Revealing the hidden epidemic of child and adolescent trauma in Australia

Exposure to traumatic events such as physical and sexual assault, domestic violence and natural disasters is prevalent among children and adolescents worldwide. Trauma exposure during this early life stage can have debilitating and enduring effects, including the development of mental health and substance use disorders. The hidden epidemic of early trauma has been recognised in Australia with governmental responses such as the Royal Commission into Institutional Responses to Child Sexual Abuse. More recently, in March 2020, the new National Guidelines for Trauma-Aware Practice in Schools and Early Childhood Services were released to facilitate schools and other youth services in ensuring their approach with young people is trauma-informed and based on best practice and evidence. However, our understanding of the prevalence and impact of early trauma among Australians remains limited. At the University of Sydney’s Matilda Centre, Dr Emma Barrett and colleagues are addressing this gap.

As the Program Lead in Trauma and Crime Research at the Matilda Centre, Dr Barrett aims to:

i) improve knowledge of the prevalence and impact of early trauma among Australians

ii) develop and evaluate innovative interventions to address this impact.

In 2017, Dr Barrett presented her research at the TEDx event in Sydney. As part of this program of work, she examined the most recent Australian National Survey of Mental Health and Wellbeing (NSMHWB), collected by the Australian Bureau of Statistics in 2007. This nationally representative survey of 8,841 adult Australians measured lifetime trauma exposure and mental health disorders.

Dr Barrett is currently analysing data collected as part of the pioneering NHMRC-funded CAP study, a cluster randomised controlled trial conducted among 2,190 students in 26 Australian secondary schools. “We have followed up this cohort annually since 2012 from age 12 to 20 and are investigating the prevalence and impact of trauma exposure among this group of young Australians," explains Dr Barrett.

Dr Barrett is also working with other academics at the Matilda Centre on the COPE-A study. "This is a world-first NHMRC-funded randomised controlled trial of an integrated CBT-based therapy for adolescents, designed to address two of the most common disorders that can develop after exposure to early trauma – post traumatic stress disorder and substance use disorder,” says Dr Barrett.

The COPE-A study is currently recruiting young people aged 12-21 years who are using alcohol or other drugs and are having difficulty coping after experiencing a traumatic event.

The NSMHWB revealed that 41% of Australian adults (approximately 6.5 million) experienced at least one traumatic event before 17 years of age The most common traumatic events reported were witnessing domestic violence and experiencing physical or sexual assault. Those exposed to early trauma were 3.6 times more likely to have a mental health or substance use disorder and were up to 7 times more likely to have co-occurring mental health and substance use disorders compared to those without trauma exposure.

Similarly, initial analyses of the CAP study data has revealed that 54% of the cohort experienced trauma before 18 years of age. The most common traumatic experiences were motor vehicle accident, physical assault and sexual assault. These findings, while startling, are consistent with studies conducted around the world that highlight the high prevalence of trauma exposure and adversity among our young people.

“Our next steps are to finalise these studies and publish them to inform future initiatives and practice. We are also developing and evaluating evidence-based interventions designed to address the psychological impacts of this pervasive issue. Our ultimate aim is to equip and empower all young Australians impacted by trauma to lead mentally healthy lives,” explains Dr Barrett.

Other Matilda researchers involved in this work include Professor Maree Teesson, Professor Katherine Mills, Dr Matthew Sunderland, Associate Professor Nicola Newton, Associate Professor Cath Chapman, Associate Professor Tim Slade, Dr Lexine Stapinski, Dr Erin Kelly, Dr Katrina Champion, Dr Natalie Peach, Julia Boyle, Ivana Kihas, Katie Dobinson, Jo Cassar, Olivia Schollar-Root, Louise Bezzina and Ashling Isik.

More information about the CAP and COPE-A studies is available at Matilda Centre projects.

For further information about the COPE-A study including how to participate in the treatment trial, please contact Dr Natalie Peach at natalie.peach@sydney.edu.au or visit copea.org.au.