Children face extensive wait times for costly private mental health support

Parents are facing extensive wait times and substantial out-of-pocket costs when seeking private mental health support for their children, according to a new study.

The research led by the Murdoch Children's Research Institute and published in the Journal of Paediatrics and Child Health, has highlighted the strain on private mental health practices, finding one-third were closed to new referrals.

The research team expressed concern about the impact of COVID-19 on already stretched mental health services, with many vulnerable children potentially going without support. 

The study found average wait times for pediatricians, psychiatrists, and psychologists were 44, 41, and 34 days, respectively. Average out-of-pocket costs for an initial appointment were $120 for pediatricians, $176 for psychiatrists and $85 for psychologists. A third was closed to new referrals and only 43 per cent could offer an appointment with the requested clinician.

MCRI Dr Melissa Mulraney said this was the first objective Australian study on wait times and costs incurred by families seeking private sector care for their child with mental health problems.

In the 'secret shopper'-style study of 317 private practices across Victoria and South Australia, researchers posed as a parent seeking an appointment for their child with anxiety or ADHD. The study was designed in consultation with the industry and was tailored to anxiety and ADHD, the two most common child mental health problems.   

One in seven Australian children aged four to 17 years has a mental health disorder. But of these, only half had accessed mental health services. 

Dr Mulraney said long wait times and high costs were the most common reasons given by parents for not seeking mental health services for their child.

Paediatrician and MCRI Professor Harriet Hiscock said while all families faced substantial out-of-pocket costs, the price was particularly likely to prevent low socio-economic status families from accessing ongoing care.

"We need a larger and more equitably distributed child mental health workforce, as well as salaried clinicians who can provide low or no cost child mental health services to ensure timely, appropriate and affordable support," she said.

Professor Hiscock said more funding for the public mental health sector would clear a backlog of patients and see fewer families seeking help from private practices. 

She said there was a shortage of child mental health specialists, especially for children under 12 years of age.

"Efforts to encourage training in the child mental health workforce are needed such as raising quotas and adding incentives for medical students to complete specialist training in child psychiatry," she said. "Financial incentives and employment security would improve and increase services across rural and low socio-economic status regions."

Professor Hiscock said a shared care model should be considered for Victoria where GPs work with child mental health specialists to co-manage children with mental health problems.

"This model is being piloted in Queensland for children with ADHD, with initially promising results," she said. "Developing and testing new care models that upskill our existing workforces should be a priority, especially as mental distress has risen sharply for children and adolescents during the COVID-19 pandemic. Children and adolescents are increasingly seeking help for high levels of anxiety, depression and sleeplessness.

"The pandemic is increasing demand on mental health services and we expect children to continue presenting with COVID-related mental health issues for some time, even as restrictions are eased," she said.

Researchers from the University of Melbourne, University of Michigan, Women's and Children's Health Network in North Adelaide, University of Adelaide, The Royal Children's Hospital and Deakin University also contributed to the study.

Publication: Melissa Mulraney, Cindy Lee, Gary Freed, Michael Sawyer, David Coghill, Emma Sciberras, Daryl Efron and Harriet Hiscock. 'How long and how much? Wait times and costs for initial private child mental health appointments,' Journal of Paediatrics and Child Health. DOI: 10.1111/jpc.15253

*The content of this communication is the sole responsibility of MCRI and does not reflect the views of the NHMRC.

Available for interview:

Professor Harriet Hiscock, MCRI Group Leader Health Services
Dr Melissa Mulraney

Media Contact:
Bridie Byrne                                                                                         
MCRI communications specialist
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About MCRI
The Murdoch Children's Research Institute (MCRI) is the largest child health research institute in Australia committed to making discoveries and developing treatments to improve child and adolescent health in Australia and around the world. They are pioneering new treatments, trialling better vaccines and improving ways of diagnosing and helping sick babies, children and adolescents. It is one of the only research institutes in Australia to offer genetic testing to find answers for families of children with previously undiagnosed conditions.

Funding
The study was funded by a project grant from the Australian National Health and Medical Research Council (NHMRC) (1129957). MCRI is supported by the Victorian Government's Operational Infrastructure Support Program. Prof Harriet Hiscock is supported by an NHMRC Practitioner Fellowship 1136222. Dr Sciberras is funded by an NHMRC Career Development Fellowship 1110688 (2016-2019) and a veski inspiring women's fellowship (2017-2019). Dr Efron is funded by a Clinician Scientist Fellowship from MCRI.