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Parents’ perception of children’s mental health: seeing the signs but not the problems
  1. Li Huang1,
  2. Harriet Hiscock2,
  3. Kim M Dalziel1
  1. 1 Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
  2. 2 Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Victoria, Australia
  1. Correspondence to A/Prof. Kim M Dalziel, Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia; kim.dalziel{at}


Background It is a public heath priority to understand why many children with mental health problems fail to access mental health services. This study aims to quantify under-recognition of children’s mental health problems by parents across income quintiles.

Methods We estimated under-recognition with parent-reported mental health problems and the Strengths and Difficulties Questionnaire (SDQ) using a nationally representative Australian data set for children aged 4–15 years with 24 269 person-wave observations.

Results Under-recognition was the highest in the lowest income quintile, with 11.5% of children from the lowest income quintile families who scored in the clinical range on the SDQ perceived by parents as having no mental health problems. For the highest income quintile this was 2.4%. In terms of gender and age, under-recognition was greater for boys and younger children.

Conclusions Parent’s mental health literacy, especially for low-income families, warrants prioritised attention from researchers, clinicians and policymakers.

  • mental health
  • parent perception
  • income-related inequality

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  • Contributors LH wrote the first draft of the manuscript and conducted the statistical analysis. All authors have contributed to the conceptualisation of the work, and the analysis and interpretation of data, and have critically revised the manuscript. All authors are responsible for the reported research and have approved the manuscript as submitted.

  • Funding This work was supported by the National Health and Medical Research Council (grant APP1129957).

  • Disclaimer The funding source had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Australian Institute of Family Studies Ethics Committee

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Appropriate approval was obtained from the Department of Social Services (Australia) to access the publicly available, deidentified longitudinal data set.