound impact on a young person’s future, including their ability to achieve their education or employment goals.
The impacts of this are considerable. In its recently released Draft Report into Mental Health, the Productivity Commission found that the cost to the Australian economy of mental ill-health and suicide is, conservatively, between $43 to $51 billion per year.
The data tells us around 1 in 7 children and young people aged between 4 and 17 in Australia have a mental disorder.
However, a disorder exists at the end of a continuum of mental health and wellbeing – so there will be many more Tasmanian children and young people experiencing some type of mental health problem at some time during their childhood or adolescence.
Further, there are Tasmanian children and young people who experience the stress and sometimes trauma that can come from living with others who experience mental health problems but who are not receiving the support they need.
In my discussions with many children and young people, family members, carers and service providers as I’ve travelled the state on a listening tour over the past year, I have heard really clearly that mental health is a priority for children and young people, that they understand what it is, and why it’s important.
I’m told there has been an increase in community demand for mental health services due to an increased understanding of the importance of good mental health.
I have also heard that services, not just for young people, but for others in their communities, can be difficult to access or in some cases, they are non-existent.
This has particularly been the case in some of the small towns and rural areas I’ve visited. Waiting lists are significant, sometimes eight weeks or more. Access to suitably qualified staff is also a barrier to the delivery of the services needed to promote good mental health and wellbeing.
I’m told there is concern about the lack of appropriate in-patient facilities to treat children with mental illness or associated substance abuse issues.
I’ve also heard that the system is difficult to navigate, especially if you don’t have the support of your parents, if you are homeless, or if you are in Out-Of-Home Care.
There are various state and federal funding mechanisms that are supporting a variety of services – in schools, hospitals and in communities – but these services are not always well connected.
I have also heard about the frustration of carers and parents who have been turned away from mental health services, who have been told their child doesn’t have “a mental health problem”; but that it’s a “behavioural issue” or “trauma related”.
Carers and parents seeking support should not have to navigate a service system in this way and neither should our young people. However, from what I have heard, they can be left not knowing where to turn. Where can they turn? I don’t know.
This is not a criticism of those many dedicated professionals providing mental health services – rather, it tells me that our service system is not as integrated as it should be and that we need to look at whether the services we do have are providing the supports and assistance that are needed.
It would be naïve to presume we could eliminate mental health conditions for our children and young people. However, we can support them better and there are opportunities arising from the current focus on mental health at both the State and Federal level. Now is the time to change our approach.
Initiatives in this space include: the current Productivity Commission inquiry into Mental Health, commitments to a more integrated mental health system in Tasmania, a commitment to reviewing the model of care for Child and Adolescent Mental Health Services in Tasmania, new facilities being built at both ends of the State, plus the additional investment flowing from the Fifth National Mental Health and Suicide Prevention Plan.
We need to acknowledge that things should and can be done differently – and we need to consider where we invest to gain the greatest bang for our buck.
This week’s forum is about how we support youth mental health – and there’s certainly a need to re-imagine our youth mental health services. However, we should also consider how we address the apparent decline in youth mental health – and an important way of doing this is to provide support and intervention much, much earlier in a child’s life.
The evidence is clear that the first 1000 days of a child’s life, from conception to the end of the second year, is the period that has the greatest potential to affect health and wellbeing over the life course.
This is, in my opinion, where we should also focus additional investment if we are to make a difference.
At the same time, we must work better together, across all levels of government as well as between government agencies and with the non-government sector, to integrate our services and make the system easier to navigate for those who seek to access it. Ultimately this will help ensure that the right support and assistance is available when it is asked for and when it is needed.
Commissioner for Children and Young People