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Around half of the children attending their first neurodevelopmental assessments showed signs of mental distress. Professor Adam Guastella and Dr. Kelsie Boulton, and Associate Professor Natalie Silove discuss what needs to be done to address mental health issues early.

One in ten people suffers from neurodevelopmental disorders, such as autism and attention-deficit/hyperactivity disorder (ADHD). The primary focus of attention is usually on diagnoses. However, research has shown that people with neurodevelopmental disorders are at an increased risk for serious health concerns. In addition, it may be difficult for them to get mental health help.

When young autistics seek help from youth mental-health organizations Headspace, they often present with severe depression and anxiety. These mental health symptoms contribute to the disability of autistic people in their daily lives.

We wanted to understand better how early mental symptoms appear. Our new study, published this week, assessed the mental health symptoms of young children who attended their first neurodevelopmental evaluation. This study was based on the Sydney Child Development Research Registry. It is an ongoing program that focuses on child development services.

The results were surprising. The results were surprising. The risk increases to 70 percent in children with multiple diagnoses.

When children present with concerns about their neurodevelopment, they will likely have concerns about mental health. More work must be done to address mental health and neurodevelopment concerns early. The neurodevelopmental assessment may be an opportunity to combine efforts.

Why are rates so high?

Our study asked 232 families about their child’s mental health during the first neurodevelopmental evaluation. There are many reasons why people with neurodevelopmental disorders have higher mental health concerns than the average.

The challenges faced by people with neurodevelopmental disorders can be more significant due to social determinants. These include unstable housing, financial problems, family conflict and separation, social isolation, and unemployment.

Social factors such as stigma, discrimination, peer rejection, exclusion from communities, and occupational and education support services play an essential role.

Some neurodevelopmentally-specific factors can increase the risk of mental health issues. For example, neurodevelopmental conditions can cause difficulties with impulsivity and problem-solving, as well as working in stressful situations. In addition, differences may exist in sensory processing and concrete thinking. These factors can make emotion regulation more difficult.

Some genes, which are associated with conditions like autism and ADHD, are also linked with other mental conditions.

What’s in the “too difficult” basket?

Mental health should therefore be at the forefront of health support for those with neurodevelopmental disorders. But unfortunately, they face many obstacles to receiving care. They include:

  • Lack of training and professional focus on mental health that considers neurodiversity.
  • Professionals mistakenly believe that neurodiverse individuals are too complicated to benefit from standard assessments and support for mental health. However, there are standard tools that have been proven to be effective for anxiety and depression.
  • Few studies have been conducted on psychotherapies to treat mental illness, especially those that include or focus on neurodiverse individuals.
  • The government’s complex structure, difficult-to-navigate pathways to funding and services, and inclusion of separate mental health and disability care.
  • Stigmatization and discrimination when needs are ignored because of a diagnosis of neurodiversity. It is too easy to attribute social anxiety or depression symptoms to autism or difficulties with social interaction. Anxiety or worry can be attributed too easily to executive function and emotional control difficulties associated with ADHD.
  • It can be challenging to get a psychologist or other mental health professional. The National Disability Insurance Scheme can support those with autism-specific needs, but mental health issues are considered separately.

Early bird discounts

More acute and chronic problems can result from failing to provide mental support when symptoms first develop. More often, people who present to acute mental services have more emergency presentations and more admissions into inpatient care for chronic and complex mental health issues.

Autistic people have a ten times higher risk of suicidal behavior than those without neurodevelopmental disorders.

This study is critical. More than half of our children had internalizing symptoms that were clinically elevated, such as anxiety, depression, and loneliness. If they were given more than one diagnosis, this increased to almost 70% of the children. These symptoms are more common among girls.

As children grow older, such problems become more common. However, addressing mental needs before they become more complex is possible. After waiting for years, most children will receive their first neurodevelopmental evaluation; they should be able to access the appropriate support they need for a lifetime of development.

The federal government commissioned a mental health strategy specifically for autism. State-specific supports include New South Wales’ new mental health hubs for people with intellectual disability.

More information needed

These new steps are encouraging. A fully integrated strategy must include everyone with neurodevelopmental disorders. Children with multiple neurodevelopmental disorders are most at risk, and mental health support should be provided as soon as possible.

Individuals, their families, and the community as a whole will need to have access to resources and support that can help them navigate, understand, and feel empowered about their mental health. The use of technology, personalized methods of care, and community involvement in the co-designing these pathways will likely facilitate this. Assessment and support processes provide a unique chance for engagement and education with other service providers, community hubs and to promote lifelong wellbeing.

The federal and state governments must collaborate to provide mental health services across the disability, education, and health systems.