Mental health problems – system down?
In the past seven years, the rate at which young people aged 10-19 have presented to emergency departments in Victoria with mental health problems has tripled. Self-harm, drug and alcohol issues, anxiety, and depression were the most common conditions treated.
We are also seeing big upsurges in 10-19-year-olds at NSW EDs in the period 2010-2014, with rates increasing at 27% per year over that period. Suicidal thinking and behaviour, self-harm, and intentional poisoning increased markedly.
Those statistics should give pause to all of us. How can that be?
It is likely that many factors are at play. The authors of the NSW study suggest possible culprits: changes to family and peer relationships, the onset of substance misuse at younger ages, improved recognition of mental health problems, and the increasing prevalence of social media and smartphone technology which some people believe have negative impacts for adolescent mental health.
It has been hypothesised that increased exposure to social media normalises self-harm, and makes teenagers vulnerable to peer pressure and cyber-bullying, as well as to low self-esteem, anxiety, depression, self-harm, and suicidal thinking.
Is ‘the system’ failing? Well, in one sense, yes. Some young people presenting at the emergency department have not accessed any help either at school or in the community until a crisis occurs. Others may have seen the school counsellor or a psychologist or have gone to Headspace.
But young people with complex problems who need extended care from a team of professionals may fall through cracks in ‘the system’, and end up at the ED, sometimes repeatedly. The fact that about a third of mental health presentations followed an earlier visit to an ED in the previous month suggests inadequate community care or follow-up.
Any parent/carer whose child needs to go to hospital for emergency treatment should ensure that adequate follow-up care plans are made and implemented without delay, and affordably, and should not hesitate to raise concerns with NSW Health or their Member of Parliament if there are shortcomings in care.
No one wants their child to end up in the ED for any reason. The earlier you seek advice and take appropriate action when you see concerning mood or behaviour changes, the easier it is to manage and resolve problems without a crisis.
Even if all is well at the moment, it’s a good idea to be familiar with available services. On the school website there is advice on finding information and support for a range of needs (Current families > Counselling).
Next time: More about the social factors behind our mental health problems.