Australia's Health Care System Must Change to Address 'Rising Tide' of Youth Mental Ill Health

In recent years, Australia has been witnessing a concerning surge in youth mental health conditions, and experts are now warning that the current health care system is ill-equipped to meet the growing demands. Psychiatrist Professor Patrick McGorry, along with Professor David Coghill and Professor Michael Berk, is calling for a reimagining of health care to address what they describe as a "rising tide" of mental ill health in young Australians.

In an article published in the Medical Journal of Australia, the trio argues that the mental health of many young Australians is deteriorating rapidly, and more needs to be done to provide comprehensive care and support for those affected. The authors specifically emphasize the need for intensive secondary care for young people with complex conditions.

While primary care is an essential component of the health care system, it is evident that it alone cannot meet the needs of young individuals with severe, complex, or persistent mental health conditions. The authors identify a significant gap in secondary care services, leaving many young people caught in what they term the "missing middle."

The statistics presented by the National Study of Mental Health and Well-being paint a troubling picture. The prevalence of mental disorders in 16- to 24-year-olds has surged by 50% from 26% in 2007 to 39% in 2021. Notably, the rise in young women facing mental health challenges is even more significant, with rates reaching 48%.

One crucial aspect emphasized by the authors is early intervention, as it can safeguard mental well-being and prevent potentially disabling illnesses such as psychosis from taking root. They propose four solutions to address the pressing issue:

1. Prevention and Understanding: The authors advocate for a deeper understanding of the trends in global society that contribute to mental health issues among the youth. Socio-economic factors, generational changes, adversity, inequality, and the impact of technological advancements are all factors that need to be considered in developing effective prevention strategies.

2. Early Intervention and Integrated Care: Primary youth mental health care should be at the forefront of early intervention efforts. However, this requires a reimagination of primary care and a new financial model to address the surge in demand and workforce shortages. Ensuring the availability of services at headspace centers and facilitating bulk-billing are vital steps in enhancing early intervention.

3. Expert Multidisciplinary Care: Young people with severe mental illnesses need access to expert multidisciplinary care teams. The establishment of specialized care tiers and back-up systems for primary care providers is necessary to cater to the needs of these individuals. Currently, such specialized care is only available in limited "oasis" zones.

4. Fair Distribution of Funding: The authors highlight the need for changes in how funding is distributed through the National Disability Insurance Scheme. Young people in the early stages of potentially disabling mental illnesses, including treatable neurodevelopmental disorders like attention deficit/hyperactivity disorder (ADHD), should be prioritized and included in the funding support.

Addressing the youth mental health crisis requires immediate action and a comprehensive overhaul of the health care system. It is imperative that policymakers, health care providers, and stakeholders come together to implement these proposed solutions. By prioritizing prevention, early intervention, expert care, and equitable funding, Australia can build a mental health system that truly caters to the needs of its young population, ensuring a healthier and more promising future for the nation.

Journal Information: Patrick D McGorry et al, Mental health of young Australians: dealing with a public health crisis, Medical Journal of Australia (2023). DOI: 10.5694/mja2.52047