A new report from the Royal Australian and New Zealand College of Psychiatrists’ Faculty of Child and Adolescent Psychiatry (FCAP) finds too many Australian children are missing out on specialist mental health care until they are older, sicker and in crisis. 

Around one in seven Australian children is living with a mental health disorder, while access to specialist care from a child and adolescent psychiatrist remains critically limited. Modelling commissioned by the RANZCP predicts a shortfall of at least 230 child and adolescent psychiatrists by 2028. 

By current projections, for every 571 children aged 0–17 expected to be living with moderate to severe mental illness, there is just one child and adolescent psychiatrist available to treat them. 

FCAP Chair Scientia Professor Valsamma Eapen AO, a leading child psychiatrist with extensive clinical and research expertise in autism and other neurodevelopmental conditions, said mental health conditions often begin years before children are able to access the care they need. 

The report highlights that 50 per cent of all mental health disorders emerge before the age of 14, yet access to early specialist care remains limited, with services increasingly focused on adolescents in acute distress. 

“Mental health conditions do not suddenly begin at 14. For many children, the signs are there much earlier, but they are not getting access to specialist care when it could make the biggest difference,” Professor Eapen said. 

“By the time many children reach services, their needs are more complex and will require intensive intervention that are more expensive but less effective.” 

Professor Eapen said this mismatch between when conditions emerge and where the system is focused was a growing concern. 

“We continue to see a strong focus on youth mental health covering 12 to 25 years, which is incredibly important. 

“But the evidence is clear that many conditions begin much earlier, and our investment needs to reflect that.” 

Child and adolescent psychiatrists are the only medical specialists trained to diagnose and treat the full range of serious mental health conditions in children, including complex presentations with co-occurring autism, ADHD, eating disorders, trauma and severe mood disorders. Despite growing demand, access to them remains extremely limited. 

The report also highlights the economic case for investment, with an estimated $13.64 in social and economic benefit for every $1 invested in the child and adolescent psychiatry workforce. 

Prof Eapen said urgent action was needed to expand specialist capacity to ensure children can access care early before complexities and comorbidities set in, similar to the investment made for 12-25 year olds. 

“This means increasing funded child and adolescent psychiatrist positions, strengthening the training pipeline, and ensuring children can access specialist care early, not just in crisis,” she said. 

“Child and adolescent psychiatrists are not optional extras. They are essential to the mental health system for Australian children and teenagers, particularly if we are serious about giving them the mental health care they need, when they need it.” 

ENQUIRIES: For more information, or to arrange an interview call Dishi Gahlowt on +61 437 315 911 or email media@ranzcp.org.   

The Royal Australian and New Zealand College of Psychiatrists is a membership organisation that prepares medical specialists in the field of psychiatry, supports and enhances clinical practice, advocates for people affected by mental illness and advises governments and other groups on mental health care. For information about our work, our members or our history, visit www.ranzcp.org. 

In Australia: If you or someone you know needs help, contact Lifeline on 13 11 14 or www.lifeline.org.au or the Suicide Callback Service on 1300 659 467 or www.suicidecallbackservice.org.au. 

In New Zealand: If you or someone you know needs help, contact Lifeline NZ on 0800 543 354 or www.lifeline.org.nz or the Suicide Crisis Helpline on 0508 828 865 or www.lifeline.org.nz/suicide-prevention.