Article Text

Download PDFPDF
Epidemiology of positive mental health in a national census of children at school entry
  1. Sharon Goldfeld1,2,3,
  2. Amanda Kvalsvig2,4,
  3. Emily Incledon5,
  4. Meredith O'Connor2,3
  1. 1Centre for Community Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia
  2. 2Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
  3. 3Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
  4. 4Department of Public Health, University of Otago, Wellington, New Zealand
  5. 5Department of Anaesthesia Pain Management, Royal Children's Hospital, Melbourne, Victoria, Australia
  1. Correspondence to Professor Sharon Goldfeld, Centre for Community Child Health, The Royal Children's Hospital Melbourne, 50 Flemington Road, Parkville, VIC 3052, Australia; Sharon.Goldfeld{at}


Background Until now, child mental health promotion efforts have focused primarily on reducing the prevalence and severity of problems; yet the absence of mental health problems does not necessarily imply the presence of healthy psychosocial functioning. We aimed to investigate the epidemiology of child mental health competence in a full national population of school entrants.

Methods The data source was the 2012 Australian Early Development Index, a national census of early childhood development completed for school entrants by teachers across Australia (n=275 800). The mental health competence outcome measure was derived from constructs that focused on children's social and emotional strengths. Children with mental health competence scores in the top quintile were compared with the standard population across individual and community characteristics.

Results Average age at assessment was 5 years 7 months. Higher odds of mental health competence were observed for children who lived in more advantaged areas (OR 1.62; 99% CI 1.49 to 1.75), had attended preschool (1.38; 1.25 to 1.51) and demonstrated effective oral communication skills in the classroom (19.01; 15.62 to 23.13). Indigenous children had lower odds compared with non-Indigenous children (0.59; 0.54 to 0.64). Children in disadvantaged areas who attended preschool did not ‘catch up’ with their more advantaged peers.

Conclusions Mental health competence is unequally distributed across the Australian child population at school entry and is strongly predicted by measures and correlates of disadvantage. Effective oral communication and attendance at preschool warrant further investigation as potentially modifiable factors that may support mental health competence in new school entrants.


Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors SG contributed substantially to the study conceptualisation and design, interpretation of the data, and manuscript drafts and revisions. AK performed the data analysis and contributed substantially to the study conceptualisation and design, interpretation of the data, and manuscript drafts and revisions. AK and MO had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. EI contributed substantially to the study conceptualisation and design, data analysis, interpretation of the data, and manuscript drafts and revisions. MO contributed substantially to preparation of the data set, as well as to the interpretation of the data and manuscript drafts and revisions. All authors approved the final manuscript as submitted. EI and AK's substantial contributions to the study were undertaken while at the Centre for Community Child Health.

  • Funding Australian National Medical Research Council, 1082922, State Government of Victoria, 10.13039/501100004752, Australian Government.

  • Competing interests None declared.

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

  • Data sharing statement Access to all unpublished data is subject to approval by the Department of Education and Training and the AEDC National Committee. Approval for access to unpublished data will be given for any legitimate research, analysis purpose or policy development. Applicants using AEDC data are bound by specific deeds of confidentiality to comply with all principles and procedures outlined in the AEDC Data Guidelines. AEDC Ethical Approval Guidelines are available to provide information around the need for ethics clearance to access AEDC data.