Psychiatrists are overwhelmed by a perfect storm they fear will have lasting impacts on young people’s mental health, new research shows.
Doctors are concerned young people in Aotearoa New Zealand are missing out on specialist mental health care with potentially life-long repercussions, according to new research.
While mental health issues were already worsening among young people, Covid-19 has increased demand, not only for mild to moderate distress, but also for moderate to severe distress, child and adolescent psychiatrist Dr Hiran Thabrew, a researcher and senior lecturer in the University of Auckland’s Centre for Infant, Child and Adult Mental Health.
The government has increased funding for mental health but it has focused on primary care.
“That’s great, but it has been done at the expense of increasing specialist services to meet the increasing demand.”
Newly published research draws on an August 2021 survey, by the Royal Australian and New Zealand College of Psychiatrists of New Zealand doctors specialising in child and adolescent psychiatry regarding the state of public mental health services.
Eighty percent of the entire workforce (97) responded and almost all (97%) said demand had “increased” or “increased a lot” in the past two years. See Australasian Psychiatry (2 August 2022).
Eighty-eight percent said young people were “often” or “very often” unable to access the right mental healthcare at the right time.
“Young people are notoriously reluctant to reach out for help; so, when they do, it's usually when things are really bad. If they are not seen and responded to, they may not ask for help again,” says Thabrew.
“We know that rates of self-harm have gone up a lot in the last few years, by about 25 percent in the 15 to 19-year age group and by about 50 percent in the 10 to 14-year age group,” Thabrew says.
“So, there are lots more referrals to services, or presentations to hospital, after mental health crises for young people,” he says. “Last year, there were over five-and-a-half thousand young people under 19 who presented to hospital [after self-harm, Ministry of Health data].”
New Zealand has the second highest youth suicide rate in the OECD and equity is an issue.
Māori aged 15 to 24 years complete suicide more as twice as often than non-Māori (34.6 deaths per 100,000 versus 16.4 per 100,000).
Māori children are 1.5 times more likely than others to experience emotional or behavioural problems.
The fact 80 percent of the workforce responded to the survey shows how strongly they feel about these issues, says lead author and psychiatrist Associate Professor Susanna Every-Palmer, head of the Department of Psychological Medicine at the University of Otago, Wellington and Chair of Tu Te Akaaka Roa, the New Zealand National Committee of the Royal Australian and New Zealand College of Psychiatrists.
“A key lesson from this research is that we urgently need to invest in the mental health workforce. Participants identified three main areas: increasing the specialist workforce by focussing on the local pipeline; recruitment of overseas-trained mental health professionals; and retaining our existing staff.
“In addition, we need to be thinking about innovative ways to engage young people such as using online tools and telehealth and e-health interventions,” Every-Palmer says.
Thabrew and colleagues at the University of Auckland have been researching e-health and developing apps for young people, including Whitu – seven ways in seven days, a toolkit of resources for coping during Covid-19 for young people, and Village (www.villageapp.kiwi), aimed at supporting young people experiencing low mood, self-harm and suicidal ideation.
The authors of the new paper concluded much needs to be done to restore the country’s ailing mental health service.
“To succeed, it will be important to heed the concerns of those already trying to do the work.”