In 1996, Ange McAuley was just 11 years old when ABC’s Four Corners profiled her family living on Brisbane’s outskirts.
At the time her mother was pregnant with her sixth child and her father had long ago moved back to Perth.
WARNING: This story contains details that may be distressing to some readers.
It was a story about child protection and the program was profiling the role of community volunteers helping her mother, who had been in and out of mental health wards.
Ange was the eldest and it fell to her to get her younger siblings ready for school.
By the time the new baby arrived, she would stay home and change nappies.
“It was pretty crazy back then â I wasn’t going to school a lot,” she said.m
By that age she was already holding a secret â she’d been sexually abused at age six by her stepfather, who would later be convicted of the crime.
“Back in the nineties, a lot of people kept stuff hidden and it wasn’t spoken about outside of the family,” she said.
“I’ve carried all these big burdens that weren’t even mine. Sexual abuse happened to me. I didn’t ask for it.”
She says the trauma triggered a lifetime of mental health problems from substance abuse and self-harm as a teen, right through to post-natal depression.
Hidden source of our mental health crisis
A new study from the University of Sydney’s Matilda Centre has established just how much Australia’s mental health crisis can be traced back to this kind of childhood abuse and neglect.
“It was pretty crazy back then â I wasn’t going to school a lot,” she said.
By that age she was already holding a secret â she’d been sexually abused at age six by her stepfather, who would later be convicted of the crime.
“Back in the nineties, a lot of people kept stuff hidden and it wasn’t spoken about outside of the family,” she said.
“I’ve carried all these big burdens that weren’t even mine. Sexual abuse happened to me. I didn’t ask for it.”
She says the trauma triggered a lifetime of mental health problems from substance abuse and self-harm as a teen, right through to post-natal depression.
Hidden source of our mental health crisis
A new study from the University of Sydney’s Matilda Centre has established just how much Australia’s mental health crisis can be traced back to this kind of childhood abuse and neglect.
If you or anyone you know needs help:
- Lifeline (24-hour Crisis Line): 13 11 14
- Kids Helpline:Â 1800 55 1800
- MensLine Australia:Â 1300 789 978
- Suicide Call Back Service:Â 1300 659 467
- Beyond Blue:Â 1300 22 4636
- Headspace:Â 1800 650 890
- ReachOut:Â au.reachout.com
The research has found that childhood maltreatment is responsible for up to 41 per cent of common mental health conditions including anxiety, depression, substance abuse, self-harm and suicide attempts.
The research, which draws on a 2023 meta-analysis of 34 research studies covering 54,000 people, found maltreatment accounted for 41 per cent of suicide attempts in Australia, 35 per cent of self-harm cases and 21 per cent of depression episodes.
It defined childhood maltreatment as physical, sexual, emotional abuse, emotional or physical neglect and domestic violence before the age of 18.
Lead researcher Lucy Grummitt said it is the first piece of work to quantify the direct impact of child abuse on long-term mental health.
It found if childhood maltreatment was eradicated it would avert more than 1.8 million cases of depression, anxiety and substance use disorders.
“It shows just how many people in Australia are suffering from mental health conditions that are potentially preventable,” she said.
Dr Grummitt said they found in the year 2023 child maltreatment in Australia accounted for 66,143 years of life lost and 118,493 years lived with disability because of the associated mental health conditions.
“We know that when a child is exposed to this level of stress or trauma, it does trigger a lot of changes in the brain and body,” Dr Grummitt said.
“Things like altering the body’s stress response will make a child hyper-vigilant to threat. It can lead to difficulties with emotion regulation, being able to cope with difficult emotions.”
While some areas of maltreatment are trending down, figures from the landmark Australian child maltreatment study last year show rising rates of sexual abuse by adolescents and emotional abuse.
That study found more than one in three females and one in seven males aged 16 to 24 had experienced childhood sexual abuse.
Dr Grummitt said the prevalence of this abuse could help explain rising rates of psychological distress among the same age group.
“It could be teenagers struggling to really cope with difficult emotions and certainly trauma can play a huge role in causing those difficult emotions,” she said.
Mental health scars emerge early
For Ange, the trauma of her early years first showed itself in adolescence when she started acting out â she remembers punching walls and cars, binge drinking and using drugs.
“I would get angry and just scream,” she said.
“I used to talk back to the teachers. I didn’t finish school. Mum kicked me out a lot as a teenager. I was back and forth between mum and dad’s.”
By the time she disclosed her abuse, she was self-harming and at one point tried to take her own life.
“I was just done,” she said.
“I was sick of having to get up every day. I didn’t want to do it anymore.”
Later on, she would have inappropriate relationships with much older men and suffered from depression, including post-natal depression.
“It’s definitely affected relationships, it’s affected my friendships, it’s affected my intimate relationships,” she said.
“Flashbacks can come in at the most inappropriate times â you’re back in that moment and you feel guilt and shame.
“I feel like it’s held me back a lot.”
Calls for mental health ‘immunisation’
Dr Grummitt said childhood abuse and neglect should be treated as a national public health priority.
In Australia, suicide is the leading cause of death for young people.
“It’s critical that we are investing in prevention rather than putting all our investments into treatment of mental health problems,” she said.
Her team has suggested child development and mental health check-ins become a regular feature across a person’s lifetime and have proposed a mental health “immunisation schedule”.
Proposed mental health immunisation schedule may include:
- Mental health screening during antenatal visits and referrals for help
- Home visits for vulnerable families during early childhood
- Embedded mental health programs in schools, sport and universities
- Intergenerational playgroups for the elderly
Chief executive of mental health charity Prevention United, Stephen Carbone, said they estimate that less than 1 per cent of mental health funding goes toward prevention.
“There’s been a big steady increase in per capita funding for mental health over the last 30 years but that hasn’t translated into reductions,” Dr Carbone, a GP, said.
“You’re not going to be able to prevent mental health conditions unless you start to tackle some of these big causes, in particular child maltreatment.”
He said most of Australia’s child protection system was about reacting to problems rather than trying to prevent them.
“If you’re not tackling the upstream risk factors or putting in place protective factors you just keep getting more and more young people experiencing problems and services being overwhelmed,” he said.
Now a mother of two teens herself, Ange says she wants to break the cycle and has been going to therapy regularly to help identify and avoid destructive patterns that she’s seen herself fall into.
“I love my girls so much and I want better for them.”
