The State of Child Psychiatry

A look at child and adolescent psychiatry, from the point of view of a patient, their parent, and a psychiatrist.

The psychiatrist interviewed, Dr Joanne Sargeant, works at the privately owned clinic Social and Emotional Wellbeing for Children and Adolescents.

Music supplied by Connum.

Kara de Groot: The iconic image of visiting a psychiatrist is of a person lying on a couch, telling their troubles to a man with a notepad. But what do you do when your child needs psychiatric help? Rough 14 per cent of Australian children and teens will experience mental health problems, and this number rises as they grow older.
John’s daughter, Ellen, has been seeing a psychiatrist for several years now, and has been admitted to hospital before. The scars of her struggle with mental illness are plain to see when she’s sitting in front of you.

John Murphy: It comes as quite a shock to some parents I think, when their children have mental health problems. You just have to take things as they come. Of course it’s difficult, but you just want to do whatever you can for your child.

Kara de Groot: Before his daughter’s illness, John had no idea if there even was mental health support services for children and adolescents. He’s more than aware of their existence now.

John Murphy: The only organisation I’d heard of before I was aware of our particular problems is Beyond Blue. One of the major problems I’ve found is there’s a severe lack of support for teenagers, for anyone under 18, it’s very difficult to find mental health support.

Kara de Groot: Do you think there’s enough government support and funding for mental health support services then?

John Murphy: I don’t think so, no.

Kara de Groot: Ellen is just grateful she’s been able to get the help she needs.
Has it helped you, do you think, being able to see a mental health professional?

Ellen Murphy: I think knowing that you have to opportunity to see one, if you want to, has helped. I guess having the opportunity to talk. So yeah I would say it has helped. I’ve been on medication a lot, and having someone to monitor that and to make sure you’re getting the right stuff is helpful, and someone who’s got a little more experience with it than just your GP. So I think that has helped.

Kara de Groot: Was it hard getting access to one?

Ellen Murphy: It was kind of hard finding one that was easy to get to I guess, and was what I wanted at the time.

Kara de Groot: Are costs and the referral process also a problem?

Ellen Murphy: You do have to go back and renew your referrals to get the Medicare rebate, whatever. At a certain point you hit the safety net and you do get most of the money back which is good. And medication as well, if you take it you get it back on Medicare. It’s not really a problem of cost so much as finding the right person.

Kara de Groot: Doctor Joanne Sargeant is one of the professionals who helps people like Ellen, through her privately run clinic. She feels that child psychiatry isn’t well enough supported.

Dr Joanne Sargeant: I think that child psychiatry is fairly significantly under-resourced especially in the private sector. The reason why I think child psychiatry and including that adolescent psychiatry is particularly rewarding and valuable for society as well as the treating person is because that’s where you get prevention happening, and the brain of a young person is so plastic and able to learn and change and adapt, whereas as we get older we get more stuck in our ways and change is slower to come. So I think it tends to have been very under resourced but it’s also where you get the most value for the government’s money.
Adolescent psychiatry has overlap with both child and adult, so adolescent is similar to both child and adult in that it’s in-between, children are different in that you obviously have to use simple language and they typically will only last for about, depending on their age, a 20 minute interview, but then you let them play while you continue to talk with the parent and observe their play. So the interview style is different, the diagnostic- the most frequent diagnoses differ slightly between the groups; ADHD is a more likely issue than it is for an adult, for instance.

Kara de Groot: Do you feel the treatments and programs we currently have available are fulfilling their function? For both professionals such as yourself and the people, children, they help.

Dr Joanne Sargeant: The answer to that I’d have to say is no. In terms of psychiatrists are we well supported as a profession? I think yes, both within ourselves with the structure of the college as well as yes, the Medicare funding for the work that you do. So I think that psychiatrists are well supported, but psychiatry, and the care for patients, certainly is under resourced.

Kara de Groot: People see psychiatrists for many different reasons, but there is one thing patients, their families, and their psychiatrists agree on; there is not nearly enough knowledge about and support of mental health awareness and services. This lack is especially evident amongst the age groups that can least care for themselves: children and adolescents.