A world-first review into youth mental health describes a lack of action as a “scandal” that is having big implications for the health, wellbeing and productivity of young people.
Professor Patrick McGorry,
Orygen’s Australia’s Centre of Excellence in Youth Mental Health
“We’re terrified of the climate, of the loneliness that we’re experiencing, the cost of living, conflict throughout the world.
Finlaey Hewlett
The issues
The Royal Commission into Victoria’s Mental Health System found that demand for youth mental health services has overtaken capacity, community-based services are under-supplied, the system has become imbalanced with an over-reliance on medication, getting help is difficult, access is not equitable, the system is driven by crisis, and emergency departments are used as entry points.
The recent National Study of Mental Health and Wellbeing showed the prevalence of operationally defined mental disorders in 16–24‐year‐olds rose by 50%, from 26% in 2007 to 39% in 2021. The rise in young women was greater than in young men, with rates of 48%. The HILDA survey of 17,000 households/people confirmed a long-term decline in the mental health of this age group.
While the 150 Headspace centres Australia-wide provide primary mental health care, the rising number of new cases is now overwhelming their capacity to provide timely access. The funding model is now no longer adequate to recruit and retain a workforce, given that other more lucrative options exist.
Young people with more severe, complex or persistent conditions need more expert, sustained and intensive care. Yet this next level of secondary care is largely absent, resulting in a large cohort of young people described as the “missing middle”.
Our plan
- Identify the trends that are increasing mental disorders such as suicide, cost of living, climate distress and social exclusion
- Intervene early to prevent more severe disabling illnesses, a more effective funding arrangement and a transition to a community mental health model such as that advocated by Orygen Youth Mental Health
- Provide specialised care for those with complex disorders (the ‘missing middle’) and expand the Early Psychosis Youth Services program to include regional areas (currently in 8 metro regions only)
- Scale up evidence-based solutions to youth mental illness
- Provide youth-specific crisis housing and arrangements for independent youth on low incomes
- Create clear pathways from crisis intervention to sustained community-based support
- Increase rates of JobSeeker, Youth Allowance, and Commonwealth Rent Assistance
- Fund more research into:
- Eating disorders
- Substance use
- Physical health and exercise
- Early psychosis
- Personality disorder
- Effects of social media
The evidence
Over 75% of mental health issues first occur before the age of 25, and suicide causes the largest loss of life of young people in Australia. 39% of young Australians have a diagnosable and treatable condition but 50% of them received no access to care.
According to the Australian Institute of Health and Welfare, the leading causes of mental health disorders for females were:
- Anxiety 17.1%
- Depression 12%
- Eating 7.3%
- Bipolar affective 6.1%
And for mental health disorders in males:
- Suicide and self-inflicted injuries 12.7%
- Anxiety 10.7%
- Depression 6.8%
- Autism spectrum 5%
Worldwide mental health issues account for 45 percent of the disease burden for 10 to 24-year-olds, but only 2 percent of health budgets globally are devoted to mental health care. Those figures are a little better in Australia but there is still a huge gap in spending on mental health compared to the scale of the crisis.
Suicide
August 1924 data released by the Coroners Court of Victoria shows that deaths among the 18-24 demographic have increased by 48% compared to the same time last year (from 44 to 65).
In 2022:
- 304 Australian young people (aged 18–24 years) took their own lives
- 77 deaths by suicide occurred among children and adolescents (aged 17 and below) with the majority occurring in those aged 15–17 (83.1%)
- deaths by suicide represented 30.9% of all deaths in young people aged 15–17 years and 32.4% of all deaths in those aged 18–24 years—up from 16.5% and 23.9% respectively of all deaths in these age groups in 2001
Cost of living
The Lancet Psychiatry Commission on youth mental health identified factors contributing to mental ill health such as cost of living, climate change, housing insecurity, and growing intergenerational inequality.
A report, led by Orygen researchers and drawing on responses from almost 20,000 people aged 15-19 to the 2023 Mission Australia Youth Survey, shows the proportion of young people who identify the economy and financial matters as one of the most important issues facing Australia, has almost tripled in two years from 11% to 31%.
Financial struggles can affect a young person’s chances of getting a good start in life and can often push them into poverty and homelessness, making it difficult for young people to fully engage in education or find employment and often leads to feelings of hopelessness.
Offending behaviours
Rates of criminal offending and onset of mental illness are highest among adolescents and young people and they are less likely to have accessed mental health services.
Climate distress
Young Australians reported that climate distress impacted their functioning, their hope for the future and their mental health. Six in ten young people are worried about climate change, according to 2023 Mission Australia Youth Survey.
Social exclusion
There are strong links between social exclusion and poor mental health outcomes such as loneliness and high psychological distress. Sixty percent of the 18,800 people aged 15-19 in the 2022 Mission Australia Youth Survey experienced social exclusion in the prior 12 months across the domains of relational difficulties, financial hardships, housing challenges and/or education and employment. These young people showed significantly poorer mental health scores than their peers who were not socially excluded.
Eating disorders
Eating disorders most often occur in young people and, while current treatments can be effective for some, around half are unresponsive to treatment. Anorexia nervosa is associated with the highest death rate of any mental illness with poor long-term recovery rates for a large proportion of individuals.
Bullying
Being bullied can affect a person’s performance at school, uni, TAFE or work, and can continue to affect them throughout adulthood. Experiencing bullying can also increase the risk that someone will develop depression and anxiety in the future, and it can increase the risk of self-harm, suicidal thinking and suicide.
Social media
Research by Headspace shows that social media is something young people feel is putting more and more pressure on them. Spending too long on social media is associated with higher levels of mental health problems, including anxiety, depression and psychological distress. Other impacts include cyberbullying, sleep problems and concerns about body image.
For advice on mental health: https://www.healthdirect.gov.au/mental-health-resources