The Government announced in last week’s Budget a plan to screen children at the age of three for not only physical health, but also emotional health. It’s part of a bigger package of spending on the prevention and early intervention of mental illness in infants and children.
Can we even diagnose mental illness in three year olds? And is it a good use of money?
Prevention and Early Intervention
We as a community readily accept the concepts of prevention and early intervention in physical health. To prevent illness, we immunise our children. We try to detect diseases at an early stage by screening babies in utero and at birth, and as adults we go for cervical smears and mammograms.
Like physical illness, mental illness causes serious suffering, disability and even death. Depression alone will affect 20% of adults, and according to the World Health Organisation is the leading global cause of years of health lost to disease. Mental illness encompasses more than depression: when we add in anxiety, psychosis, and substance abuse the impact is staggering.
We can’t immunise against mental illness, but we can detect problems at an early stage and act on them.
Do mental health problems in young children even exist?
Yes, without a doubt. Studies show that 11%-18% of children under two have a mental health disorder. They don’t present in the same way as adults, but emotional and behavioural disturbances are common.
A quarter of people with a mental disorder experienced their first episode before the age of 12, and almost two-thirds before the age of 21.
Why should we screen for mental health problems in young children?
We can reliably diagnose many common disorders in young children. We know that emotional and behavioural disorders in childhood seriously harm a child’s development. A child who is displaying problems even before going to school will not be able to make friends, or learn, or develop a healthy self esteem. Problems will continue throughout adolescence and early adulthood. They will lack social and educational protective factors and be far more vulnerable to mental illness and substance abuse later in life.
Children with mental health issues are suffering, as are their families.
They are children. We need to do something.
Could the money be better used elsewhere?
It’s a harsh reality that Australia has a limited budget and decisions must be made about where each health dollar is spent for the maximum impact. There is $11 million (over 5 years) earmarked for this project: a small amount in the grand scheme of things, really.
Children with emotional difficulties grow into adults with emotional difficulties and mental illness. There comes a time when we need to try to break the cycle. We can keep spending all the money on those people who have already developed mental illnesses, or we can try to allocate some of the budget to child and adolescent mental health, and make sure our children grow into healthy, resilient teenagers, adults, and parents.
Prevention is better than cure
There is no doubt that the entire public mental health system needs more money. Ideally, all Australians with mental health issues would be promptly assessed and have optimal access to community and hospital resources, regardless of their age, location or diagnosis.
But with the limited resources that we have, isn’t prevention better than cure? By intervening early in life, we can make sure that as our children grow up, the rates of mental illness in adults are reduced. Investing in the mental health of our young children now means that we can make a step towards improving the mental health of our adolescents, adults, and their own children.
The Royal Australian and New Zealand College of Psychiatrists: Report from the Faculty of Child and Adolescent Psychiatry. Prevention and early intervention of mental illness in infants, children and adolescents: Planning strategies for Australia and New Zealand, 2010