With children, the old truth applies: Prevention is better than cure

Pay attention to the early development of children and their future will be brighter, writes Fiona Stanley.

In this still new 21st century, what are our major concerns about the future for our children and young people? How best should we expend our scant resources, not just money, but energies and passion, to improve the life chances of our most precious commodity? What can we do in Australia to contribute to our progress in these areas, and can we also help all the world's children?

In reviewing the available data on child and youth health, in Australia over the last 30 years, we are faced with some unpalatable, rather frightening statistics. There are very few indicators of child and youth outcomes that are improving and many are worsening. Fortunately, the death rates in infancy and childhood are very low, amongst the lowest in the world, for non-indigenous Australians. The rates of death in older children, however - dominated by suicides and accidents, particularly among males - are of concern. Those for young male suicide have risen over the last 30 years to be the highest ever recorded.

Apart from suicides in young men and indigenous child fatalities from all causes, deaths are rare. It is the alarming rise in rates of illnesses, conditions, mental health and behaviour problems, educational difficulties, drug and substance abuse, and juvenile crime that must engage and worry us. They coincide with marked changes in the social fabric, in the way we live, work, and socially interact. While many of the changes have been beneficial and many children and young people are managing very well in modern Australia, many others are struggling. An increasing proportion of families are finding it difficult to bring up children and to enable them to develop the essential characteristics of resilience, social and intellectual capacity, to manage successfully in this challenging world. In the 1950s less than 5 per cent of marriages involving children ended in divorce; in the 1990s it was nearly 50 per cent and in 1998 nearly a million children were living with only one natural parent. Again such social and family changes have been international.

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One in five teenagers in Australia has a mental health problem that interferes with daily life, 12 per cent of primary school children have depression, behaviour problems or educational difficulties, 30 per cent of Australian children develop allergic asthma by the age of 10, an unacceptable (and not accurately measurable) number of children are abused and neglected, are homeless or in care, 15 per cent of 12-year-old males and females report hazardous drinking in the previous month. There has been a marked increase in the proportion of children classified as obese, and at the other end of the spectrum, a rising proportion of young girls (and even young men) have eating disorders and are unhappy with how they look. Many of these problems lead directly to self harm and suicides.

Research on many of these problems suggests that effective early prevention may reduce a broad range of them. For example, addressing risk factors to enhance mental health also improves educational outcomes and reduces crime in young people.

Getting it right early is so much better than expensive and less effective treatments. Today's social and environmental influences are far more powerful in child and adolescent mental health than are the drugs or therapies we have to treat them.

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Why are current policies and practices not working? One hears comments all the time such as "all the money spent on Aboriginal health and we haven't seen any improvement in health status" or "expenditure on mental health but no results". If you look at the causal pathways to most mental health problems, it is obvious that current interventions are too late and will not effect improvements in mental health outcomes. It is only by acknowledging the factors early in these pathways and avoiding them, that we will be able to reduce these tragedies and improve mental health in young people.

Can anyone give me any evidence that incarceration of juveniles reduces juvenile crime? Most evidence points to non-rehabilitative detention actually increasing it, particularly in indigenous children. And how can you treat suicide when the child is already dead?

Prevention is the name of the game and our new Australian Research Alliance for Children and Youth is a national collaborative whose purpose is to facilitate the generation and translation of knowledge to enhance the well being and life chances of children and young people.

Our messages - based on the best data and evidence - will be for all levels of government, for non-government organisations, for parents, schools, practitioners and communities. We owe it to parents to give them information about early development and the importance of the first years of a child's life for health, mental health and capacity. Then they will be able to make informed choices for their families, lobby governments themselves on what is important for their children's future and collectively start to turn around these statistics.

If Australia can do this, working together, we can export what we have learned and help children all over the world.

Professor Fiona Stanley, Australian of the Year, is chief executive officer of the Australian Research Alliance for Children and Youth.
 

http://www.smh.com.au/articles/2003/02/02/1044122258577.html

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