Last week’s Monash University findings from the largest ever study into Australian mental health services paint a bleak picture for individuals living in rural and remote areas. This examination of 25 million mental health items, taken between 2007 and 2011 from Medicare data, highlights that those living in metropolitan areas have about three times better access to psychological services than those living in rural and remote locations. Unfortunate as this is, these findings should not at all be surprising given the high levels of mental illness in rural and remote areas. However, what is alarming is the significant number of young people experiencing mental illness within this demographic. Given that 75 per cent of mental illness occurs before a person turns the age 26, it places an already vulnerable population group at an increased risk. But unequal access isn’t the only challenge in youth mental health. The McClure report on welfare also shone a light on the proportion of people who receive disability support pensions, a significant 30 per cent of whom are diagnosed with psychiatric or psychological conditions, and again, who develop these illnesses young in life. Despite the overwhelming majority of young people wanting to complete education and work, life chances are often damaged due to a lack of early intervention and a mismatch in care delivery for them and their families. This pattern of young people as most at-risk extends to drug and alcohol abuse, suicides, and so many other mental ill-health scenarios. Costing the world about $16 trillion to address, mental illness profoundly impacts families and communities, but no doubt, bears a particular burden on the one in four young people who live with serious mental ill-health.
Despite the massive reforms in youth mental health over the past decade, enormous obstacles still stand. And in order to conquer these new and emerging challenges, the most important actors need to be front and centre of forming the solutions – young people. Termed by mental health professionals as youth participation, this concept is nothing other than young people having ownership over their mental health, and being empowered to shape mental healthcare in all respects. Youth participation is not only essential for an individual’s own healing process, but it can be an instrument of enormous change. We are beginning to see examples of this engagement in action – the Youth Reference Groups affiliated with headspace Centres around the country, and ReachOut, the online youth-led mental health network. But deeper investment in this area is urgently needed. For young people to make a meaningful difference on the mental health landscape, they need to work alongside researchers in shaping future priorities. Together with policy makers, they need to design the systems of care that will best match their needs. To the fullest extent possible, young people should be involved in every aspect of health services. Among both young people experiencing mental ill-health as well as mental health professionals, there can at times be a patronising tone in the way we are addressed. But the lived experiences of young people need to be part of the diagnosis, prevention, and cure of mental illness. Such an approach can also work to reduce the stigma experienced by so many young people that live with mental illness, and builds trust in health care services. Taking stock of the bigger picture – within local communities and across the nation, we are indeed in need of a revolution that is driven by young people to tackle these complex health challenges. Young people who are prepared to demand appropriate health services, equipped to influence others, excited to innovate with technology and other tools in therapy and committed to driving positive reform on mental health.
This article first appeared Sydney Morning Herald, 9 March 2015.