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The number of adolescents presenting to emergency departments in New South Wales and Victoria for mental health crises has increased 53% in the past decade, and should serve as 鈥榗anaries in the coalmine鈥� for the state of community mental health services.

The increase has occurred despite major investment in mental health care over the past decade in Australia, including the national rollout of Headspace centres,聽according to the authors of an editorial published in the (MJA).

In commenting on two recent studies published in the MJA, Professor Susan Sawyer and Professor George Patton,聽from the , and in Melbourne,聽wrote that these findings should raise alarm, and that 鈥渢he emergency department data reported [recently] should be seen as canaries in a coalmine鈥�.

鈥淒espite major investments in the mental health service system, it is failing to provide alternatives to emergency聽departments for adolescents in crisis,鈥� they wrote. They also noted that in Australia, national recommendations for more emphasis聽on prevention 鈥渞emained unheeded鈥�.

There is a pressing need to understand why, particularly in the context of persisting high prevalence rates, they said.

鈥� 鈥� [showed that] presentations leading to a primary diagnosis of self-harm, suicidal ideation聽and behaviour, and intentional poisoning dramatically increased in all age groups, except 0鈥�9-year-olds,鈥� Sawyer and聽Patton wrote. 鈥淭he peak age band for presentations was 10鈥�19 years, the group that also experienced the greatest聽increase in presentation numbers.鈥�

鈥� 鈥� found a disproportionate increase in the numbers of presentations for mental disorders compared with those for physical disorders (46% v 13%). During 2014鈥�15, 77% of these mental聽health-related presentations were by 15鈥�19-year-olds and 19% by 10鈥�14-year-olds. Self-harm presentations had聽increased by 53% since 2008鈥�09.鈥�

Sawyer and Patton聽cited another recent study that concluded that many treatments did not meet minimum clinical standards and聽were not tailored to help those in greatest need. They also suggested that 鈥渕ore extensive and more frequent surveys聽of child and adolescent mental health are needed to understand trends in prevalence and important risk factors. Better聽linkage with health care system data would also provide essential information about service coverage and quality.

鈥淭wo further messages are clear,鈥� Sawyer and Patton concluded.

鈥淭he dramatic increases in the numbers of presentations by adolescents with mental health problems require a聽commensurate response from emergency departments that does not detract from community services.

鈥淔urther, while improving the quality of clinical services is important, it is likely that only effective prevention will聽ultimately stem the tide of mental health problems in adolescents; this will require greater emphasis on supporting聽struggling families and disadvantaged communities.鈥�

Image credit: 漏stock.adobe.com/au/Alexander Raths