Children's mental health and wellbeing

Overview of mental health and wellbeing for children 

Children’s mental health and wellbeing shapes their everyday experiences and influences their ability to live a long, fulfilling life. When a child has good mental health, they can:

• reach their full potential    
• build strong, meaningful relationships
• adapt to challenges and cope better with stress.

Mental health challenges often begin during childhood. If left unaddressed, they can lead to poor outcomes later in life (National Mental Health Commission). 

Children’s mental health and wellbeing is best understood as a continuum ranging from well to unwell, as pictured in the graphic below. This graphic helps us recognise that mental health is not fixed, and children may move along this continuum at different times.

Children often express emotional or psychological distress through their behaviour. This may be seen as disruptive, angry, hyperactive, withdrawn, worried or other strong emotional responses (Better Health Channel). Recognising these signs early can help adults better understand and then respond with care and support.

The following 2-minute video introduces Emm. Emm will bring the key elements of children’s mental health to life. This short video helps viewers understand how children experience and express mental wellbeing. 

Psychotropic medication

Psychotropic medication is any prescribed medication which affects cognition (such as perception and thinking), mood, level of cognitive arousal (alertness) and behaviour.

Psychotropic medication includes antidepressants, antipsychotics and stimulants. Medication, used in conjunction with other therapeutic approaches such as individual or group therapy, can be beneficial for some people. It will be important to liaise with the health professional, the child and parents or carers to work out the best treatment option. 

If a child is being assessed for psychotropic medication:

• consider going with the child, parent or carer to the medical appointment, or seeking feedback from the doctor
• share information with the health professional about the child’s history of abuse and neglect as the more information the doctor has about the child’s history, the better they will be able to make a decision about diagnosis and treatment
• discuss the possibility that the child might be responding to or resisting experiences of violence, provide trauma informed explanations for behaviours and emotional wellbeing
• ask questions about the doctor’s recommendations
• ask advice about the side effects of this medication to make sure the child, carer and other key people and professionals are aware of this
• in the first weeks that the child is taking medication, ask the carer to monitor the child’s behaviour, emotions, concentration, sleep and appetite and discuss any changes with the medical practitioner.

Refer to procedure 5 Support a child in care, Management of psychotropic medication.

Treatment orders 

Treatment orders are formal authorisations that allow mental health professionals to provide treatment to a child without their consent in specific circumstances. These orders are possibly issued when a child is experiencing a severe mental health condition, such as psychosis, severe depression, or other conditions that pose a risk to their safety or the safety of others.

The two main types of treatment orders relevant to children are:

Treatment authorities: These are issued when a child requires involuntary treatment for a mental illness and cannot make decisions about their care. Treatment authorities allow authorised mental health services to provide care and treatment, even if the child or their guardian does not consent.

Court-ordered treatment: In some cases, the Mental Health Court or other judicial bodies may issue orders for treatment as part of a legal process, particularly if the child’s mental health condition is linked to criminal behaviour or other legal matters.

How treatment orders are made

There are four key steps in making a treatment order: 

Treatment orders for children are typically used in situations where the child:

• is experiencing mental illness that, without treatment, is likely to result in serious deterioration
• poses a risk to themselves or others
• is unable to make informed decisions about their care due to their mental health condition
• or their guardian refuses necessary treatment, and delaying care would result in harm
• has a mental health condition which is linked to legal issues, such as criminal behaviour, requiring court-ordered treatment.

Safeguards and rights

Queensland’s mental health system includes the following safeguards to protect the rights of children under treatment orders:

• Treatment and care should impose the least possible restriction on a child's rights and choices, considering their living situation, support network, and the needs of carers or family. Wherever possible, care should be delivered in the community rather than in restrictive settings.
• Decisions must prioritise the child’s best interests and developmental needs.
• Children and their guardians have the right to be informed about the treatment and to participate in decisions where possible.
• Orders are regularly reviewed by the Mental Health Review Tribunal to ensure they remain justified.
• Advocacy and support services, such as the Office of the Public Guardian, are available to assist children and families.

Child development and mental health 

Understanding how child development and mental health interact is essential for supporting children effectively. Sometimes, developmental delays and trauma responses can look similar, however they require different types of intervention and support. For example, consider a child who is showing speech regression as they may have a developmental delay, or they may be showing a trauma response. 

To understand what’s happening:

• observe the child’s behaviour in context
• consult with trauma professionals such as a mental health clinician, allied health professional, paediatricians. 

Nurturing growth through culture 

Child development is deeply shaped by cultural values, beliefs, and practices — what is considered ‘normal’ or ‘healthy’ development can vary greatly across societies. Much of our understanding of child development has been produced through a Western lens, meaning it often reflects Western norms around independence, family structure, and child-rearing. It’s important to recognise this cultural bias and remain open to diverse ways that children grow, learn, and thrive in different cultural contexts. 

Culturally grounded developmental support is especially important for Aboriginal and Torres Strait Islander children. Practices such as connection to Country, cultural routines, storytelling can help children grow, heal and feel safe. 

Working closely with cultural consultants, including Elders and ATSICCOs ensures these practices are embedded into Child Safety’s interventions (Australian Institute of Family Studies). 

Emerging Minds worked with communities across Australia to create this 3-minute video which offers a glimpse into the deep connections Aboriginal and Torres Strait Islander peoples have to Country, culture, spirituality, family and community.

Neurodivergence, neurodevelopmental disorders and mental health

Children with autism, ADHD or neurodevelopmental disorders (such as FASD) also experience anxiety, depression or other mental health challenges. They may struggle with environments or expectations that don’t align with how they naturally think, feel, or behave.

Therapeutic approaches encouraging a neurodivergent child to behave in neurotypical ways can unintentionally cause harm. This approach may lead to shame, anxiety, depression and reduced self-worth. In contrast, a ‘neurodivergent affirming’ approach to help a child feel safe, understood and empowered will focus on:

• celebrating neurodiversity
• equipping children and families with tools and strategies that work for them
• making environmental accommodations to support their needs (Emerging Minds (d)). 

Overlap of trauma, neurodivergence and neurodevelopmental disorders

Children with trauma histories, neurodivergence, or neurodevelopmental disorders may display similar behaviours, such as emotional dysregulation, sensory sensitivities, or difficulties with attention and social interaction. However, their support needs can differ significantly, and effective intervention requires addressing the underlying cause rather than focusing solely on the behaviour.

For example, hypervigilance resulting from trauma can resemble hyperactivity, and emotional shutdown may look like autistic withdrawal. Interventions that target behaviour without understanding its root cause are rarely successful.

Neurodivergent children are more vulnerable to trauma 

They may experience more bullying, exclusion, or misunderstanding, which can lead to anxiety, depression, or post-traumatic stress disorder.

Misdiagnosis and missed diagnosis is common

Trauma may mask neurodivergence, or vice versa, leading to unhelpful interventions.

To support children effectively:

• recognise that trauma and neurodivergence can overlap, and avoid assuming behaviour stems from one or the other
• take time to understand the child’s full story, including their development, cultural background, and lived experiences
• adopt trauma-informed and neurodivergent-affirming approaches to prioritise safety, respect, choice, and empowerment
• collaborate with families and professionals, including psychologists, paediatricians, and cultural consultants, to provide tailored support.

Mental health for young people

Adolescence is a time of rapid physical, emotional, cognitive, and social change. These transitions increase vulnerability to mental health and wellbeing challenges, while also providing a critical window for early intervention and resilience-building.

More than 70% of mental illnesses will emerge for the first time by the age of 25 years (SANE Australia).

Young people may experience a range of mental health challenges, including: 

• drug and alcohol use
• eating disorders
• suicide thoughts and behaviours (Refer to Suicide and non-suicidal self-injury.) 
• unsafe or unhealth relationships.

Engagement approaches with children and young people 

Conversations with children and young people about their mental health can be challenging. They may struggle to understand and find the words to describe their emotional wellbeing. 

Listen deeply to a child or young person by creating a safe space, both in time and location, for them to share whatever is on their mind. Avoid the urge to immediately cheer them up, as this can come across as dismissive or signal that you are not ready to fully hear and acknowledge their experiences and feelings. 

The following table offers practical strategies to create a safe and supportive environment where children and young people feel heard, understood, and empowered to share their thoughts and feelings.

Support a child following disclosure of abuse, trauma or experiencing a mental health crisis 

When a child disclosures trauma or is experiencing a mental health crisis, the immediate priority is to ensure their emotional and physical safety. Remaining calm, present, and non-judgmental helps create a sense of stability. Techniques from Mental Health First Aid such as active listening, validation, and reassurance, can be useful in offering reassurance and helping the child feel supported in the moment.

Children’s trauma responses vary. Some may express distress through crying, agitation, or anger, while others may become quiet, withdrawn, overly compliant, or appear emotionally flat. These less visible signs can be easily missed but may indicate the child is overwhelmed or dissociating. 

Remain attuned to subtle cues and avoid interpreting silence or compliance as coping.

Coordinate support across systems and needs to include both immediate and longer-term responses. Work closely with families, ATSICCOs, schools, and mental health professionals to create wraparound care, responsive to the child’s developmental needs in a holistic and culturally safe way. For Aboriginal and Torres Strait Islander children, recognise the importance of cultural identity, connection to Country, and the role of kinship in healing.

Navigating the mental health system can be confusing and overwhelming for children. Provide clear explanations of processes, offer emotional and physical support during referrals, and help them understand what to expect from appointments. Ensure the child feels informed and involved. When long waitlists delay access to services, interim supports are essential. These can include psychoeducation, grounding and mindfulness techniques, consistent support within the care system, and relational support from trusted adults.

Children in care arrangements are particularly vulnerable to mental health challenges, with anxiety disorders—such as panic disorder, obsessive-compulsive disorder, phobias, social anxiety, generalised anxiety disorder, and post-traumatic stress disorder—being common. Post-traumatic stress disorder is the most frequently reported among children involved in child protection intervention (Queensland Health). These concerns often arise from complex developmental trauma and disrupted attachment, requiring sensitive, long-term support.

Healing is not a straightforward process. Children may revisit their trauma at different developmental stages, with their needs evolving over time.