Health & Safety

Children's Mental Health and Wellbeing


Mental health difficulties affect approximately 14 per cent, or one in seven, of Australian children. Most people will experience mental health difficulties at some point in their life, including children. It’s normal to go through a period of difficulty and then improve. At these times, children will benefit from support from the important adults in their lives. But, sometimes, mental health difficulties in children can be on- going and can interfere with many aspects of their life.

Mental health difficulties affect children’s emotions and behaviour, and can cause concern for the child, parents and carers, and also the child’s school. Other terms for mental health difficulties include mental health problems and emotional/behavioural problems. In some cases when difficulties are persistent and/or severe they may be diagnosed as a ‘mental disorder’ by a mental- health professional.

Attention Deficit Hyperactivity Disorder (ADHD), anxiety and depression are examples of common mental health difficulties in primary school-aged children. Diagnosis is based on established international criteria that define specific sets of symptoms and behaviours for each disorder. For a diagnosis to be made, the symptoms must be severe enough to cause distress and interfere with the child’s ability to get on with everyday activities and enjoy life.

Because mental health difficulties can place enormous stress on children and families, professional help can be a useful aid. However, children with mental health difficulties often do not receive appropriate professional support for a number of reasons, such as parents not knowing where to go for help. One of the major aims of KidsMatter Primary is to make information about children’s mental health and ways to get help available to parents, carers and school staff so that children experiencing mental health difficulties can receive appropriate treatment.

Identifying children’s mental health difficulties early and providing helpful professional support can make a significant difference to children’s lives. It can help to resolve mental health difficulties before they become worse, improving the quality of life for children and their families. Early recognition and effective responses are important and provides children with skills for positive coping that have lifelong benefits for their mental health and wellbeing. The earlier in life difficulties are addressed, the better chance a child has at reducing the impact on their long-term mental health and wellbeing.


One way to understand mental health in children is through risk and protective factors.

A number of specific factors have been identified through research that increase the risk of children experiencing poor mental health. Other factors have been identified as having a protective effect. Protective factors act to strengthen children’s mental health and wellbeing, making

them less likely to develop mental health difficulties. They help to balance out the risk of develop- ing mental health difficulties and build resilience; the ability to cope with life’s difficulties.

The diagram above shows some key examples of risk and- protective factors that influence children’s mental health.

It is important to note that just because a child is exposed to mental health risk factors, it does not mean he or she will experience mental health difficulties. However, when multiple risk factors are present this likelihood is significantly increased.

The relationship between risk and protective factors is complex. However, it is known that reducing risk factors and building protective factors in children has a positive effect on their mental health and wellbeing. KidsMatter

Primary works to strengthen children’s protective factors during their primary school years to improve their mental health and wellbeing.


Children’s mental health difficulties are generally classified as being one of two types: ‘internalising’ and ‘externalising’. Children with internalising difficulties show behaviours that are inhibited and over-controlled. They may have a nervous or anxious temperament and be worried, fearful and/or withdrawn. Children with externalising difficulties show behaviours that are under- controlled. They may have a more challenging temperament, shown in impulsive or reactive behaviour. Sometimes this pattern can lead to difficulties with attention, aggression or oppositional behaviour.

Externalising behaviours cause difficulties for others as well as for the children themselves. It is not uncommon for children to show behaviours associated with both internalising and externalising patterns of behaviour. The typical features associated with each pattern are summarised below.

Features associated with children’s ‘internalising’ difficulties include:

  • nervous/anxious temperament
  • excessive worrying
  • pessimistic thinking
  • withdrawn behaviour
  • peer relationship difficulties (eg can be isolated).

Features associated with children’s ‘externalising’difficulties include:

  • challenging temperament
  • reduced problem-solving skills
  • attention difficulties, hyperactivity • oppositional behaviour (eg doesn’t like to be told what to do; won’t follow rules)
  • aggressive behaviour.

Children with ADHD often show severe externalising difficulties. Children with other serious behaviour problems also show externalising patterns of behaviour, such as persistent aggression. Children with severe internalising difficulties may be diagnosed with an anxiety disorder or with depression.
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Mental health professionals who may help with children’s difficulties

School psychologist/school counsellor
Talk with your child’s school about the possibility of seeing the school psychologist or counsellor. School psychologists and counsellors provide assessment and support for children with mental health difficulties. They advise parents and carers and school staff about helping individual children and may recommend specialist services outside the school.

General practitioner (GP)

Your family doctor will give advice and help you decide whether further investigation and treatment is needed. A doctor’s referral is needed to be able to claim the Medicare rebate for mental health treatment from other professionals.


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