National Children's Mental Health and Wellbeing Strategy Report
The National Children’s Mental Health and Wellbeing Strategy Report

5. Summary of Actions

Responsibility for implementation of these actions may be shared between groups or amended as requirements are scoped.

Summary of Actions

The order in which the Focus Areas and associated actions are presented in this Strategy is not indicative of their priority for attention or implementation. Many of the proposed actions would need to be implemented concurrently as they are dependent on each other. Responsibility for implementation of these actions may be shared between groups or amended as requirements are scoped. However, an overview of who is likely to be responsible for each action is included below.

Focus Area 1: Family and Community

Objective 1.1: Supported familiesWho’s responsible?
a. Implement perinatal mental health screening for expectant parents in maternity services (public and private), monitoring and reporting on alignment with the National Perinatal Mental Health Guidelines (see action 4.1.a).State and Territory Governments
b. Ensure evidence-based resources that provide practical suggestions on how families can support children’s emotional wellbeing are made easily accessible and promoted widely. These must include specific resources for families where there are additional physical, neurodevelopmental or cultural needs, developed via genuine co-design.PHN/LHD
c. Routinely offer evidence-based parenting programs to parents and carers at key developmental milestones for their child – for example, the perinatal period (from 6 weeks), at commencement of early childhood education (age 2-4); transition to primary school (age 4-6), when their child moves to the penultimate year of primary school (age 10-11); and at the commencement of high school (age 12+), with targeted engagement and tailored programs for fathers and male caregivers.Commonwealth, State and Territory Governments
d. Implement a nation-wide campaign aimed at promoting the availability and value of parenting programs, with specific efforts to address stigmatising attitudes towards participation in such programs and to removing practical and financial barriers to participation, especially in refugee and migrant communities.Commonwealth Government
e. Promote parent helplines and hotlines (available in each state and territory) as the first ‘port of call’ for any parenting concerns, and enable helplines to take calls through the Translating Interpreting Service, to communicate with parents who do not have English as a first language.State and Territory Governments
f. Include emotional wellbeing modules and information about locally available supports in all antenatal and parenting training courses delivered to new parents.State and Territory Governments
g. Design systematic methods for identifying children who do not start primary school by the required age, with this prompting a compassionate outreach of support to engage the child and family.State and Territory Governments
Objective 1.2: Increased mental health literacyWho’s responsible?
a. Plan and implement a program of activities (such as campaigns) to increase parents’ and carers’ understanding of the signs that a child needs mental health support, including during and after national disasters. These activities should directly address any common myths or misconceptions about child mental health and wellbeing, and promote children’s participation in mental health discussions.Commonwealth, State and Territory Governments
b. Ensure mental health literacy resources do not assume any background knowledge about mental health, use terminology and examples that have universal relevance wherever possible, and are translated into languages other than English.Commonwealth, State and Territory Governments, and parenting services
c. The concept of the wellbeing continuum and its associated anchor points should be tested to see if they have resonance for different communities, including assessing how well they translate into different languages and cultural norms.Commonwealth Government
d. Provide resources about mental health to those in community organisations working or volunteering with children, including information on how to listen to and advocate for the child’s perspective and where they can direct children and families if they need additional mental health and wellbeing support.State and Territory Governments, and Local Councils
Objective 1.3: Community-driven approachesWho’s responsible?
a. Identify and invest in communities that could benefit most from community level support; for example, those with low school attainment, high unemployment, poor physical and mental health, high imprisonment rates, high incidence of child abuse or neglect, or any other factors that contribute to or maintain an environment of social and economic disadvantage.Commonwealth, State and Territory Governments, and Local Councils
b. Work with communities to develop and deliver tailored programs focused on improving child wellbeing and based on the key characteristics of successful place-based approaches. These may build upon existing social networks organically built through contact with maternal and child health, educational settings, sport and other community settings.Commonwealth, State and Territory Governments, and Local Councils

Focus Area 2: The Service System

Objective 2.1: Improve system navigationWho’s responsible?
a. Build on and promote existing online navigational tools (such as HealthPathways) to enable both providers and community members to find the most appropriate locally available supports for children struggling with their mental health.Commonwealth, State and Territory Governments
b. Review consumers’ experience of transitions between services (including across jurisdictions and sectors) and redesign processes to ensure children and families experience optimal transition of care.State and Territory Governments
c. Establish model of integrated child and family care (see page 47-49) networked across Australia that provides holistic assessment and treatment for children 0-12 years old and their families.Commonwealth, State and Territory Governments
d. Examine how policy, services and implementation affect transition from childhood to adulthood in the healthcare system, and redesign to allow for a seamless transition.Commonwealth, State and Territory Governments
e. Model the current and future demand for mental health services and identify gaps.State and Territory Governments

Integrate System Navigation

Objective 2.2: Collaborative careWho’s responsible?
a. Incentivise all relevant service providers to participate in case conferencing. This could be done by enabling providers of all disciplines to claim the existing case conferencing Medicare item numbers.Commonwealth Government
b. Require all service providers, including outside of the health system, to communicate with a child’s nominated GP about supports they are arranging or providing. This communication should be regular to ensure the GP is aware of the supports a child is receiving.Service provider organisations
c. Enable service providers to claim Medicare payments for consultations with parents and carers as part of a child’s mental health treatment, removing the requirement for the child to be present.Commonwealth Government
d. Require mental health professionals to communicate with educators and other service providers about a child’s treatment and support plan, with the family’s permission and subject to this being deemed clinically appropriate.Commonwealth, State and Territory Governments
e. Equip child mental health services to identify parents and carers who are struggling with their own mental health and require them to connect those parents and carers with appropriate supports.Service provider organisations
f. Equip adult mental health services to identify any children in their clients’ care who need mental health support and require them to connect those children with appropriate supports.Service provider organisations
g. Include content specifically targeting parents in workplace mental health programs, with a particular focus on new parents during the return to work phase.Workplace mental health program providers
Objective 2.3: Access and equityWho’s responsible?
a. Increase resourcing for public mental health services to support children aged 12 and under. Funding should be attached to implementation of the model of integrated child and family wellbeing services (action 2.1.c).Commonwealth, State and Territory Governments
b. Provide accessible and affordable training and resources to GPs, paediatricians and other care providers to help them respond to children and families who are struggling, including for practitioners in regional and remote areas.PHN
c. Implement innovative service delivery models that integrate face-to-face and telehealth consultations, digital interventions, and phone helplines to improve access to services.PHN/LHD
d. Commit to ongoing Medicare funding for telehealth services.Commonwealth Government
e. Embed the principles of genuine co-design into the design, delivery and evaluation of all services supporting children and families; actively inviting involvement from the people the service aims to support.PHN/LHD
f. Establish accountability mechanisms (for example, audit and public reporting) that encourage services to improve their accessibility for children and families, including those from Aboriginal and Torres Strait Islander communities and culturally and linguistically diverse communities.PHN/LHD
g. For programs involving specialists providing advice, education or professional support to rural providers, adopt governance arrangements that make funding dependent on the rural provider’s needs being met.Commonwealth, State and Territory Governments
h. Ensure free or low cost mental health services are accessible to parents and carers with mental illness.Commonwealth, State and Territory Governments
Objective 2.4: Built for complexityWho’s responsible?
a. Provide specific funding for care coordination to be available to children and families with complex needs, offered at key points of contact with services.Commonwealth, State and Territory Governments
b. Suicide prevention programs and activities, such as aftercare, should consider the unique needs of children who may access the services.Commonwealth, State and Territory Governments
c. Require relevant services to give priority access to children who are in State care, or who have been the subject of notifications, and Aboriginal and Torres Strait Islander children who have been placed with kin/community networks, and for care to be provided more frequently.Commonwealth, State and Territory Governments
d. Support all government departments to outline and regularly report on what they do to support children in State care, with independent monitoring of outcomes.Commonwealth, State and Territory Governments
e. Require relevant services to outline and regularly report on what they do to ensure they are accessible and effective for children with physical or intellectual disability or neurodevelopment disorders, with independent monitoring of outcomes.Commonwealth, State and Territory Governments
f. Children struggling with their mental health should also be examined for physical health problems to ensure a holistic approach to health and wellbeing.PHN/LHD
g. Child and family mental health and wellbeing supports for Aboriginal and Torres Strait Islander communities should be delivered by Aboriginal Community Controlled Organisations wherever possible, with activity and outcome measures to be collaboratively determined between the funder, service provider and the community to ensure they are appropriate.PHN/LHD
h. Redevelop systems and criteria that prevent children with complex needs from accessing services, including addressing workforce capability where required.Commonwealth, State and Territory Governments
i. Build on holistic support models for children who have had contact with the justice system or are at risk of coming into contact with the justice system.Commonwealth, State and Territory Governments
Objective 2.5: Skilled workforceWho’s responsible?
a. Increase requirements for early career training in child and family mental health for all relevant service providers.Universities, specialist colleges, LHD
b. Incentivise existing service providers (including GPs, maternal child and family health nurses and allied health), with a focus on practitioners in rural and remote areas, to complete training in children and family mental health assessment and treatment.Commonwealth, State and Territory Governments
c. Support public mental health services to act as training facilities for new graduates through designated training places and funding of supervision time.State and Territory Governments
d. Create and incentivise training opportunities for mental health professionals (for example, psychologists, psychiatrists, social workers, nurse practitioners) to work in regional and remote areas.LHD/specialist colleges/ Commonwealth, State and Territory Governments
e. Develop cultural understanding amongst health professionals to work safely and effectively with Aboriginal and Torres Strait Islanders children and families, and provide greater support for Aboriginal Health Workers to engage in child mental health focused ongoing education and training.Universities/LHD/ specialist colleges
f. Build on existing models of supervision and case consultation for private practitioners using a peer support/supervision model.Profession peak bodies
g. Develop workforce projections in the public sector based on evidence and epidemiology and use these to inform further recommendations.Commonwealth, State and Territory Governments, PHNs

Skilled Workforce

Focus Area 3: Education Settings

Objective 3.1: A wellbeing cultureWho’s responsible?
a. Conduct thorough reviews of school and early childhood policies and processes, looking for opportunities to reduce possible stigma and discrimination.Schools and early childhood learning services
b. Identify senior staff within early childhood learning services to be responsible for (1) planning and coordinating wellbeing activities for the students, and (2) maintaining knowledge of and relationships with locally available and online supports.Early childhood learning services
c. Employ wellbeing coordinators in each primary school to be responsible for (1) planning and coordinating wellbeing activities for the students, and (2) maintaining knowledge of and relationships with locally available and online supports. These positions should be funded on an ongoing basis.State and Territory Governments and schools
d. Identify opportunities to incorporate conversations about mental health and wellbeing into the school or early childhood daily routines, with the expectation that all staff and students have the opportunity to contribute to these discussions.Schools and early childhood learning services
e. Promote evidence-based, locally available or online supports and services to children and families through schools and early childhood learning services.Commonwealth, State and Territory Governments
f. Outline and regularly report on how schools and early childhood learning services are improving on current levels of cultural accessibility for children who identify as Aboriginal or Torres Strait Islander or from culturally and linguistically diverse backgrounds.State and Territory Governments
g. Implement evidence-based wellbeing programs within schools and early childhood learning services, with support from existing initiatives such as Be You.Commonwealth Government and early childhood learning services
h. Increase accessible activities after school and during school holidays to provide respite for parents and children.State and Territory Governments
Objective 3.2: Targeted responsesWho’s responsible?
a. Require all early childhood learning services and primary schools to develop a comprehensive wellbeing plan, which should outline what the service or school will do to address issues identified as a priority for their students (including those identified as part of actions 3.1.a and 4.1.c). Progress against these plans should be reported on regularly.State and Territory Governments
b. Make funds available for schools to implement quality improvement activities related to student mental health and wellbeing.Commonwealth, State and Territory Governments
c. Make funds available for schools to deliver evidence-based programs targeting the needs identified as part of action 3.2.a, with a particular focus on bullying and racism.Commonwealth, State and Territory Governments
d. Adapt existing resources and training programs to provide educators with the skills to discuss mental health concerns about a child/student with their parents or carers, including provision of interpreting services where necessary.State and Territory Governments and training providers
e. Establish and implement trauma-informed procedures for responding to students disengaging from education.State and Territory Governments
Objective 3.3: Well-equipped educatorsWho’s responsible?
a. Develop professional learning courses/modules specifically designed for educators that focus on key mental health and wellbeing topics.State and Territory Governments and training providers
b. Create clear processes to guide educators when concerned about the mental health of a student/child, including up-to-date information regarding the range of locally available or online support options for children and families (note role of wellbeing coordinators, see action 3.1.c).State and Territory Governments
c. Provide designated wellbeing coordinator staff (see action 3.1.c) with appropriate training to undertake their role.State and Territory Governments
d. Ensure formal, independent mental health and wellbeing supports are made available to all educators for their own mental health and wellbeing, building on existing teacher and principal wellbeing plans and frameworks.State and Territory Governments
e. Establish professional learning requirements for educators in relation to mental health, with paid protected time for participation.State and Territory Governments

Focus Area 4: Evidence and Evaluation

Objective 4.1: Meaningful data collectionWho’s responsible?
a. Expand the Perinatal National Minimum Data Set to include indicators of mental health screening in the weeks before and immediately after birth (see also action 1.1.a).Commonwealth, State and Territory Governments
b. Establish national system for pooling key information related to child mental health (wellbeing indicators) gathered via routine developmental checks or vaccinations conducted during the preschool years.Commonwealth, State and Territory Governments
c. Establish a national minimum dataset on student wellbeing with annual collection conducted via schools and regular reporting on how schools are addressing any issues identified.Commonwealth, State and Territory Governments
d. Task the Inter-Departmental Committees proposed by this Strategy (see section 4.1) with resolving current barriers to relevant data sharing across sectors such as education, justice and community health, for the purposes of informing child mental health and wellbeing.Commonwealth, State and Territory Governments
e. Ensure that data capture and evaluation practices related to Aboriginal or Torres Strait Islander child mental health and wellbeing are consistent with the principles of co-design (i.e. with significant involvement from the communities represented in the data).Commonwealth, State and Territory Governments
f. Develop measures that appropriately represent cultural conceptualisations of wellbeing in collaboration with the relevant communities, where such measures do not currently exist.Commonwealth, State and Territory Governments

Meaningful Data Collection

Objective 4.2: Embedded evaluation and feedbackWho’s responsible?
a. Require and resource service providers to build evaluation into their programs from the beginning, with reporting on findings a requirement for further funding.Commonwealth, State and Territory Governments
b. Require wellbeing programs delivered within schools or early childhood learning settings to have demonstrated evidence of improving student/child wellbeing.State and Territory Governments
c. Include implementation evaluation as part of the broader evaluation of child mental health and wellbeing programs to highlight what is required to deliver these programs with fidelity.Commonwealth, State and Territory Governments
d. Openly communicate the evaluation results for child mental health and wellbeing programs that are being delivered, including both positive and negative outcomes.Commonwealth, State and Territory Governments
e. Require service and program providers to enable children and their families to provide feedback on the services they are receiving. Require service providers to outline how they use this feedback to inform quality improvement of their services.Commonwealth, State and Territory Governments
f. Aboriginal and Torres Strait Islander organisations should be resourced to build evaluation capability and their own information management systems.Commonwealth, State and Territory Governments
Objective 4.3: High-quality researchWho’s responsible?
a. Advocate for research into child mental health needs and treatment as a priority, arguing for child mental health research to receive funding that is comparable to child physical health.National Health and Medical Research Council
b. Identify research priorities for child mental health, incorporating a focus on priority populations and the current gaps in our collective knowledge regarding treatments. Allocation of funding must be aligned with these identified priorities.National Health and Medical Research Council, Medical Research Future Fund
c. Review current research ethics approval processes, looking for ways to facilitate innovative research without compromising the safety of research participants.Research ethics committees and researchers
d. Require researchers to consult with children, family and relevant community members as part of the research design process, with the expectation that those involved are also informed of any results of the research.Research ethics committees
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Acknowledgement of Country

The Commission acknowledges the traditional custodians of the lands throughout Australia.
We pay our respects to their clans, and to the elders, past and present, and acknowledge their continuing connection to land, sea and community.

Diversity

The Commission is committed to embracing diversity and eliminating all forms of discrimination in the provision of health services. The Commission welcomes all people irrespective of ethnicity, lifestyle choice, faith, sexual orientation and gender identity.

Lived Experience

We acknowledge the individual and collective contributions of those with a lived and living experience of mental ill-health and suicide, and those who love, have loved and care for them. Each person’s journey is unique and a valued contribution to Australia’s commitment to mental health suicide prevention systems reform.