Warning: This article discuses death, suicide, violence and child abuse.
This year, in Australia, an estimated 315 babies and pre-schoolers will be diagnosed with cancer. Most of them will go in to remission, however around 25 of these children will not make it (Cancer Australia, 2016).
It is true: the numbers of children dying from cancer used to be much higher. But – largely as a result of extraordinary donations to fund research and health services – we now see many more children survive childhood cancer than dying from it. Fortunately, most of us will be spared from having to watch a child in our family or social circle battle this horrific disease.
But…despite all these advances, each little life is important. Each one matters. In the 0-4 age group, cancer robs children of their childhoods and families of their children. Childhood cancer robs us all of our future Environmental Warriors, Artists, Pioneers and Heroes. We lose so much to early childhood cancer. Twenty five little lives lost is still too many.
The question is, how do we find those final pieces of the childhood cancer jigsaw puzzle? How do we make sure the funding doesn’t dry up? How do we make sure we can keep our best scientists, doctors, and nurses working to ensure that cancer no longer poses a threat to our children?
Here is a statistic that may hide one of the missing pieces:
For every baby and preschooler who will be diagnosed with cancer this year , an estimated 758 children in the same age group are already experiencing risks to their mental health. For every one baby or preschooler we lose to cancer this year, 11,946 little people will go on to experience at least one episode of mental illness in their life – typically before they reach adulthood (we crunched these numbers in a crude but logical way from: Australian Bureau of Statistics, 2016; Australian Research Alliance for Children and Youth, 2013; Cancer Australia, 2016).
Despite a section of the community still believing that mental illness is something to do with being ‘soft’ (whatever that means) and can be cured by simply ‘toughening up’, mental illness can be just as life-threatening as cancer. In the field we work in, suicide and other psycho-social factors are the leading cause of maternal deaths. Suicide is also the leading cause of death in young Australian men. And suicide is not the only way that mental illness kills. Poor mental health is linked with a vast range of chronic health issues, including (perhaps ironically) adult cancer. And it doesn’t just kill. It can debilitate entire families in the most chronic of ways, for years on end. Mental illness is believed to cost our economy $190billion every year*.
And, by all accounts, the numbers are growing.
Unlike childhood cancer, almost every person in Australia is, or will be, impacted by mental illness in some way. These statistics are staggering, and difficult to picture in a meaningful way. So, think about it this: if early childhood cancer robs our community of 25 important lives every year, poor mental health in early childhood is robbing our communities of thousands and thousands of equally important lives: the same lives that potentially could go on to be the very scientists, doctors or medical engineers who develop the final cure for cancer (or any solution to the myriad of other problems we face as a community).
But, just like we have been able to eliminate most deaths due to childhood cancer, we also now know a lot about what to do to prevent mental illness altogether. Thanks, in large part, to studies like the Adverse Childhood Experiences Study, researchers now predict that around 50% (not a misprint) of all mental illness may be preventable through better supports for mental health development during infancy and childhood. There are growing numbers of practitioners who are exceptionally skilled at supporting (and restoring) mental health development in this age group.
The problem is not that we don’t know how to reduce mental illness. We do. The problem is that mental illness is just not invested in the same way. For example, Baby in Mind is one of the few Australian organisations working exclusively in this area. And, even with all the statistics, evidence-based infant mental health promotion initiatives like ours receive no government funding in Australia, and very little philanthropic or community support.
We can, and should, be doing everything in our power to prevent the last few remaining deaths caused by cancer in infancy and early childhood. But if we are to stand up for these 25 children, we also need to stand up for all children who are at risk of developing life-threatening consequences from illnesses that, at least in a great many cases, are thought to be preventable. This includes the 239,000 babies and young children experiencing mental health vulnerabilities as of today. As an organisation we work to promote infant mental health development not for ‘the sake of it’. We do it because we want to see an end to loneliness. An end to bigotry and violence. An end to depression and isolation. An end to child abuse, poverty, hunger, homelessness and so much more. Just as much as anyone else, we want to see an end to cancer.
To do this, we need to fully invest in the mental health development of our future. We need to take infant mental health development seriously. This is where hope truly lies. Infant and early childhood mental health promotion is notoriously cheap and cost effective. For example, it costs our organisation around $10 to reach and provide a service to one family. We don’t even need more expensive services to do it: we can provide this care simply by giving skills to workers and community members who are already supporting families. Infant mental health promotion does require specific skills that are different from treating mental illness, but they are not hard skills to teach. In theory, this means that we could get a mental health promotion program to every Australian family with a baby for less than $2.5million a year…that’s only 1.4% of the amount the government spends on cancer research alone*.
For every dollar spent in this age group, the community gains an average saving of $8.74…and often much more. Much like a vaccination, infant mental health promotion and early intervention won’t prevent every instance of mental illness, but it can (and does) reduce the incidence, severity and long-term costs dramatically.
So, if the economics of early child mental health are so compelling, why is it such a difficult issue to engage people in? One of the reasons may be that one of the central requirements for child mental health is strong, secure, affectionate and safe relationships between parents and their children. And herein lies the problem. To really support infant mental health development, we need to have a some conversations about parenting: how it works, what it looks like, and how we as a village can best support it. And these are inconvenient conversations, often uncomfortable ones, largely because we have created such a culture of parent-blame that most of us are on the defensive.
But have these conversations we must. The survival rates for childhood cancer are going up. But this didn’t happen on its own. It was ordinary people who got behind the issue and said enough is enough. Government apathy aside, imagine if our community simply decided enough was enough when it came to preventable mental illness and supported infant mental health research and services – and parents – in the way same we have supported cancer research and services over the years? Not only would this leave us more money to beat the tough challenges like cancer, but also a much more healthy, empathetic and productive society to solve our collective challenges well into the future.
*Footnote: The $190billion cost of mental illness is not the amount of money government spends on mental health care (which is actually just $8billion). And even within the mental health budget, government spending on mental health promotion and mental illness prevention is almost non-existent – despite significant knowledge about how to reduce rates of mental illness through promotion and prevention. The amount of $190billion refers to the actual economic burden to our community as a result of mental illness, and (arguably, at least in part) the failure to support cost-effective, evidence-based prevention and early-intervention programs.
Research funding trends are also interesting. From 2006 – 2011, the Australian government contributed $856 million toward cancer research (66% of all cancer research funding) – that’s about $171million per year. However, the government-funding for mental illness research during the same period, equated to $44million (about 1/3) – despite mental illness contributing to a much larger proportion of the disease burden and debt in Australia.
If this article has raised any issues for you, please contact:
Lifeline: 13 11 14 www.lifeline.org.au
Suicide Call Back Service: 1300 659 467 www.suicidecallbackservice.org.au
beyondblue: 1300 22 4636 www.beyondblue.org.au
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