New data on the rise in presentations should be seen as canaries in the coal mine
Australia has in recent decades made major investments in mental health care; government expenditure has risen rapidly,1 the availability of psychological therapies has expanded,2 antidepressant use has increased,3 and the size of the mental health workforce has grown.4 There has also been a major focus on adolescents with the national rollout of Headspace centres and early psychosis programs.5 Data in two articles in this issue of the Journal, describing trends in mental health crisis presentations by adolescents to emergency departments in Australia’s two most populous states, provide an important test of the success of these investments.
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- 1. Australia Institute of Health and Welfare. Mental health services in Australia. Updated Feb 2018. https://www.aihw.gov.au/reports/mental-health-services/mental-health-services-in-australia/mental-health-resources/expenditure-on-mental-health-related-services (viewed Mar 2018).
- 2. Whiteford HA, Buckingham WJ, Harris MG, et al. Estimating treatment rates for mental disorders in Australia. Aust Health Rev 2014; 38: 80-85.
- 3. Stephenson CP, Karanges E, McGregor IS. Trends in the utilisation of psychotropic medications in Australia from 2000 to 2011. Aust N Z J Psychiatry 2013; 47: 74-87.
- 4. Organisation for Economic Co-operation and Development. Health at a glance 2013: OECD indicators. Paris: OECD, 2013. https://www.oecd.org/els/health-systems/Health-at-a-Glance-2013.pdf (viewed Mar 2018).
- 5. Reavley NJ, Jorm AF. Mental health reform: increased resources but limited gains. Med J Aust 2014; 201: 375. <MJA full text>
- 6. Perera J, Wand T, Bein KJ, et al. Presentations to NSW emergency departments with self-harm, suicidal ideation, or intentional poisoning, 2010–2014. Med J Aust 2018; 208: 348-353.
- 7. Hiscock, H, Neely RJ, Lei S, Freed G. Paediatric mental and physical health presentations to emergency departments, Victoria, 2008–15. Med J Aust 2018; 208: 343-348.
- 8. Spillane IM, Krieser D, Dalton S, et al. Limitations to diagnostic coding accuracy in emergency departments: implications for research and audits of care. Emerg Med Australas 2010; 22: 91-22.
- 9. Lawrence D, Johnson S, Hafekost J, et al. The mental health of children and adolescents. Report on the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Canberra: Department of Health, 2015. https://www.health.gov.au/internet/main/publishing.nsf/Content/9DA8CA21306FE6EDCA257E2700016945/%24File/child2.pdf (viewed Mar 2018).
- 10. Zubrick SR, Hafekost J, Johnson SE, et al. Suicidal behaviours: prevalence estimates from the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry 2016; 50: 899-910.
- 11. Jorm AF, Patten SB, Brugha TS, Mojtabai R. Has increased provision of treatment reduced the prevalence of common mental disorders? Review of the evidence from four countries. World Psychiatry 2017; 16: 90-99.
- 12. Australasian College of Emergency Medicine. Quality standards for emergency departments and other hospital-based emergency care services. Melbourne: ACEM, 2015. https://acem.org.au/getmedia/cbe80f1c-a64e-40ab-998f-ad57325a206f/Quality-Standards-1st-Edition-2015.aspx (viewed Mar 2018).
- 13. Hunt G. Interview with Sabra Lane on ABC Radio National AM Program [transcript]. 6 Mar 2018. http://www.health.gov.au/internet/ministers/publishing.nsf/Content/health-mediarel-yr2018-hunt180306.htm (viewed Mar 2018).
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