Saturday, 20 June 2009

Sobering statistics from the National Health Survey- Part 2

The National Health Survey of children, A Picture of Australia's Children 2009, states that greater than 1 in 10 children has mental health issues:

It is estimated that as many as 20% of children in modern societies are
affected by mental health problems and, in Australia, mental health problems and
disorders as a broad cause group accounted for the highest burden of disease
among children in 2003 (Bayer et al. 2007; Begg et al. 2007). Children with
mental health problems experience a number of adverse outcomes,
including general suffering, functional impairment, exposure to stigma and discrimination, and increased risk of premature death (Patel et al. 2007).

There are a number of developmental factors that contribute to the
onset of mental illness in children, including
prenatal brain damage, genetic
factors, low intelligence, difficult temperament, poor social skills and
low self-esteem. Other contributing factors include those within the school
context, such as bullying and failure to achieve academically; physical
or psychological trauma
, such as sustaining injuries, experiencing abuse or
neglect, or loss of family
; as well as community and cultural factors such as
low socioeconomic status or discrimination (DHAC 2000).

Parenting and family factors are also important determinants of
children’s mental health. Those identified as increasing the risk of mental health problems in children include:
  • the lack of a warm, positive relationship with parents;
  • insecure attachment between carers and infants;
  • harsh, inflexible or inconsistent discipline;
  • inadequate supervision of, and involvement with, children;
  • marital conflict and breakdown; and
  • parental psychopathology (particularly maternal depression and
    levels of parenting stress)
    (Sanders 2002).

These factors increase the risk of children developing major behavioural and
emotional problems, including conduct problems, substance misuse, antisocial
behaviour and participation in delinquent activities (Sanders 2002). A number
of mental disorders first manifest in childhood and adolescence, and many
disorders that are diagnosed in adulthood have their origins in childhood.
Disorders known as ‘impulse-control’ disorders have the earliest typical age of
onset—7–9 years for ADHD, 9–14 years for conduct disorder and 7–14 years for
some anxiety disorders (phobias and separation anxiety disorder) (Kessler et al.

According to the ABS 2004–05 National Health Survey, among children aged
4–14 years:

􀁴􀀁 An estimated 253,600 or 9% had a mental or behavioural problem as a
long-term condition.

􀁴􀀁 The most commonly reported problems were

– behavioural and emotional problems with usual onset in childhood or
adolescence (3%)
– problems of psychological development (3%)

anxiety-related problems (2%).

The Strengths and Difficulties Questionnaire collects information about
children’s mental health and behaviour (Goodman 2001). This questionnaire has
been widely used within Australia and has good reliability and validity.
Children are scored on each of five domains (emotional symptoms, conduct problems, hyperactive behaviour, peer relationships and prosocial behaviour) as
‘normal’, ‘borderline’ or ‘of concern’. Children scoring ‘of concern’ are at
substantial risk of developing a clinically significant behavioural problem. The
questionnaire has been used on a representative sample of children in New South
Wales and Victoria, and has been used in Western Australia for Indigenous and
non-Indigenous children.

Results from the Strengths and Difficulties Questionnaire indicate that among children aged 4–12 years:

􀁴􀀁 In New South Wales, 7% of children had behaviour problems that were
rated ‘of concern’ in 2005–06 (Table 8.1). Around 11% of children scored ‘of
concern’ on both the emotional symptoms and hyperactivity scales, and 9% on the
conduct disorders scale.

􀁴􀀁 In Victoria, 6% of children had behaviour problems that were rated
‘of concern’ in 2006.
Around 11% of children scored ‘of concern’ on the
hyperactivity scale, 9% on the conduct disorder scale and 8% on the peer
problems scale.


ADHD, depressive disorder and conduct disorder have great significance for child
and adolescent health in Australia (Sawyer et al. 2000), with ADHD and
anxiety and depression among the leading specific causes of the disease
burden among children in 2003 (Begg et al. 2007). These conditions have
implications for a child’s psychosocial growth and development,
health-care requirements, educational and occupational attainment and
their involvement with the justice system (Bhatia &; Bhatia 2007; Eme
2007; Laurel & Wolraich 2007).

What do doctors see?

The most common mental health problems managed for children were:

  • behaviour symptom/complaint (27%)
  • I> ADHD (18%)
  • sleep disturbance (14%)
  • depression/anxiety disorder (13%)

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