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    Malcolm Gillies`

    Many thanks to Melissa Raven for shedding some light on this murky area.

    I would love to see a further analysis of the figures, putting some figures on the specific treatment gaps, and comparing them to gaps in other population segments.

    Promulgating the idea that 1 in 4 young people need professional psychological care implies a disturbing level of medicalisation. But perhaps more disturbing, crying wolf in this way risks provoking even greater public apathy towards real gaps in youth mental health services.

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    Previous (1999/2000) statistics published by both Commonwealth and NSW Governments placed the prevalence of adolescent mental health issues at between 12 and 14 percent depending on age grouping and sex demographics. This prevalence rate is considered closer to the ‘point prevalence’ Melissa mentions. I base this estimate on the work I have done working with adolescents in NSW over the last 14 or so years.
    I also agree with Melissa’s comment that many adolescent mental health issues are transient. Recent initiatives within Australia in general and NSW (in particular to my work) include the advent of ‘Resilience Programs’ through the Education Department and various adolescent programs. I also note that often young people recover when supported by family and peers, particularly when they have been exposed to a Resilience Program and where there is ‘linking’ between the providers of the resilience training and the young persons’ parents/carers through a care program.
    As Melissa notes many (?) adolescent mental health issues, as defined within the frameworks of the ICD-10 and the DSM-IV probably do not need psychiatric intervention/treatment because of a lower level of severity. An analogy to physical health explains the issue. A mild cold is definitely a physical health issue but is probably not one that needs immediate professional medical intervention. Usually some ‘over the counter’ symptom ease and some home care does the trick. Should the cold begin to show symptoms indicating a more serious respiratory tract infection then medical intervention should be enlisted. Hospitalisation is only considered once such an infection becomes acute and possibly life threatening. A situational depression following the death of a family member can usually be dissipated in reasonable time with care from family and friends and with the young person’s involvement in the funeral rites. Should the depression begin to become chronic and/or acute then some psychological counselling might be in order, but psychiatric care only if the psychological intervention is not effective.
    In his introduction to Positive Psychology (American Psychologist, Jan 2000, p.5) Martin Seligman was somewhat critical that psychology was persuaded to intervention on psychological pathology and away from the other two goals of psychology; making ‘all peoples’ lives better and nurturing intelligence’ (p.6). As I see it accepting the statistics presented in the National Survey of Mental Health and Wellbeing, 2007 as a call to arms for psychologists is to further immesh our discipline within the medical model of care to the detriment of our focus on the wellness of all persons through the sound principles of ‘prevention rather than cure’ and, when it is required, ‘early intervention’. Positive Psychology initiatives such as the Resilience Programs already in place focus on those principles and promise to address many of the issues that are considered precursor to the 2007 Survey statistics, eg., Socio-economic status, AOD use/abuse.


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