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Children’s mental health is no longer a taboo topic. We’ve moved past questioning whether children can experience mental health challenges to focusing on how best to support them. It’s increasingly recognised that fluctuations in emotion, behaviour and functioning are a normal part of child development, and that promoting mental health is as important as responding to mental illness. This article explores the emerging shift in how we conceptualise and discuss children’s mental health.
Since we wrote about the language of children’s mental health in 2019 and 2022, there has been a growing consensus that wellbeing and mental health challenges exist on a continuum, not as separate categories of health and illness. Governments and the industry, health, education and community sectors are increasingly speaking about children’s mental health in non-medicalised terms, which has supported destigmatisation of children’s mental health. This shift challenges the idea that mental health is solely the domain of limited and hard to access specialised services, emphasising that support should begin in the family and extend across community-based health and education systems.
The importance of language in driving cultural change is not new. The evolution of climate change from awareness to action provides an analogous example for us to look to in moving the field and practice of children’s mental health forward. A common understanding of terms such as “global warming”, “sustainability” and “carbon footprint” has created a framework for effectively discussing problems and solutions, uniting stakeholders, and facilitating a more focused, action-oriented dialogue. This framework has also increased public awareness and literacy, galvanising public action and resulting in the signing of the Paris Agreement. A shared language, once established, sets the scene for collective action.
Similarly, the field of children’s mental health is now poised for action with the publication of a clear roadmap via the National Strategy for Child Mental Health and Wellbeing, which calls for cross-sector collaboration, embedding children’s mental health in all policies and practices, and significant and sustained investment in children’s mental health. A shared language has been instrumental in shifting how children’s mental health is being understood by the public and key sectors. However, for this cultural shift to translate to systemic reform, language must be accompanied by sustained, strategic, collective and intentional action. Below we unpack five key recommendations and actions to sustain this momentum.
Shift the narrative from “crisis” to “prevention and early support”, promoting mental health literacy that builds on children and families’ strength and supports early action:
Actively reframe public discourse on children’s mental health to emphasise shared experiences and developmental perspectives, rather than crisis-oriented narratives. This includes empowering families, educators and communities to support children’s emotional development, build resilience, and recognise when early support may be needed.
Action: Develop communication strategies that frame mental health as a continuum, integrating it into broader child development discussions. Collaborate with media, educators and health care providers to disseminate messages that normalise mental health experiences and encourage proactive support-seeking behaviours to the adults supporting children. National campaigns and community-based initiatives should make children’s mental health visible and relatable, using language that resonates with families and reflects cultural and community diversity. A shared national framework for mental health language, co-designed with key stakeholders, could help align practice and communication across sectors, improving mental health literacy and guiding resource and policy development. Messaging should promote emotional wellbeing as part of healthy development, encourage early help seeking, and equip adults with the tools to have everyday conversations about mental health. Messaging should be consistent, culturally inclusive, and free from fear-based framing, recognising that mental health is not just about illness but about helping all children to thrive.
Develop accessible, age-appropriate and culturally responsive mental health resources:
Children require information in different formats and focused on varying topics depending on their age, literacy level, emotional maturity and other contextual and cultural factors. To be effective, resources need to be tailored based on these factors, allowing children to be heard, and feel supported and empowered to talk about and seek help for their mental health.
Action: Support the creation and implementation of mental health resources that are created with and for children, amplifying their voices, and taking into account their cognitive, emotional and social development.
Build cultural competencies for the mental health and related workforces:
We know that cultural narratives around mental health shape the way that families and communities respond to mental health difficulties in children. Western-centric notions of mental health and wellbeing can dominate the conversation and lead to minimisation of family priorities and needs when caring for children for those who come from non-Western backgrounds. Groups who are denied equity also face systemic barriers to accessing universal care and other services that need to be acknowledged and addressed sensitively. Although we have limited data on the child-specific mental health needs of non-Western communities in Australia, utilisation of crisis related youth mental health services appear disproportionately high for those from a culturally and linguistically diverse background, and mental health service use by adults born outside Australia remains lower than in Australian-born counterparts. Cultural safety and competencies in the mental health workforce have also been identified as a key priority in the National Mental Health Workforce Strategy and the Fifth National Mental Health and Suicide Prevention Plan.
Action: Support cultural safety training and development for professionals who see families who access child-specific mental health services. This development should also be extended to other community members, such as teachers and school staff, who may need to be involved in conversations about child mental health with families.
Increase integration of evidence-based mental health support across sectors (ie, health and education):
Continue integrating mental health literacy and support across all community-based universal services such as schools, general practice and maternal child health nursing, where early interventions and a stigma-free “mental health culture” can have the most impact.
Action: Scale up successful, evidence-based initiatives such as the Mental Health in Primary Schools Initiative (MHiPS), Connecting Mental-health Paediatric Specialists and community Services (COMPASS), Child and Family eHub and sustained nurse home visiting to ensure all schools, community health services (general practice), maternal and child health nurses and families have access to capacity-building resources that use the same language and can promote and support emotional resilience, coping skills, and mental wellbeing from the earliest age.
Monitor and evaluate progress using diverse data:
Ongoing evaluation and data collection are critical to monitor the effectiveness of the policy shifts and public discourse on children’s mental health. Real-time, multisource data are essential for carrying out continuous quality improvement approaches to the implementation of actions detailed above.
Action: Prioritise regular, cross-source data collection to assess the impact of the actions detailed above (including mental health literacy programs and policy changes), and adjust strategies based on feedback and outcomes in a continuous quality improvement cycle. Integrate traditional scientific measures (ie, cohort/megacohort studies, national surveys) with more contemporary measures (eg, social listening, media metrics) to get a pulse across information systems and create a harmonised, national dataset that includes mental health metrics from across the continuum to inform policy makers or program leads on whether language reforms are translating to cultural shifts.
Associate Professor Simone Darling is a Principal Research Fellow at the Murdoch Children’s Research Institute and a nationally recognised leader in children’s mental and digital health, with an extensive track record of catalysing research-driven system reform across education, health, and policy sectors. A/Prof Darling’s work integrates innovative research with real-world translation, resulting in evidence-based programs and initiatives that have reshaped prevention efforts nationally.
Dr Sarthak Gandhi is a junior doctor, researcher, and youth mental health advocate working across clinical care, research, advocacy, and policy. He works to advance prevention and youth-led, strengths-based approaches to mental health grounded in evidence, equity, and the lived experience of children and young people.
Catherine (Cat) Johnson is a mental health and education researcher with over a decade of experience across academic, community, and school-based settings. Her expertise spans program evaluation, implementation science, and applied research, with a focus on early intervention and mental health literacy in primary school and community contexts.
Professor Frank Oberklaid, AM, MD, FRACP, DCH, was the Foundation Director of the Centre for Community Child Health at The Royal Children’s Hospital – Melbourne for over 25 years. He is currently Co-Group Leader of Child Health Policy, Equity and Translation at the Murdoch Children’s Research Institute and an Honorary Professor of Paediatrics at the University of Melbourne. Professor Oberklaid is an internationally recognised authority and advocate for children’s health who has focused on helping children with developmental and behavioural problems through research-based programs.
The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.
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