Australia's welfare 2021, Chapter 8: Mental health of young Australians (AIHW)

Mental health of young Australians 8 Australia's health 2022 data insights 263

264 Australia's health 2022 data insights Mental health of young Australians Key messages More young Australians are experiencing higher levels of psychological distress than people in older age groups. This pre-dates the COVID-19 pandemic. More young females experience higher levels of psychological distress than young males. Young Australians tend to make use of mental health services at a higher rate than people in older age groups, although many do not, cannot or choose not to access support. The importance of young peoples' mental health is universally recognised. Youth is a key transition period in a person's life, and also the period when mental illness is most likely to emerge (Kessler et al. 2005). A 2020 survey of Australians aged 15–19 found that around two-thirds of respondents consider mental health to be very or extremely important (Brennan et al. 2021). This article presents mental health-related statistics and information on Australians aged 12–24 years. It focuses on available national data sources and selected research findings and considers aspects such as the prevalence of mental illness, changes in mental health over time, the use of mental health services, and spending on these services. The impact of the COVID-19 pandemic on the mental health of young Australians is also considered. Box 8.1: Who are Australia's young people? Young people are often defined as people aged 12–24. According to the Australian Bureau of Statistics (ABS), more than 4.1 million Australians, or 16% of the total population, were aged 12–24 as at June 2020 (ABS 2021). However, definitions of who constitutes young people vary between data sources according to different frameworks, policies and legislation, which can make comparisons difficult. Where a source in this article uses a different age range, this is noted. As of 2020, more than half of the people aged 15–19 in Australia are happy (59%) and feel positive about the future (56%) (AIHW 2021a). However, many young people do experience psychological distress and mental illness.

265Australia's health 2022 data insights Box 8.2: Mental health and mental illness 'Mental health is a state of well-being in which an individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and can contribute to their community' (WHO 2018). Mental ill health can affect the potential of young people to live fulfilling and productive lives. Mental illnesses (also referred to as mental disorders) are diagnosable health conditions. They are conditions that affect how a person feels, thinks, behaves and interacts with others. Someone may experience poor mental health or symptoms of mental illness without meeting the diagnostic criteria for a mental illness. In recent years, the number of young people, especially young females, experiencing psychological distress (see Box 8.4) has been increasing at a greater rate than for other age groups. This has coincided with rising mental health-related hospital admissions and community health care engagement. Although this trend pre-dates the COVID-19 pandemic, concern about the impacts of the pandemic on young people has generated greater interest in the challenges facing young Australians, and what may be done to assist. Box 8.3: The state of mental health data Although a new nationwide mental health prevalence survey was conducted in 2021 – with results expected to be released mid-2022 – major data sources currently available are several years old. The most comprehensive source of data on the prevalence of mental illness in Australia is the 2007 National Survey of Mental Health and Wellbeing (NSMHWB). This survey asked participants about their history of mental illness and included symptom measures that could be used to suggest a diagnosis (ABS 2008). The Child and Adolescent Survey of Mental Health and Wellbeing (also known as Young Minds Matter), specifically aimed at Australians aged 4–17, was last conducted in 2013–14 (Goodsell et al. 2017). The Household, Income and Labour Dynamics in Australia Survey (HILDA) has followed the wellbeing of around 17,000 Australians each year since 2001. However, many longitudinal surveys, including HILDA, have recorded declining participation rates over time, particularly among the young and among people experiencing poor health (Butterworth et al. 2020). Thus, many of these surveys may underestimate the extent and prevalence of mental illness among young Australians.

266 Australia's health 2022 data insights Box 8.3 (continued): The state of mental health data Very few surveys report data on Aboriginal and Torres Strait Islander people; culturally and linguistically diverse groups; young Australians with disability; or lesbian, gay, bisexual, transgender, intersex, queer, asexual and other sexually or gender diverse (LGBTIQA+) young Australians. This is often due to concerns about the small number of participants. A notable exception is the Writing Themselves in 4 Survey of LGBTIQA+ young people (Hill et al. 2021). Although substantial gaps remain, the mental health data landscape has been improving its scope, scale and quality since the first National Mental Health Plan in 1993. In addition to the 2021 NSMHWB, the 2021 Census of Population and Housing (Census) included a question on whether a long-term health condition, including a 'mental health condition', had ever being diagnosed by a health practitioner (ABS 2020). This is the first time this question has been included in an Australian Census. Data from the 2021 Census are expected to be available from June 2022. How many young Australians are affected by mental illness? The 2007 NSMHWB found that more than one-quarter (26%) of Australians aged 16–24 (males 23%, females 30%) had experienced any mental illness in the previous 12 months, with anxiety disorders being the most common overall (males – substance use disorders, females – anxiety disorders), compared with 1 in 6 (16%) Australians aged 25–85 (males – 14%, females – 18.3%) (ABS 2008). If this rate for Australians aged 16–24 was applied to the population in 2020, it would suggest that more than one million young Australians (males 486,000, females 607,000) experienced mental illness in the previous 12 months. Based on the Young Minds Matter Survey, in 2013–14, 1 in 7 (14%) young people aged 12–17 met the clinical criteria for a mental illness in the previous 12 months (males 16%, females 13%). The most common disorder overall, and in males, was Attention Deficit Hyperactivity Disorder (ADHD), while anxiety disorders were the most common disorder in females (Lawrence et al. 2015). It should be noted that the NSMHWB did not report on ADHD or on Conduct Disorder, the third most common disorder in the Young Minds Matter Survey. According to the ABS 2017–18 National Health Survey, more than one-quarter (26%) of Australians aged 15–24 (males 21%, females 30%) were experiencing a mental or behavioural condition at that time (ABS 2018).

267Australia's health 2022 data insights Box 8.4: Psychological distress Psychological distress is an individual's overall level of psychological strain or pain. Someone experiencing psychological distress will not necessarily be experiencing mental illness, although high scores on the Kessler 10 Psychological Distress Scale (K10) are strongly correlated with the presence of depressive or anxiety disorders (Andrews and Slade 2001). As psychological distress is relatively straightforward to measure, high and very high levels are often used as a 'proxy' for menta