Towards improved mental health for students
Mental health issues have a profound and long-lasting impact on Australian children and young people. School psychologists have a key role to play in delivering universal support, but more investment is urgently required.
Every year, an estimated 14%1 of Australian school children experience one or more mental, behavioural or neurodevelopmental disorders. School-aged children and young people with mental health struggles also experience impairments in other areas of development.
Worryingly, the pandemic has added an extra dimension to the problem, in many cases exacerbating existing mental health issues or sparking new ones. And there’s more to it than the early years, with psychological distress in childhood often continuing into adulthood.
The size and scale of mental health issues among Australian children calls for a more comprehensive approach in our schools – one that is universal, evidence-based and, most importantly, puts psychologists at the forefront of care.
Charting the impact of mental health issues
Mental health issues have a significant and potentially long-lasting impact on children and young people. After asthma, anxiety, depression and conduct disorder are the leading causes of disease burden for children aged 5–14. For young people aged 15–24, suicide and self-inflicted injuries are the most common mental health issues, followed by anxiety and depression.
The effects of the pandemic, from school shutdowns and social isolation to loneliness and economic strain for families and communities, have further impacted mental health and wellbeing. In particular, children who experienced the most significant deterioration in mental health during the pandemic are from many of the same cohorts already at increased risk of experiencing mental health struggles before the pandemic, including children from diverse cultural backgrounds, and children with a disability or chronic illness.
Looking ahead, experts are predicting a surge in longer-term mental health and wellbeing issues associated with the pandemic, especially among vulnerable children and young people.
Added to this, research that shows mental, behavioural and neurodevelopmental disorders in children and young people can provoke a damaging developmental cascade. For many children, symptoms of mental ill-health can undermine school engagement, learning and relationships, which in turn impacts social adjustment and academic achievement. The spiralling negative effects of poor social and educational attainment further exacerbate mental distress.
The cascade does not stop there, with evidence revealing that psychological distress in childhood often continues into adulthood. About 50% of adult mental health disorders are estimated to begin before the age of 14.
The important role of school psychologists
The evidence is clear that lifelong mental health begins in childhood. Schools are an important environment for promoting universal wellbeing and identifying problems early, and as leading mental health experts school psychologists have a key role to play.
School psychologists have the training and skills to coordinate and deliver evidence-based, whole school, multi-tiered school-based mental health and wellbeing approaches. They also possess specific skills in assessment and interventions for mental health, developmental, learning and behavioural issues, helping children and young people achieve social and emotional wellbeing and academic success. School psychologists also partner with school staff and leaders as in-house trainers, coaches, consultants and advisors as they implement mental health initiatives.
What’s more, school psychologists are perfectly positioned to be the bridge linking young people and their families to mental health support outside of schools, including primary health care, specialist community mental health treatment services and social services. School psychologists know this services landscape well and can effectively refer and partner with these services if required for more intensive assessment and/or treatment.
The trouble is that there are simply not enough school psychologists in Australian schools. Estimates suggest that there is about one school psychologist to every 1500 students. This poor workforce ratio prevents many school psychologists from working to their full scope of practice. With high numbers of students to serve, school psychologists’ work must often focus on the more complex cases, leaving the broader student population vulnerable to a lack of support and unable to live up to their full potential.
It’s a trend seen across the profession, with recent estimates suggesting that Australia has only 35% of the required psychology workforce. Surges in help-seeking for mental health issues during the pandemic, especially during the lockdown periods, have seen waitlists for psychologists extend up to six to 12 months. One in three psychologists have now closed their books, compared to one in 100 before the pandemic.
A ratio of at least one full-time psychologist to every 500 students will enable best-practice comprehensive school-based mental health support services throughout all Australian schools.
Scaling up support and services
The way forward is touted as embedding within all schools a comprehensive, evidence-based approach to universal mental health promotion and prevention, and early intervention for mental ill-health, that’s led by a highly trained and skilled psychology workforce.
Crucially, a more favourable ratio of at least one full-time psychologist to every 500 students will enable best-practice comprehensive school-based mental health support services throughout all Australian schools. It is imperative to ensure that all children and young people are supported to be mentally healthy and well, not only those with complex mental health, learning or developmental support needs. In particular, this improved ratio must include providing mental health support to children and young people in the typically underserved areas of regional, rural and remote Australia.
At least 8000 school psychologists are needed to serve a student population of four million students. With the right investment in postgraduate university training, sponsored placements and quality professional supervision, the number of fully trained psychologists available to work in schools could be scaled up within a short timeframe of two to three years.
Dedicated university places and scholarships to greatly improve Aboriginal and Torres Strait Islander representation in school psychology roles are a priority. These investments in training psychologists will deliver immediate benefits for students’ mental health and wellbeing by providing access to a psychology intern workforce, particularly in rural and remote schools.
Children and young people with good mental health are more likely to be resilient in the face of challenges, realise their potential, live fulfilling lives and become productive members of society. Yet school-based mental health services can only meet their full potential when led, coordinated and supported by a dedicated and highly skilled psychology workforce.
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1One in seven = 14%