Young peo­ple know men­tal health is cru­cial — let’s help them

Ser­vices must step in much ear­lier in life — from be­fore birth, ex­plains Leanne McLean

Mercury (Hobart) - - TALKING POINT - Leanne McLean is Tas­ma­nian Com­mis­sioner for Chil­dren and Young Peo­ple.

TO­DAY 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 Tas­ma­ni­ans aged 12-25.

I’ve been asked to share what I’ve learnt about how chil­dren and young peo­ple, and those who sup­port them, are feel­ing about men­tal health and ac­cess to ser­vices.

This is a dis­cus­sion we des­per­ately need to have.

The im­por­tance of good men­tal health for chil­dren and young peo­ple and the need for im­proved ac­cess 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 well­be­ing 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 well­be­ing. It can in­flu­ence the way they think or feel about them­selves and 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 ed­u­ca­tion or em­ploy­ment goals.

In its re­cent Draft Re­port into Men­tal Health, the Pro­duc­tiv­ity Com­mis­sion found the cost to the Aus­tralian econ­omy of men­tal ill-health and sui­cide is, con­ser­va­tively, $43 to $51 bil­lion a year.

The data tells us about one in seven chil­dren aged 4 to 17 in Aus­tralia have a men­tal dis­or­der.

How­ever, a dis­or­der ex­ists at the end of a con­tin­uum – so there will be many more Tas­ma­ni­ans ex­pe­ri­enc­ing a men­tal health prob­lem at some time dur­ing their child­hood or ado­les­cence.

Fur­ther, there are 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 sup­port they need.

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 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, can be dif­fi­cult to ac­cess or in some cases are non-ex­is­tent.

This is par­tic­u­larly the case in some small towns and ru­ral ar­eas. Wait­ing lists are sig­nif­i­cant, some­times eight weeks or more. Ac­cess to qual­i­fied staff is also a bar­rier.

I’m told there is con­cern about the lack of in­pa­tient fa­cil­i­ties to treat chil­dren with men­tal ill­ness or as­so­ci­ated sub­stance abuse is­sues.

I’ve also heard the sys­tem is dif­fi­cult to nav­i­gate, es­pe­cially if you don’t have the sup­port of par­ents, if you are home­less or in out-of-home care.

There are state and fed­eral fund­ing mech­a­nisms that sup­port ser­vices – in schools, hospi­tals and com­mu­ni­ties – but th­ese are not al­ways well con­nected.

I have also heard about the frus­tra­tion of car­ers turned away from men­tal health ser­vices, who have been told

their child doesn’t have a men­tal health prob­lem, that it’s a “be­havioural is­sue” or “trauma re­lated”.

Car­ers and par­ents seek­ing sup­port should not have to nav­i­gate a sys­tem in this way and nei­ther should our young peo­ple. 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 – rather, it tells me our ser­vice sys­tem is not as in­te­grated as it should be and we need to look at whether the ser­vices we do have are pro­vid­ing the as­sis­tance needed. It would be naive to pre­sume we could elim­i­nate men­tal health con­di­tions for our young peo­ple. How­ever, we can sup­port them bet­ter and there are op­por­tu­ni­ties aris­ing from the cur­rent fo­cus on men­tal health at both state and fed­eral level. Now is the time to change our ap­proach.

Ini­tia­tives in­clude the Pro­duc­tiv­ity Com­mis­sion in­quiry into Men­tal Health; com­mit­ment 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 in­vest­ment flow­ing from the Fifth Na­tional Men­tal Health and Sui­cide Pre­ven­tion Plan.

We need to ac­knowl­edge things can be done dif­fer­ently – and we need to con­sider where we in­vest to gain the great­est bang for our buck.

To­day’s fo­rum is about how we sup­port youth men­tal health – and there’s cer­tainly a need to re-imag­ine our youth men­tal health ser­vices. 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, 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 and be­tween govern­ment agen­cies and non-govern­ment sec­tor, to make the sys­tem eas­ier to nav­i­gate. Ul­ti­mately this will help en­sure the right sup­port and as­sis­tance is avail­able when it is asked for and when it is needed.

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