Half of Aboriginal children come to the attention of the Northern Territory's overwhelmed child protection system before the age of 10 in what amounts to a humanitarian crisis, a royal commission has heard.
The system is struggling to cope with a more than doubling in notifications and substantiated concerns in the decade since the federal government's controversial intervention in remote Aboriginal communities, the inquiry heard.
Half of Aboriginal children born in the NT have had at least one notification of a child protection concern by the age of 10 and one in four have had substantiated harm or risk of harm, clinical child psychologist and researcher Professor Sven Silburn said.
"In public health terms you'd consider that to be of epidemic proportions," Prof Silburn told the NT child protection royal commission in Darwin on Monday.
"And as a public health concern (given) what we know about the detrimental long-term effects on health, behaviour and learning, we'd see this as a public health if not a humanitarian crisis."
NT Children's Commissioner Colleen Gwynne said a more holistic approach was needed, based on a public health model.
"If we think about child abuse and neglect the same as we think about public health like cancer and the range of public health issues and apply the same rigour to child abuse and neglect, it's going to lead us to a different response," Ms Gwynne said.
Ms Gwynne said notifications to Territory Families have doubled over the last five years to 20,465 (involving 10,851 children) in 2015-16, almost half of which related to neglect.
The commission heard child protection notifications, substantiations and out-of-home placements have all more than doubled since 2007.
Prof Silburn said a widening gap between notifications and substantiations could indicate the number of children at risk of harm is increasing and/or that the investigative capacity of the child protection system is being overwhelmed by the increasing volume of notifications.
The gap had become more pronounced since 2012, which Prof Silburn said was probably due to limitations in the system's operational capacity and substantial public sector cuts.
Prof Silburn, of the Menzies School of Health Research, said the NT's rates of child protection involvement are much higher in the first few years of life than in other Australian jurisdictions.
Neglect and emotional abuse are the predominant forms of harm in pre-school years.
He said the fact that half of NT Aboriginal children have had notifications to child protection by age 10 showed why it should be an issue of national concern.
"I think it also highlights why the department is clearly struggling and that if this trend continues the current system is clearly not sustainable."
In 2014-15 there were 7365 Aboriginal children notified to the child protection system, 1439 with a substantiated concern and 1067 who had an out-of-home care placement.