Child maltreatment accounts for more than 66,000 years of healthy life lost through mental ill-health in Australia, a new review has found.
Researchers from the University of Sydney, led by PhD candidate Lucinda Grummitt, have calculated the public health burden of exposure to childhood maltreatment, which was found to be as high as 62% in a recent survey of adults.
Moreover, suicide has become the leading cause of death for young Australians.
Mental health conditions, including substance use disorders, self-harm and suicide, are known to be the leading cause of disease burden globally, and studies have confirmed strong associations between childhood maltreatment and virtually all mental health conditions.
Childhood maltreatment includes physical, sexual, or emotional abuse; emotional or physical neglect, and domestic violence before the age of 18 years.
“Childhood maltreatment is a robust risk factor for mental health conditions across the life course,” Ms Grummitt said.
“In a synthesis of Australian studies, Moore et al found that childhood maltreatment accounted for 16% and 23% of depressive disorders and 21% and 31% of anxiety disorders in males and females, respectively.
“However, the full proportion of mental disorders causally attributable to child maltreatment was still unknown.”
She said population attributable fractions (PAFs) were used to quantify the impact of child maltreatment, drawing on three recently available national prevalence and burden of-disease studies to calculate the proportion, number, and burden of attributable mental disorders in Australia.
The prevalence of child maltreatment in Australia was estimated to be 53.8%, accounting for a substantial proportion of mental health conditions including 21% for depression, 39% for self-harm, and 41% of suicide attempts.
Mental disorders were responsible for more than 655,000 DALYs, of which 63,000 were attributable to suicide attempts, 52,000 to anxiety disorders, and more than 35,000 through depressive disorders.
Overall, maltreatment was responsible for 66,143 years of life lost in Australia, and more than 1.8 million cases of depressive, anxiety and substance use disorders could be prevented if childhood maltreatment was eradicated.
“The findings suggest that addressing childhood maltreatment has the potential to avert millions of cases of mental disorders in Australia and should be used to inform more efficient allocation of resources,” Ms Grummitt said.
“Current mental health–related spending in Australia and other high-income countries disproportionately targets treatment for mental health outcomes rather than prevention,” she said.
“Altogether, greater investment of resources upstream to the prevalent and early drivers of suicide attempt, such as childhood maltreatment, may be a promising path forward for suicide prevention.”