Medicare Benefit Schedule (MBS) service engagement among a prospective cohort of children with symptoms of poor psychological adjustment: trends, gaps and unmet need

Stream: Child wellbeing
Date: Monday, 9 September 2019
Time: 3.40 pm – 5.00 pm

Abstract

A significant minority of Australian children aged as young as four experience mental health disorders. Early intervention could prevent the development and exacerbation of adverse psychological outcomes over time. We examined MBS service engagement among a prospective cohort of children over 12 years and investigated whether above-average risk of experiencing symptoms of poor psychological adjustment was predictive of service utilisation.

Sociodemographic information for N=4,272 children and their households was sourced from Waves 3-7 of the prospective Longitudinal Study of Australian Children and linked with MBS data. Study children’s risk of experiencing emotional, hyperactivity, conduct and peer symptoms/problems or low prosocial skills was assessed using parents’ responses to the Strengths and Difficulties Questionnaire. Service types included: General Practitioners (<20 mins., >20 mins., after hours and mental health-specific), Paediatricians, Psychologists and Specialists.

In multivariable analyses, above-average risk of experiencing emotional symptoms was consistently independently (p<0.05) associated with increased odds of accessing all service types [Odds Ratios (ORs): 1.23-4.26)], except for General Practitioners for <20 mins. Socioeconomic indicators were generally not predictive of service engagement. Notably, children at above-average risk of low prosocial skills were not significantly more likely to engage with any of the service types investigated.

Children’s risk of experiencing emotional symptoms appears to be a strong predictor of service engagement; however, it seems levels of unmet need exist among children experiencing symptoms of conduct problems, peer problems and – especially – low prosocial skills. These children and their families could possibly benefit from early intervention initiatives.

Authors

Brendan Quinn (Presenter), Australian Institute of Family Studies
Dr Quinn is a Research Fellow with the Australian Institute of Family Studies’ Longitudinal Lifecourse Studies team, where he works on prospective cohort studies such as Ten to Men and the Longitudinal Study of Australian Children. His background is in epidemiology, and key research interests include men’s health issues, licit and illicit drug trends and related harms, blood-borne virus transmission, and international health concerns.

Diana Warren, Australian Institute of Family Studies
Dr Diana Warren is an economist who joined the Institute as a Research Fellow early in 2014. Her research focuses on the application of longitudinal data analysis for complex survey data, particularly using the data from the Longitudinal Study of Australian Children and the Household Income and Labour Dynamics in Australia Survey. Her main research interests are economics of education and labour economics.

Elly Robinson, Parenting Research Centre
Elly specialises in projects that assist health and welfare organisations to engage in evidence-informed practice and program development. Her current role at the Parenting Research Centre focuses on increasing the skills and knowledge of universal health service providers to identify and respond to risks for, and early signs of, child mental health problems.

Laura Hayes, Parenting Research Centre
Dr Hayes is a psychologist and Research Specialist at the Parenting Research Centre, with experience in evidence-based interventions for recovery, family-inclusive practice and child and adolescent mental health. She has interests in all aspects of the evidence system, including program evaluation, evidence synthesis, dissemination and implementation.

Catherine Wade, Parenting Research Centre
Dr Wade is a psychologist and Principal Research Specialist at the Parenting Research Centre with research and clinical expertise in families affected by vulnerability, disability and disadvantage. She leads research, evaluation and analysis activities, investigating aspects of the knowledge-to-practice gap in the provision of supports to families. Her work focuses on the implementation, impact and sustainability of evidence-based practices within the child welfare, parenting education and family-support sectors.

Galina Daraganova, Australian Institute of Family Studies
Dr Daraganova is a quantitative psychologist with the Australian Institute of Family Studies. Her research focuses on the theory and application of longitudinal data analysis for complex survey data, particularly using data from the Longitudinal Study of Australian Children. Prior to joining AIFS, Galina worked in the MelNet group at the Department of Psychology, University of Melbourne. Her research focused on the development of statistical models for network-based social processes and on applications of these models in the epidemiology and labour market research.

Pilar Rioseco, Australian Institute of Family Studies
Pilar Rioseco joined the Institute in July 2016 and works in the Longitudinal and Lifecourse area conducting research and analysis of the Building a New Life in Australia study and the Longitudinal Study of Australian Children. Pilar previously worked as a researcher on the Social Networks and Ageing Project at the School of Demography, The Australian National University, and in the Flinders Centre for Ageing Research, Flinders University. Her work on this project included investigating associations between social networks and successful ageing.