Adequacy of treatment for child and adolescent mental disorders in Australia: A national study

Michael G. Sawyer, Christy E. Reece, Alyssa C.P. Sawyer, Harriet Hiscock, David Lawrence

Research output: Contribution to journalArticle

1 Citation (Scopus)
94 Downloads (Pure)

Abstract

Objective: Worldwide, little information is available about the extent to which children with mental disorders in the general population receive treatment from health professionals that meets minimal clinical practice guidelines. This study identifies the percentage of 6–17 year olds with mental disorders in the 2013–2014 Australian national survey of mental health who had sufficient contact with health professionals during the 18 months after the survey to have received treatment meeting criteria for minimally adequate treatment (MAT). It also identifies factors associated with children having this level of contact with health professionals. Method: Mental disorders were identified using the Diagnostic Interview Schedule for Children Version IV completed by parents. Health professional attendances and psychotropic medications dispensed were identified from linked national Medicare Benefits Schedule and Pharmaceutical Benefits Scheme records. Results: Only 11.6% (95% confidence interval [CI] [9.1, 14.8]) of children with disorders (n = 517) had sufficient contact to achieve study criteria for MAT. Furthermore, among children with mental disorders who had severe functional impairment and whose parents perceived that their child needed help (n = 146), 20.2% (95% CI [14.3, 27.9]) had contact sufficient for MAT, 46.0% (95% CI [37.8, 54.4]) had contact that did not achieve MAT criteria and 33.8% (95% CI [26.1, 42.3]) had no contact with health professionals. In multivariable regression, children with moderate or severe functional impairment were more likely to have had sufficient contact to meet MAT criteria. Conclusion: During the 18 months after being identified with a mental disorder, only a small percentage of children have enough contact with health professionals to allow provision of MAT. This may be contributing to the unchanging high prevalence of childhood mental disorders.

Original languageEnglish
Pages (from-to)326-335
Number of pages10
JournalAustralian and New Zealand Journal of Psychiatry
Volume53
Issue number4
DOIs
Publication statusPublished - 1 Apr 2019

Fingerprint

Mental Disorders
Health
Confidence Intervals
Therapeutics
Appointments and Schedules
Parents
Neurodevelopmental Disorders
Medicare
Practice Guidelines
Mental Health
Interviews
Pharmaceutical Preparations
Population
Surveys and Questionnaires

Cite this

Sawyer, Michael G. ; Reece, Christy E. ; Sawyer, Alyssa C.P. ; Hiscock, Harriet ; Lawrence, David. / Adequacy of treatment for child and adolescent mental disorders in Australia : A national study. In: Australian and New Zealand Journal of Psychiatry. 2019 ; Vol. 53, No. 4. pp. 326-335.
@article{a59d08fde58d42aba3ba06b0fbfcaa42,
title = "Adequacy of treatment for child and adolescent mental disorders in Australia: A national study",
abstract = "Objective: Worldwide, little information is available about the extent to which children with mental disorders in the general population receive treatment from health professionals that meets minimal clinical practice guidelines. This study identifies the percentage of 6–17 year olds with mental disorders in the 2013–2014 Australian national survey of mental health who had sufficient contact with health professionals during the 18 months after the survey to have received treatment meeting criteria for minimally adequate treatment (MAT). It also identifies factors associated with children having this level of contact with health professionals. Method: Mental disorders were identified using the Diagnostic Interview Schedule for Children Version IV completed by parents. Health professional attendances and psychotropic medications dispensed were identified from linked national Medicare Benefits Schedule and Pharmaceutical Benefits Scheme records. Results: Only 11.6{\%} (95{\%} confidence interval [CI] [9.1, 14.8]) of children with disorders (n = 517) had sufficient contact to achieve study criteria for MAT. Furthermore, among children with mental disorders who had severe functional impairment and whose parents perceived that their child needed help (n = 146), 20.2{\%} (95{\%} CI [14.3, 27.9]) had contact sufficient for MAT, 46.0{\%} (95{\%} CI [37.8, 54.4]) had contact that did not achieve MAT criteria and 33.8{\%} (95{\%} CI [26.1, 42.3]) had no contact with health professionals. In multivariable regression, children with moderate or severe functional impairment were more likely to have had sufficient contact to meet MAT criteria. Conclusion: During the 18 months after being identified with a mental disorder, only a small percentage of children have enough contact with health professionals to allow provision of MAT. This may be contributing to the unchanging high prevalence of childhood mental disorders.",
keywords = "adolescents, Australia, Children, health service use, mental disorders",
author = "Sawyer, {Michael G.} and Reece, {Christy E.} and Sawyer, {Alyssa C.P.} and Harriet Hiscock and David Lawrence",
year = "2019",
month = "4",
day = "1",
doi = "10.1177/0004867418808895",
language = "English",
volume = "53",
pages = "326--335",
journal = "Australian & New Zealand Journal of Psychiatry",
issn = "0004-8674",
publisher = "SAGE Publications Ltd",
number = "4",

}

Adequacy of treatment for child and adolescent mental disorders in Australia : A national study. / Sawyer, Michael G.; Reece, Christy E.; Sawyer, Alyssa C.P.; Hiscock, Harriet; Lawrence, David.

In: Australian and New Zealand Journal of Psychiatry, Vol. 53, No. 4, 01.04.2019, p. 326-335.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Adequacy of treatment for child and adolescent mental disorders in Australia

T2 - A national study

AU - Sawyer, Michael G.

AU - Reece, Christy E.

AU - Sawyer, Alyssa C.P.

AU - Hiscock, Harriet

AU - Lawrence, David

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Objective: Worldwide, little information is available about the extent to which children with mental disorders in the general population receive treatment from health professionals that meets minimal clinical practice guidelines. This study identifies the percentage of 6–17 year olds with mental disorders in the 2013–2014 Australian national survey of mental health who had sufficient contact with health professionals during the 18 months after the survey to have received treatment meeting criteria for minimally adequate treatment (MAT). It also identifies factors associated with children having this level of contact with health professionals. Method: Mental disorders were identified using the Diagnostic Interview Schedule for Children Version IV completed by parents. Health professional attendances and psychotropic medications dispensed were identified from linked national Medicare Benefits Schedule and Pharmaceutical Benefits Scheme records. Results: Only 11.6% (95% confidence interval [CI] [9.1, 14.8]) of children with disorders (n = 517) had sufficient contact to achieve study criteria for MAT. Furthermore, among children with mental disorders who had severe functional impairment and whose parents perceived that their child needed help (n = 146), 20.2% (95% CI [14.3, 27.9]) had contact sufficient for MAT, 46.0% (95% CI [37.8, 54.4]) had contact that did not achieve MAT criteria and 33.8% (95% CI [26.1, 42.3]) had no contact with health professionals. In multivariable regression, children with moderate or severe functional impairment were more likely to have had sufficient contact to meet MAT criteria. Conclusion: During the 18 months after being identified with a mental disorder, only a small percentage of children have enough contact with health professionals to allow provision of MAT. This may be contributing to the unchanging high prevalence of childhood mental disorders.

AB - Objective: Worldwide, little information is available about the extent to which children with mental disorders in the general population receive treatment from health professionals that meets minimal clinical practice guidelines. This study identifies the percentage of 6–17 year olds with mental disorders in the 2013–2014 Australian national survey of mental health who had sufficient contact with health professionals during the 18 months after the survey to have received treatment meeting criteria for minimally adequate treatment (MAT). It also identifies factors associated with children having this level of contact with health professionals. Method: Mental disorders were identified using the Diagnostic Interview Schedule for Children Version IV completed by parents. Health professional attendances and psychotropic medications dispensed were identified from linked national Medicare Benefits Schedule and Pharmaceutical Benefits Scheme records. Results: Only 11.6% (95% confidence interval [CI] [9.1, 14.8]) of children with disorders (n = 517) had sufficient contact to achieve study criteria for MAT. Furthermore, among children with mental disorders who had severe functional impairment and whose parents perceived that their child needed help (n = 146), 20.2% (95% CI [14.3, 27.9]) had contact sufficient for MAT, 46.0% (95% CI [37.8, 54.4]) had contact that did not achieve MAT criteria and 33.8% (95% CI [26.1, 42.3]) had no contact with health professionals. In multivariable regression, children with moderate or severe functional impairment were more likely to have had sufficient contact to meet MAT criteria. Conclusion: During the 18 months after being identified with a mental disorder, only a small percentage of children have enough contact with health professionals to allow provision of MAT. This may be contributing to the unchanging high prevalence of childhood mental disorders.

KW - adolescents

KW - Australia

KW - Children

KW - health service use

KW - mental disorders

UR - http://www.scopus.com/inward/record.url?scp=85060204762&partnerID=8YFLogxK

U2 - 10.1177/0004867418808895

DO - 10.1177/0004867418808895

M3 - Article

VL - 53

SP - 326

EP - 335

JO - Australian & New Zealand Journal of Psychiatry

JF - Australian & New Zealand Journal of Psychiatry

SN - 0004-8674

IS - 4

ER -