Kids receiving ‘good enough’ mental health treatment do not improve

The majority of children and adolescents with mental health problems in Australia are not receiving the basic standard of treatment and those that do not actually improve, according to a new study.    

The research, led by the Murdoch Children's Research Institute and The University of Melbourne and published in the Journal of Affective Disorders, found no evidence of better quality of life or mental health symptoms for children who received 'minimally adequate' treatment. 

Professor Harriet Hiscock, Murdoch Children's Group Leader of Health Services and Honorary Professor at The University of Melbourne said the lack of evidence between minimally adequate treatment and outcomes in children had implications for how we evaluate and fund mental health systems. 

"Clinical trials have shown how mental health treatments such as psychological and pharmacological therapies can be successful, but this study reveals children who received routine but minimally adequate treatment didn't experience better outcomes compared to those who had lower levels of treatment," she said.  

The research found 40 per cent of children with mental health symptoms received some form of Medicare-rebated treatment and 12 per cent received treatment classified as minimally adequate treatment.

Minimally adequate treatment (MAT) is based on clinical practice guidelines regarding the minimum level of treatment considered sufficient to treat common mental health problems. For children, it involves either eight or more mental health visits or four to seven visits plus relevant medication over a 12-month period. It's also used to identify those missing out on adequate care. 

Murdoch Children's research associate and The University of Melbourne's Dr Jemimah Ride said it was not known until this study whether minimally adequate treatment was associated with improved outcomes for children with mental health problems.  

The study followed 596 children ages 15 years with mental health problems from the Longitudinal Study of Australian Children and linked them to Medicare-rebated mental health treatments.  

Murdoch Children's Team Leader of Health Services and The University of Melbourne's Associate Professor Kim Dalziel said the findings reinforced the need for routine monitoring of outcomes in mental health care and a better understanding of the impact of children's mental health treatment.  

"The lack of information on quality or content of consultations, or on outcomes, in routinely collected health service data restricts our ability to evaluate treatment adequacy and to understand whether mental health services provide quality care or value for money," she said. 

Despite increased investment in youth mental health diagnosis and treatment in the past three decades, mental health disorders affect 13 per cent of children worldwide. Half to three-quarters of children and adolescents with mental health disorders go untreated.     

Professor Hiscock said this these findings were important messages for the Royal Commission into Victoria's Mental Health System which will hand down its final report next year.

"What we are doing now is not working and we can't afford to be providing inadequate treatment to young children struggling with mental health problems," she said.

"It is clear the way we measure mental healthcare outcomes in Australia is not sufficient and a shake-up to the system is needed."  

The Royal Children's Hospital, University of Adelaide and Deakin University also contributed to the study.   

Publication

Jemimah Ride, Li Huang, Melissa Mulraney, Harriet Hiscock, David Coghill, Michael Sawyer, Emma Sciberras, Kim Dalziel. 'Is 'minimally adequate treatment' really adequate? Investigating the effect of mental health treatment on quality of life for children with mental health problems,' Journal of Affective Disorders. DOI: 10.1016/j.jad.2020.07.086

Available for interview

  • Dr Jemimah Ride, Murdoch Children's Research Associate
  • Professor Harriet Hiscock, Murdoch Children's Group Leader of Health Services
  • Associate Professor Kim Dalziel, Murdoch Children's Team Leader of Health Services

Media contact for Murdoch Children's

About Murdoch Children's

The Murdoch Children's Research Institute 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.

About The University of Melbourne

The University of Melbourne is a world-leading university that has been at the heart of discovery and the cultural fabric of contemporary Australia for over a century. With strong research performance and excellence in learning and teaching, we are consistently ranked amongst the world's leading universities and are currently ranked number one in Australia and 32 in the world. Our strategic objective is to benefit global communities and society through the transformative impact of education and research.

Funding

The Longitudinal Study of Australian Children was funded by the Australian Government. The study was supported by a Project Grant (1129957) from the Australian National Health and Medical Research Council (NHMRC)*. H.H. is supported by an NHMRC Practitioner Fellowship (1136222). E.S. is funded by an NHMRC Career Development Fellowship (1110688) and a veski Inspiring Women's Fellowship. This research was also supported by the Victorian Government's Operational Infrastructure Support Program to the Murdoch Children's.  

*The content of this communication is the sole responsibility of Murdoch Children's and does not reflect the views of the NHMRC.