The Wrong Way Round

Australia spends its mental health support where the burden is lowest

About one in five Australians has a mental disorder right now. That number gets a lot of airtime. What doesn’t is the follow-up question: which one in five, and are they actually getting help?

The ABS ran its most comprehensive mental health survey between 2020 and 2022. Break the numbers down by age and something uncomfortable comes into view. Young Australians aged 16 to 24 are not experiencing a milder version of the same problem as their parents and grandparents. They are dealing with a different crisis altogether. Yet the mental health system was not designed around it and still has not fully caught up.

The five charts below show where the crisis is concentrated, how severe it really is, and why so many young Australians keep falling through the gaps.

The national figure of 21.5% is cited so often it has become a kind of shorthand. But it describes almost nobody accurately. Australians aged 16 to 24 experience mental disorders at 38.8% — nearly four times the rate of those aged 65 to 74.

Among 16 to 24 year olds, only half report low distress. The other half sit somewhere from moderate to very high. The country’s oldest citizens are, by this measure, its most mentally well. Its youngest are carrying a load the system was not built for.

Here is where it gets uncomfortable. Disorder rates fall steeply with age. Medication rates among people who already have a disorder rise just as steeply. Plot both on the same chart and the two lines cross.

Some of this has a clinical explanation. Anxiety dominates the youth mental health profile, and the standard first-line treatment for anxiety is psychological therapy, not medication. So young people seeking help are more likely to see a psychologist than a GP. Older Australians do the opposite.

The problem is that psychologists are harder to get to. Waiting lists are longer, out-of-pocket costs are higher, and the Medicare Better Access scheme caps subsidised sessions at 10 per year.

The people carrying the heaviest load are also the hardest to reach. LGBTQ+ Australians have a 12-month disorder rate of 58.7%, nearly three times the national average. People who have ever been without a permanent home sit at 39.1%. Unemployed Australians at 36.1%. These are exactly the groups a functioning mental health system would be built around. They are the ones falling through the gaps.

None of this means the system has done nothing. The Better Access initiative expanded psychological therapy access after 2006. Headspace operates in more than 150 communities. Telehealth opened new access routes during COVID. But the structural mismatch between where the burden falls and where support flows has not been corrected, and the ABS data from 2020 to 2022 makes that difficult to ignore.

Australia has a mental health system. The data suggests it was not designed with these populations in mind.