Centre of Research Excellence in Childhood Adversity and Mental Health

Overview

What is the Centre of Research Excellence in Childhood Adversity and Mental Health?

The Centre of Research Excellence (CRE) in Childhood Adversity and Mental Health brings together families with lived experience, practitioners, researchers and policymakers from health, social care and legal sectors. Together, we aim to prevent the significant mental health burden experienced by children and families experiencing adversity.

Visit the CRE website

Why is this issue important?

Ensuring that children in Australia have the best start in life involves providing equitable access to quality services and support for families. 

Family adversity can have a significant impact on a child's health and wellbeing and a multi-sectoral approach is necessary to intervene and prevent issues early. 

Studies show that children who face challenges or adversities in childhood are more likely to develop mental health problems later in life.

What does the CRE hope to achieve?

We’ve co-designed, implemented and are evaluating integrated Child and Family Hubs. Our Hubs aim to improve children’s mental health by providing families with a ‘one-stop shop’ to aid earlier detection and response to family adversities.

What are Child and Family Hubs?

Our Child and Family Hubs co-locate:

• Healthcare – including medical and allied health practitioners.
• Social care – including lawyers, financial counsellors and social prescribers. 

This improves identification of family adversity as an upstream and preventable determinant of mental health problems, and helps to identify and address existing issues for children aged newborn to 8 years and their families. 

Our approach

Approximately 30% of all adult mental disorders are attributed to adverse childhood events. This includes:

• 40% of anxiety disorder cases
• 40% of depression cases
• 67% of lifetime suicide attempts

Our research shows that adverse childhood experiences are associated with a two-fold higher risk of common mental disorders or suicidality:

• Anxiety disorders (pooled odds ratios (ORs): 1.94; 95% CI 1.82, 2.22)
• Internalising disorders (OR 1.76; 1.59, 1.87)
• Depression (OR 2.01; 1.86, 2.32)
• Suicidality (OR 2.33; 2.11, 2.56)

These associations do not significantly vary by gender or the age of exposure.

Australian experts, via a Delphi consensus, have identified interventions most likely to be effective for the Australian context in preventing adverse childhood experiences and reducing their negative impact on children’s mental health. 

Priority interventions span four general areas: 

1.    Community-wide interventions
2.    Parenting programs
3.    Home-visiting programs
4.    Psychological interventions 

The experts endorsed two broad intervention programs: 

1.    School-based anti-bullying interventions
2.    Psychological therapies for children exposed to trauma 

Australia has many policies related to family adversity, with most focused within existing primary care platforms. Given these policies, Australia should be well positioned to identify and respond to family adversity. 

Integrated health and social care initiatives, such as our Child and Family Hubs, could increase uptake and engagement with services who deliver such services and hence improve child mental health outcomes.