Are young people with mental health disorders receiving adequate treatment?

This was the question posed by a group of researchers who investigated how many children and adolescents identified as having a mental health disorder received adequate intervention following their diagnosis.

With increasing investment in addressing mental health in the community, there has been concern at the lack of change in the prevalence of mental health disorders in children and adolescents. The authors of this paper undertook a survey to look at whether one explanation may be that young people are not accessing adequate treatment. They used criteria for minimum adequate treatment set by Saloner, Carson and Cook (2014)¹ who proposed a minimum of four visits with a mental health professional plus medication, or eight visits without medication, as being necessary for effective treatment of children with a diagnosis of depression or attention deficit hyperactivity disorder.

The study

Participants were 517 young people aged 6–17 years identified as having a mental health disorder in the second Australian Child and Adolescent Survey of Mental Health and Wellbeing2, and for whom parents had provided consent to participate. The authors used data collected over a period of 18 months under Medicare to determine access to services provided by health professionals and data sourced from the Pharmaceutical Benefits Scheme to determine prescribed psychotropic medication.

The data categorised contact with health professionals as (a) meeting minimum adequate treatment (4–7 visits with a health practitioner plus medication or more than eight visits (with or without medication), (b) visits not meeting minimum adequate treatment, or (c) no visit. Data was also collected on a range of demographic and parental coping variables including family structure, socioeconomic status, residential location (metropolitan vs regional/rural), family functioning, parental distress, as well as level of functional impairment for the child.

Findings

The findings showed that few young people in Australia with mental health disorders are accessing minimum adequate treatment. The authors propose that this may be one reason for the lack of change in prevalence rates over time. While 47 per cent of young people had contact with a health professional in the 18 months following their identification, only 11.6 per cent had contact that met the minimum adequate treatment protocol set in this study.

Only 20 per cent of children identified as having a severe functional impairment and whose parents reported a perceived need for assistance had contact that met the criteria. Demographic variables did not appear to have an impact on whether the young person did or did not have access to minimum adequate treatment. However, moderate or severe functional impairment was more likely to result in adequate intervention.

doi.10.1177/0004867418808895

1. Saloner, B., Carson, N. & Cook, B. L. (2014). Episodes of mental health treatment among a nationally representative sample of children and adolescents. Medical Care Research and Review, 71, 261-279.
2. For information about the data set and analyses see Zubrick, S. R., Lawrence, D., Sawyer, M., et al. (2014). Young minds matter dataset: The second Australian Child and Adolescent Survey of Mental Health and Wellbeing, 2013-2014. Canberra: Australian Data Archive.