GPs and their role in children’s mental health

It is well known that mental health issues are on the rise among Australians, with GPs identifying them as the leading concern in patient consultations.
 
But it is less commonly known that mental health conditions are becoming more prevalent among the young, with one in seven young people aged between 4—17 experiencing a mental disorder.
 
According to Dr James Best, Chair of the RACGP Child and Young Person’s Health Specific Interests network, there is a variety of factors behind rising rates of mental health problems in children and adolescents, such as social and intergenerational issues.
 
‘[These can include] pressures on parents and increasing problems within families, particularly in high-risk areas or groups, such as substance abuse and domestic violence, child sexual abuse, incarceration, parental separation,’ he told newsGP.
 
‘In particular, mental health problems in a parent is one of the biggest risk factors.’
 
Increasing understanding of these risk factors, known as adverse childhood experiences, means that they do not have to determine the outcome of a child or young person’s life, but can rather provide a vital indicator for intervention.
 
‘We’re becoming increasingly aware of these risk factors, and our ability to pick up on mental health problems in children has also started to improve,’ Dr Best said.
 
‘There’s a large body of evidence to show that early intervention and preventive and remediative strategies when these problems are present can transform the situation, can transform lives.’

As the most accessible entry point to healthcare for many families, particularly those that may be vulnerable or at risk, Dr Best believes GPs are uniquely placed to facilitate that intervention.
 
‘That is why I think it’s so important GPs take on this role, because this sort of stuff can make parents feel isolated and overwhelmed, and it is very easy for them to think they can’t get any help,’ he said.
‘But this is where GPs can make a huge difference.’


There is a variety of factors behind rising rates of mental health problems in children and adolescents, including social and intergenerational issues.
 
Dr Best understands, however, that such issues can also seem overwhelming for GPs if they are not provided with the training and support to assist vulnerable children and their families.
 
‘I think there are a lot of GPs who want to be involved in this area, but have some hesitation in dealing with it, because it can be very confronting,’ he said.
 
‘But we need to be asking the questions, and we also need to have the skills to deal with it – supporting parents and children in crisis should be core GP business.’
 
It may seem difficult, even for trained medical professionals, to know where to start with these often complex and sensitive issues.
 
It is for that reason children and family mental health Emerging Minds, a government-funded organisation dedicated to the mental health of children and their families in Australia, has partnered with the RACGP to create free podcasts, webinars and online courses for GPs and other health professionals.
 
‘I want to encourage as many GPs as possible to do the course and look at the webinars, because it’s a really important part of general practice. This is a really fantastic area to increase your knowledge, awareness and skills, and make a difference in patients’ lives.  
 
‘The main difference [in providing mental health care to children] is that often you are talking to the child through the parent or carer, and so in that context there can be several people involved.
 
‘What children need are long-term, secure, safe relationships. That is the most important thing in terms of their mental health development. So helping parents and carers understand how important those secure relationships are, and giving them guidance about how to nurture those relationships is the most effective way in dealing with children and mental health issues.’
 
With the proper guidance and training, Dr Best believes GPs can manage many of children’s mental health issues either within their practice, or in tandem with other healthcare professionals, building on the relationship they have with patients.
 
‘The family doctor can have an enormously positive influence on this issue, because we are often so trusted and we have such a longitudinal relationship with our patients,’ he said.
 
‘That can really put us in the driver’s seat in terms of making a difference to parents and children in difficulty.’

children's health Emerging Minds mental health young people