Mental health of Australia's young people and adolescents (Australia's health 2016, AIHW)

Australia's health 2016 Australian Institute of Health and Welfare 2016. Australia's health 2016. Australia's health series no. 15. Cat. no. AUS 199. Canberra: AIHW. A u st ra li a 's h e a lt h 2 0 1 6 A u st ra li a 's h e a lt h 2 0 1 6 5.5 Mental health of Australia's young people and adolescents Mental health disorders that emerge during the formative years of childhood can have a lasting impact on the health and wellbeing of the individual and on the lives of those around them (Erskine et al. 2015). The development of programs and initiatives for young people who need mental health care and support requires a sound understanding of the scope of the problem, which is best achieved through population-based prevalence studies. Australia has an epidemiological mental health program, known as the National Survey of Mental Health and Wellbeing, which comprises three surveys: a survey of the adult population, a survey of people living with psychotic mental illness, and a survey of children and adolescents. Together, these surveys provide a detailed national view of the prevalence of mental health issues in Australia and of their impact. The Australian Child and Adolescent Survey of Mental Health and Wellbeing (known as the Young Minds Matter Survey), conducted in 2013–14, is the second survey to be conducted on the prevalence of mental health disorders in children and adolescents (Telethon Kids Institute 2015), which surveyed households with 4–17 year olds (the methodology is briefly summarised in Box 5.5.1). The survey also examined the health behaviours of young people and their use of the available support services and provided the opportunity to make comparisons against the first survey, conducted in 1998. Box 5.5.1: The Young Minds Matter Survey methodology Responses were obtained from over 6,000 households in Australia using two components. 1. A component for parents and carers Parents and carers were questioned by a trained interviewer on a range of topics, including: • family structure and sociodemographics • health of the child and any disabilities • the child's mental health service usage in the 12 months prior to the survey • school attendance • family characteristics. Survey instrument examples included: • strengths and difficulties questionnaire in relation to one selected child • the Diagnostic Interview Schedule for Children Version IV. (continued)

Australia's health 2016 Australian Institute of Health and Welfare 2016. Australia's health 2016. Australia's health series no. 15. Cat. no. AUS 199. Canberra: AIHW. A u st ra li a 's h e a lt h 2 0 1 6 2 A u st ra li a 's h e a lt h 2 0 1 6 Box 5.5.1 (continued): The Young Minds Matter Survey methodology 2. A component for young people A total of 3,000 people aged 11–17 from the participating households completed a self-report questionnaire that included: • a strengths and difficulties questionnaire • the Diagnostic Interview Schedule for Children Version IV major depressive disorder module • the Kessler Psychological Distress Scale. Questions included information about: • self-harm and suicidal behaviours • mental health service usage in the 12 months prior to the survey • experience of bullying and health risk behaviours • use of the internet and informal support mechanisms. Source: Lawrence et al. 2015. Prevalence of mental health disorders in young people Results from the 2013–14 Young Minds Matter Survey indicate that the majority of children and adolescents in Australia have good mental health. However, the results also indicate that 1 in 7 (14%, or 560,000) children and adolescents aged 4–17 had a mental disorder in the previous 12 months. Common mental disorders covered in the Young Minds Matter Survey are briefly described in Box 5.5.2. Prevalence rates were higher overall among males (16%) than females (12%) across all disorders except Major depressive disorder (Figure 5.5.1). Attention deficit hyperactivity disorder (ADHD) was the most prevalent disorder for males, and more common in the 4–11 years age group than in the 12–17 years age group. Anxiety disorders was the most prevalent disorder group among females, and more common in the 12–17 years age group. The prevalence of Major depressive disorder was higher when young people aged 11–17 provided the information themselves (7.7%) than when the information was provided by their parent/carer (4.7%). Box 5.5.2: Common mental disorders covered in the Young Minds Matter Survey Major depressive disorder—the key feature is the presence of either depressed mood, loss of interest or pleasure or being grouchy, irritable and in a bad mood. Symptoms of major depressive disorder may include significant weight change, loss of appetite, difficulty sleeping, restlessness, fatigue and loss of energy, feeling of worthlessness and inability to concentrate. The diagnostic criteria for this disorder specify that at least five symptoms of depression must be present for a minimum of a 2-week period; that these symptoms cause clinically significant distress; and that they interfere with normal functions at school, at home or in social settings. (continued)

Australia's health 2016 Australian Institute of Health and Welfare 2016. Australia's health 2016. Australia's health series no. 15. Cat. no. AUS 199. Canberra: AIHW. A u st ra li a 's h e a lt h 2 0 1 6 3 A u st ra li a 's h e a lt h 2 0 1 6 Figure 5.5.1: 12-month prevalence of mental health disorders, by disorder type, by age and sex, 2013–14 Box 5.5.2 (continued): Common mental disorders covered in the Young Minds Matter Survey Anxiety disorders—a class of mental disorders defined by the experience of intense and debilitating anxiety. The type of anxiety disorders covered in the survey were social phobia, separation anxiety disorder, generalised anxiety disorder, and obsessive-compulsive disorder. Attention deficit hyperactivity disorder (ADHD)—a persistent pattern of inattention and/or hyperactivity-impulsivity. Children and adolescents with this condition may find it difficult to pay attention and to see tasks or activities through to the end, or may make careless mistakes with school work or other tasks. Children and adolescents with problems in the area of hyperactivity may talk excessively; have trouble staying still when it is appropriate or expected; and act like they are 'always on the go'. Conduct disorder—repetitive and persistent behaviour to a degree that violates the basic rights of others, major societal norms or rules—in terms of aggression towards people or animals, destruction of property, deceitfulness or theft, and serious violation of rules. Source: Lawrence et al. 2015. 05101520 Per cent Disorder Any mental disorder ADHD Anxiety disorders Conduct disorders Major depressive episode Males 5 10 15 20 4–11 years 12–17 years 4–17 years Females Comparison of the 2013–14 data with the results of the first survey of young people, conducted in 1998, was limited due to changes in the survey design—most notably differences in the types of disorders that were assessed—and was limited to the 6–17 year old age group. Overall prevalence of any mental health disorder was similar to that indicated in the earlier 1998 survey; however, there were changes in the prevalence of specific disorders between the two surveys. Prevalence rates for ADHD