Thriving Kids must be matched by improved access to specialist mental health care for children with complex needs

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) has welcomed the commencement of Thriving Kids, while warning that the reforms must be matched by clear pathways to specialist mental health care for children whose needs are complex, changing or extend beyond developmental supports.

As Thriving Kids is progressively implemented across Australia, the College is calling for psychiatrists and the broader child and adolescent mental health sector to be meaningfully involved in national and jurisdictional implementation planning.

RANZCP President Dr Astha Tomar said the aim of providing earlier, more accessible support for children and families was welcome, but the system must also be equipped for children whose needs become more complex.

“Many children will benefit from accessible developmental and community-based supports. But some children will also experience significant mental illness, or have developmental and mental health needs occurring together, and we need to be very clear about where they go for specialist care,” Dr Tomar said.

“Children’s needs do not fit neatly within the boundaries of the NDIS, disability services, primary care, education or mental health services. Their needs can also change considerably as they develop.

“Thriving Kids therefore needs clear referral and escalation pathways so that children requiring specialist assessment and treatment can access it early, rather than families having to navigate multiple systems themselves.”

The RANZCP is calling for psychiatry and specialist child and adolescent mental health services to be directly involved in designing these pathways and determining how children with co-occurring or escalating mental health needs move between services.

“Psychiatrists bring particular expertise in assessing and treating complex mental illness, including where developmental, behavioural, physical health, family and psychosocial factors intersect,” Dr Tomar said.

“That expertise needs to be built into the architecture of these reforms, not added later once children begin presenting to already stretched specialist services.”

The College also warned that the transition must not result in responsibility simply shifting from the NDIS and Commonwealth-funded supports to state and territory health services without corresponding investment in specialist capacity.

“Reform cannot simply move demand from one part of the system to another,” Dr Tomar said.

“If more children are expected to receive care through community and state-based mental health services as NDIS arrangements change, governments must ensure those services have the workforce, funding and specialist clinical capability to meet that additional demand.

“Otherwise, the risk is that children who no longer fit comfortably within one system find there is insufficient capacity waiting for them in another.”

Workforce capacity is already a significant concern. In a recent RANZCP survey of child and adolescent psychiatrists in New South Wales, more than 70 per cent of respondents did not believe the specialist workforce was prepared to absorb the additional demand anticipated as more children receive support through community and state-delivered systems.

Dr Tomar said implementation must therefore be closely monitored, with transparent data on access, waiting times, unmet need and movement between Thriving Kids, the NDIS and specialist health services.

“We should be able to see very quickly if children are falling between services or waiting longer for specialist care, and governments must be prepared to respond.

“As Thriving Kids develops towards full implementation, there is an important opportunity to get this right.

“Early developmental support and specialist mental health care should not be seen as alternatives. Children need access to the right level of care at the right time, with pathways between services that are clear to families and clinicians alike.

“Ultimately, success should be measured by whether children receive the support they need to thrive, reach their potential and have the best possible start in life.”

ENQUIRIES: For more information, or to arrange an interview, call 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.