No wrong door: why it is still too hard for a child to get mental health support

Mental health is still the most common reason someone comes to see me as a GP. Sadness, anxiety, burnout, grief. Raw emotions, and a feeling of being lost. Increasingly, the person sitting in front of me is a child or a teenager, and their family has run out of places to turn.

Not long ago a mum sat in front of me and cried, not knowing what she was meant to do next for her child. Her 13-year-old daughter had been to our local children's hospital emergency department four times for suicidal thoughts. Each time, she was discharged back to us, her GP, for follow-up. CAMHS could not take her on because she did not meet their criteria. I tried referring to private mental health specialists, knowing how few are available for this age group, and she was declined for being too high risk.

This is a sensible family, in a major Australian city, willing to pay for support and trying desperately to get help. At every turn they were sent back to us. So we did what we could with what we had. Weekly check-ins. Our nurses met with her and her parents. We contacted her school to create a compromise on her learning. We started medication and psychology. It sounds like exactly what GPs are for, but we are not trained for this level of complexity, and we need to be honest about that. More and more often we have no choice, because no one else can help.

Right now, across Australia, it is far too hard to get mental health support for a child. In a nation as lucky as ours, nothing should stand between a child, a teen or their family and the help they need. No young person should feel this trapped or unheard. If they really are our future, why are we not funding and building the systems to support them?

Too often the care is siloed, underfunded, and confusing for families. There is no clear front door for a family in crisis that is not an emergency department. Children get divided into boxes of labels and diagnoses, and then fall through the gaps between them. I have seen a child excluded from one service because his difficulties were put down to autism, and from another because his NDIS funding was said to cover it. These kids keep falling between the cracks.

We should not be waiting for children to break before we help them. Early, simple support should be available long before a child is unwell enough to meet a threshold. The families who do best are the ones with a team around them, a GP, teachers, parents, an OT and a psychologist all talking to each other. When that happens, families finally feel heard.

One day, in the not too distant future, I hope we can say that every person in Australia who needs mental health care can actually access it. Far less stigma, much easier access, and no wrong door, so anyone can put their hand up when they need support. I will keep speaking up about this, simply because I keep seeing it, every single week.

If you or someone you love is struggling, please reach out. In Australia you can call Lifeline on 13 11 14 or Kids Helpline on 1800 55 1800.