A complete shake-up of the health system is needed to better care for children with mental health disorders in the community rather than clogging EDs, Australian researchers say.

Three studies, led by Murdoch Children’s Research Institute (MCRI) in Melbourne, have highlighted treatment gaps in the community in Victoria, where paediatric mental health-related visits to ED have increased by 6.5% each year between 2008-09 and 2014-15.

The rise was three times faster than that of physical health presentations, despite significant mental health investment and could not be explained by population growth.

Almost one in four children presenting with self-harm to the Royal Children’s Hospital ED in Melbourne re-presented for self-harm within 12 months, according to the team’s retrospective audit of 950 patients in 2017 and 2018 — a rate higher than that found in previous studies.