"Behavioural issues, particularly those that begin in early childhood, are among the strongest predictors or serious health and social problems in adulthood." Mental Health Commission of NSW
On this page
What makes a troubled kid?
Who are we talking about?
What is important for school-aged children?
'Danny' - a story
Why has it been so tough?
The research tells us
How we can make things better
I can get there
Most kids thrive through childhood with support from parents, family and community. But for some, through no fault of their own, this isn’t the case.
They may be kids who have been in negative environments, from conception through the critical stages of early brain development, or who have been victims of trauma, violence, abuse or neglect.
They may be kids whose parents, for a variety of reasons including drug and alcohol abuse or mental illness, struggle in that role.
They may have complex mixes of developmental, relationship, behavioural, trauma and mental health issues.
They are likely to be challenging and disruptive in early education and school, the truants, the ‘difficult’ kids.
They are the children diagnosed with a conduct problem or anti-social behaviour that reflects the complexity of their home and family environments as much as anything medical.
They are at greater risk of struggling at school, and later of unemployment, poverty, severe mental illness and alcohol misuse and criminal offending.
Children exposed to extreme poverty or disruption – sometimes through immigration – from their cultural, family and community supports are particularly at risk.
A difficult future for these children is not inevitable, but the critical time for doing something about it is in childhood.
Of the one million or so school-aged children in NSW, about 100,000 will have mental health problems such as disruptive behaviour, anxiety and depression. One in 10 preschool children (aged 3 to 5) show significant mental health problems, including poor emotional, behavioural and social skills and the rate of mental health problems among children aged 4 to 16 years is about 14%.
Almost a quarter of children live in a family with a parent who has mental illness.
Many are capable parents or have partners or close social supports who help share the load in raising children, but the impact of a parent’s psychological distress can still be high.
It can have direct effects on child development and indirect ones through poverty, social isolation and stigma.
Severe and persistent parental mental illness contributes to child emotional and behavioural disturbances and can materially increase the risk of subsequent mental illness.
A substantial number of Australian children live in households where adults routinely misuse alcohol and other drugs and this is often combined with mental illness.
These families face very complex issues with drug and alcohol misuse contributing to poverty, domestic violence and relationship breakdown.
Nearly two-thirds of families reported to Community Services have at least one biological parent with a history of either drug or alcohol misuse.
Children and young people with complex mixes of trauma, mental health problems and antisocial behaviour can do a significant amount of harm to themselves
Behavioural issues, particularly those that begin in early childhood, are among the strongest predictors of serious health and social problems in adulthood.
- Access to services
- Coordinated approach
- Early intervention
- Highly skilled professionals
- Intensive and individualised programs
- Keeping families together
- Peer support
- Specialist services
- Support for families
Ten-year-old Danny is a bright, articulate child to those who know him. He has asthma, which limits his participation in activities.
His mother was abused as a child, has a history of serious mental illness and experiences poor physical health. She lives with Danny and his sister, five-year-old Amy, in a public housing unit in metropolitan Sydney.
Their father is absent and they are not well connected to their extended family. Danny likes playing computer games but has limited peer relationships or social networks.
Danny has patchy school attendance. He is seen as under-performing, as developing oppositional behaviour and there are queries about whether he also has learning difficulties.
As a society we tend to isolate troubled kids, seeing them as the responsibility and problem of our special education services or care and protection agencies and services. They are, in effect, excluded from a wider spectrum of support and services.
Overall availability of interventions and services that could make a difference to children is low and biased towards crisis support, especially where there is a combination of mental health, drug and alcohol and child safety issues.
Spending on child and adolescent mental health services is a relatively small proportion of total spending on mental health despite offering protection against difficulties later in life and being generally good value for money.
We need a co-ordinated and mutually reinforcing approach from parents, teachers, health professionals and other key adults in the life of a child on this journey. Without it we can’t respond effectively.
But we do not have enough highly skilled, well-trained professionals to deliver services, and the ones we do have are not evenly distributed across the state.
- 1 in 10 preschool children (aged 3 to 5) show mental health problems.
- Between 21% and 23% of children live in a household where at least one parent is experiencing a mental illness.
- About 1 in 4 school children are bullied every few weeks or more.
- Children living in disadvantaged families are more than 3 times more likely than those in well-off families to suffer from mental health disorders.
- It is estimated that the 45% of children who have mild or moderate conduct problems go on to commit half of all crime.
- Things that contribute to mental health problems include peer bullying, impact of stigma, family relationship stress, abuse, trauma and unsafe environments.
The children and young people who find themselves on this pathway need more intensive, specialist and individualised services to redirect antisocial or other detrimental behaviour.
We need service systems and partnerships that are integrated and comprehensive across different settings so that it’s as easy as possible for parents, carers and children to find their way to the help they need and have a right to.
Investment in school-based programs and support for vulnerable families need to be matched with investment in early mental health and drug and alcohol misuse responses for parents, as well as integrated mental health support for the children.
- I'll get on the right track if I'm supported when I start school: School-based mental health promotion, prevention and early intervention approaches using social and emotional learning methods will have a positive impact on me.
- I'll stay on track if I get help early when I'm having difficulties: Early intervention works. We need the skills, understanding and models of care that promote access to this kind of support for me.
- My family has a lot of problems and we need help with all of them: The system needs better, more integrated ways of engaging with families such as mine where mental health issues are complicated by drug and alcohol misuse, violence or abuse.
- I need good support for my serious mental health and behaviour issues: Children like me who have a combination of behavioural and mental health issues that generate antisocial behaviour, exposure to the justice system and reliance on care and protection services, need intensive support.
- Things will be better if my whole family gets support: My needs and the needs of my wider family are easily overlooked in a mental health system oriented to individuals.
*This composite story describes what the experience of someone on this journey might look like.
Source material for content on this page is from the Living Well Report