Mental disorders are prevalent in young people. In any one year 14% of Australians aged between 4 and 17 years experience a mental disorder. Many of these disorders are multifaceted and complex to assess, and difficult to treat. For instance, in young people diagnosed with depressive disorder most can be diagnosed with additional disorders e.g. in up to 57% of cases Attention Deficit Hyperactivity Disorder (ADHD) can also be diagnosed; and in 30-75% Anxiety Disorders can be present in addition to depressive disorder.
Diagnostic instruments for young people are the least reliable for any age group; and availability of expert assessment services are so limited that only 3% of young people with a mental disorder in Australia access specialist community mental health services.
Diagnostic complexity is compounded by the fact that the same mental disorder presents differently at different ages. Moreover, distinguishing between mental illness and normal adolescent adjustment is complicated by the very high reactivity of young people to emotional climate at home, bullying at school, changing dynamics of peer relationships, sexual maturational changes, and even powerful mass media messaging.
There is growing community concern over increasing use of long-term psychotropic medication in children, despite the fact that clinical guidelines for most conditions recommend drug treatment only be used after all non-medical interventions have been tried and failed, and the fact that there is limited research on the long-term side-effects of many medications. These issues suggest only specialist practitioners experienced with the diagnosis of children prescribe such medications, and if possible after a second opinion is sought. These issues also suggest that even when specialist care is being received where treatment is not producing the desired result, tertiary referral for an independent specialist assessment, which includes psychometrically sound standardised measurement, might be indicated. But, like many other services for young people, an easily accessed second opinion service for complex psychiatric cases simply does not exist in Queensland.
ClearThinking is creating a series of assessment centres for young people aged between 11 to 18 years initially, where every effort will be made to help parents feel that no stone was left unturned in trying to understand potential diagnoses, plus the provision of a treatment plan based on a comprehensive assessment incorporating the latest in research knowledge.
This is a unique offering for the young people of Queensland at risk of developing serious mental illness.