Psychiatric prescriptions for children skyrocket

Federal Government data has revealed that mental health prescriptions for people under 18 have risen sharply in the past 10 years, with stimulants seeing one of the most significant spikes.
 
According to information compiled from 2013–23 through the Australian Bureau of Statistics and the Pharmaceutical Benefits Scheme, originally provided to the ABC, children are accessing psychiatric medication at unprecedented levels.
 
Stimulant prescriptions went up from 101 per 1000 people under 18 in 2013 to 380 per 1000 in 2023 – an increase of 276%.
 
Antidepressants went up 165% from 2013 and are now at a rate of 196 prescriptions per 1000, with selective serotonin reuptake inhibitor (SSRI) scripts tripling in that time.
 
Although antipsychotic medication is still sparsely used by comparison, prescriptions still rose 37%.
 
A world-first review from the new Lancet Psychiatry Commission on Youth Mental Health, published earlier this year, found an alarming 50% increase in rates of mental ill-health in minors.
 
Australian Institute of Health and Welfare data shows GPs wrote 85% of mental-health related prescriptions in 2022–23.
 
GP Dr Andrew Leech, who has a special interest in child and adolescent mental health, told newsGP the causes of these increases are multifactorial, but it’s undeniable that GPs are seeing a surge of distressed young patients.
 
‘Mental health is not just one part of a person’s life, and GPs need to be aware that lots of factors can cause a child or an adolescent to become unwell,’ he said.
 
‘A lot of clues as to why things are going poorly for that child or teenager will come from the broader life of that child, like their home life, use of screens, sleeping quality, diet and nutrition or the amount of exercise they’re doing.
 
‘A lot of these factors are becoming different for families at the moment.’
 
In order to address the social harm caused by social media and the damage it has on youth mental health, the Federal Government announced plans to ban it for those under 16.
 
Last month, a newsGP poll found 89% of respondents backed these age restrictions being imposed on children having social media accounts.
 
This comes as the RACGP’s latest national survey found 71% of GPs say mental health is in their top reasons for patient consults.
 
As for treatment options, Dr Leech says GPs need to be mindful of the role of medication and remember to ‘look at the whole picture’.
 
‘Medication has a role, and it is a great tool because it tends to work well to get things started for those children who are really struggling but it’s not the only part of the treatment,’ he said.
 
Dr Leech recommends that medications be used for moderate to severe cases in children, but he says GPs are often left with few choices when presented with families in crisis who are struggling with costs and accessibility.
 
‘Psychology’s prices have gone up and it’s not unusual now for it to be $280 a session and it’s harder to get into as well,’ he said.
 
‘Some GPs may feel that it is a stepping stone, while they’re waiting, to use medication and that’s all we’ve got sometimes, when we can’t get the help we need, for these tricky cases that are having a difficult time.’
 
What is missing, Dr Leech says, is clear guidelines on the use of psychiatric medications for children.
 
‘We really need a guideline around how to use this safely, because there are some initial issues with it,’ he said.
 
‘When you do start it, you have to be careful with children as some children may feel worse before they get better.’
 
But Dr Leech says there is advice out there for GPs, including a GP Psychiatry Support Line.
 
‘If you are unsure about medication, you really should get advice and not do something if you’re not comfortable with it,’ he said.
 
‘You don’t have to have the answers, but just listen as sometimes you have to just be a sounding board.
 
‘That’s what we’re really good at as GPs, absorbing that information for a family that might be in crisis.’
 
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children and young people’s health medication mental health mental health services