Practitioner perspectives on the child and youth mental health system in Australia: what needs to change?

Mental health problems in children and young people in Australia are not improving and continue to have a costly impact. Significant changes to the current child youth mental health (CYMH) system are needed and should be informed by key stakeholders such as practitioners “on the ground” delivering services. Australian practitioners (<i>N</i> = 206) working in CYMH were surveyed using quantitative rating scales and qualitative open-response items. The survey examined current waitlists and waitlist management strategies, treatment dropouts, perceived barriers to accessing care, satisfaction levels, and ease of navigating services. Around 70% practitioners reported being dissatisfied with the current CYMH system in meeting the needs of children, young people, and families. About 50% reported it is difficult to navigate the system to find referrals. About half of practitioners reported their service currently has a waitlist. Of those practitioners, approximately 32% reported wait times of between one and three months, and 21% reported wait times of three-to-six months. Qualitative responses from practitioners highlighted several systems issues including long waitlists, underfunded public services, and a lack of specialised training in CYMH. The results reveal several practice, policy, and research priorities for improving the CYMH system in Australia. <b>What is already known about this topic:</b>Like what is observed globally, the prevalence of mental health disorders in children and young people in Australia is not decreasing.Key stakeholders in the Australian mental health system are well placed to provide commentary on issues and targets for change in the current system, though most existing studies focus on parents.There is limited research exploring practitioner perspectives about the current child youth mental health system. Like what is observed globally, the prevalence of mental health disorders in children and young people in Australia is not decreasing. Key stakeholders in the Australian mental health system are well placed to provide commentary on issues and targets for change in the current system, though most existing studies focus on parents. There is limited research exploring practitioner perspectives about the current child youth mental health system. <b>What this topic adds:</b>This study provides a recent account of the state of the child youth mental health system on issues such as waitlists, approaches to managing treatment drop-outs, and satisfaction levels.The majority of surveyed practitioners were dissatisfied with the current system, and their perceived barriers for accessing care were similar to those previously reported by parents.Several priorities of change were identified from the results, including increased government funding, enhanced workforce training based on core child youth mental health competencies, and further research into technology-enhanced service delivery. This study provides a recent account of the state of the child youth mental health system on issues such as waitlists, approaches to managing treatment drop-outs, and satisfaction levels. The majority of surveyed practitioners were dissatisfied with the current system, and their perceived barriers for accessing care were similar to those previously reported by parents. Several priorities of change were identified from the results, including increased government funding, enhanced workforce training based on core child youth mental health competencies, and further research into technology-enhanced service delivery.