youth mental health

The COVID-19 pandemic didn’t just challenge our physical health, it unleashed a mental health crisis¹⁰ that became a silent “second wave.” Amid lockdowns and uncertainty, it became clear that mental health must no longer sit in the shadows.

And for Australia’s young people, the need for action¹¹ has never been more urgent.

Pressing Issue

Mental health is one of the most pressing issues facing young Australians today. With two-thirds of mental health conditions emerging by age 25, early intervention and accessible care are critical to ensuring positive outcomes for young people.

However, financial barriers continue to prevent many children and young Australians from accessing the support they need. Mental Health Australia (MHA) has called for a national commitment to free mental health care for everyone under 25, urging all political parties to include this as part of their federal election platforms.

Free mental healthcare?

Let’s explore the rationale behind the idea of free mental health care for children and young people in Australia, the challenges in implementation, and potential solutions that could be considered.

The current landscape

Young Australians face increasing mental health challenges, exacerbated by economic pressures, social media, climate anxiety, and the lingering effects of the COVID-19 pandemic. Between 2007 and 2022, mental health conditions among young people increased by 50%, with two in five young Australians experiencing a mental health condition in any given year. Furthermore, recent data suggests that 22% of five year-olds show vulnerability to mental health issues in their first year of school. Despite the increasing need, access to mental health services remains inequitable and costly.

Young Australians face increasing mental health challenges, exacerbated by economic pressures, social media, climate anxiety, and the lingering effects of the COVID-19 pandemic. Between 2007 and 2022, mental health conditions among young people increased by 50%, with two in five young Australians experiencing a mental health condition in any given year. Furthermore, recent data suggests that 22% of five year-olds show vulnerability to mental health issues in their first year of school. Despite the increasing need, access to mental health services remains inequitable and costly.

Barriers to accessing mental health care

Despite the growing demand for mental health services, many young Australians continue to face significant barriers^[9] in accessing the support they need. The following factors illustrate the key challenges impeding access to mental health services:

Financial costs

Financial barriers significantly hinder access to mental health care for many Australian families, especially amid the current cost-of-living crisis. A 2023 survey by Beyond Blue revealed that 37% of respondents felt cost-of-living pressures had negatively impacted their mental health over the previous 12 months. ​

A two-tiered system

The Australian Institute of Health and Welfare (AIHW) reports that over $1.5 billion was spent on mental health-related Medicare services and $691 million on Pharmaceutical Benefits Scheme (PBS) mental health-related prescriptions in 2023–24. Despite this significant expenditure, affordability remains a persistent barrier, particularly for those without financial safety nets. ​

High cost of services

The high cost of private psychological services, ranging from $150 to $300 per session, creates a major financial burden, particularly for those who exceed the Medicare-subsidised sessions limit, effectively pricing out many individuals from consistent, high-quality mental health care. ​

Many bulk-billing clinics have also reduced availability due to rising operational costs, limiting affordable options and forcing individuals to either pay prohibitively high fees or forego treatment altogether. Additionally, private health insurance coverage for mental health services remains inconsistent, with gaps in coverage leading to further out-of-pocket expenses and creating uncertainty for those seeking comprehensive care.​

Service availability

Access to mental health services in Australia is significantly hindered by extended waiting periods, particularly affecting young people. In metropolitan regions, approximately 73.5% of psychologists have waiting lists, with clients often waiting up to three months for an appointment.

In regional and rural areas, the situation is more severe; about 79.2% of psychologists maintain waiting lists, and face-to-face support can involve long waiting times due to a shortage of professionals. ​

Better Access

The Better Access initiative, designed to enhance accessibility to mental health care through Medicare-subsidised sessions, has seen substantial utilisation. However, demand continues to surpass supply, leading to extensive waitlists that delay diagnosis and intervention, potentially worsening mental health conditions. ​

Workforce shortages

Australia faces a critical shortage of mental health professionals, particularly in regional and rural areas, making it challenging for young Australians to access necessary care. The Australian Psychological Society (APS) highlights that only about 20% of psychologists practice in regional, rural, and remote areas, where approximately 30% of the population resides.

This disparity leads to prolonged wait times, reduced service availability, and increased reliance on under-resourced GPs for mental health support. The shortage extends beyond psychologists to include psychiatrists, social workers, and school counsellors, further straining the system. Many professionals are concentrated in major cities, drawn by better infrastructure, career opportunities, and financial incentives, leaving rural communities underserved.

Industry Burnout

Additionally, burnout and high attrition rates among mental health workers exacerbate the issue, with many professionals leaving the field due to overwhelming caseloads and inadequate systemic support. Addressing these shortages requires targeted recruitment programs, financial incentives for professionals to work in underserved areas, expanded training pathways for mental health workers, and investment in telehealth services to bridge the accessibility gap in remote locations. ​

The APS has highlighted that rural communities face severe workforce shortages, with only one psychologist available for every 5,000 people in some regions. This shortage leads to longer wait times, limited service availability, and increased travel burdens for families seeking care. ​

Attracting workers

To address these challenges, the National Mental Health Workforce Strategy 2022–2032 outlines goals to attract, train, and retain a skilled mental health workforce, emphasising the need for equitable distribution across Australia, particularly in regional, rural, and remote areas. ​

Fragmented system

GPs in Australia often serve as the initial point of contact for individuals with mental health concerns. However, they may face challenges due to limited specialised training and fragmented referral networks, hindering their ability to connect patients with appropriate support. The Royal Australian College of General Practitioners (RACGP) emphasises the need for enhanced mental health education and training for GPs to improve patient outcomes. ​

Schools and educational institutions play a vital role in early intervention but frequently lack sufficient mental health professionals, leading to inconsistent support for students in distress. Studies into mental health services across Australia, underscore the need for better integration and resources within educational settings.

Operating in silos

Community-based services and crisis support organisations often operate in silos with minimal communication between providers, delaying access to holistic, continuous care. The Australian Government’s response to the “Contributing Lives, Thriving Communities” review acknowledged the critical need for long-term reform to address the complexity, inefficiency, and fragmentation of the mental health system.

Specialist mental health services are in high demand, with long wait times for psychologists and psychiatrists further impeding access. This bottleneck exacerbates difficulties for young people transitioning between different levels of care, such as moving from school-based counselling to clinical treatment, due to administrative hurdles and a lack of integrated care models. ​

Working together

A clear pathway

Many young Australians find it challenging to navigate the system, often being referred between multiple services without clear direction. This fragmentation leads to delays in treatment and disengagement from care. Reports suggest that greater investment in case management and multidisciplinary care models could help address these gaps.

The case for free mental health care

Providing free mental health care for young Australians is not just a moral imperative, it can be classed as an investment in the country’s future. By ensuring universal access to essential mental health services, Australia can foster a healthier, more productive population while alleviating financial burdens on families. The following points highlight the broader benefits of implementing free mental health care:

The Case Against

While there is broad public support for increased mental health services, some public figures and policymakers have expressed concerns about implementing a fully subsidised model for youth mental health care. Arguments against the policy include:

• Budgetary Constraints: Critics argue that funding free mental health care for all under-25s would place a significant strain on public finances, potentially leading to higher taxes or cuts to other essential services.
• Risk of Overuse and System Overload: Some policymakers contend that making mental health services completely free may lead to unnecessary utilisation, increasing wait times and straining an already overstretched system.
• Encouraging Personal Responsibility: A few commentators suggest that individuals and families should take greater responsibility for their mental wellbeing and that government intervention should be limited to only those in the most critical need.
• Workforce Shortages: There are concerns that an increased demand for services without a corresponding increase in mental health professionals could worsen access issues rather than alleviate them.
• Alternative Funding Models: Some propose a means-tested system, where only those in financial distress receive full subsidies, while others contribute based on their income.

Additionally, While the majority of public figures and experts acknowledge the growing mental health challenges among young people, a few have expressed differing views. For instance, Nigel Farage, a British politician and commentator, has suggested that an increasing number of teenagers receiving disability benefits for mental health issues may indicate a cultural shift towards dependency rather than a genuine crisis. He emphasises the need to promote a culture of work among young people.

The cost of inaction

While concerns about cost and workforce strain are valid, they must be weighed against the cost of inaction. Failing to invest early means greater economic loss, increased youth disengagement, and pressure on emergency services.

It’s important to note that such perspectives are in the minority, and the prevailing consensus among health professionals and policymakers is that youth mental health issues are a significant and pressing concern. Yet these views are frequently aired, are consumed as fact by the public and can sway the mainstream parties’ policy think-tanks.

While concerns about cost and workforce strain are valid, they must be weighed against the cost of inaction. Failing to invest early means greater economic loss, increased youth disengagement, and pressure on emergency services.

Proposed policy solutions
To ensure comprehensive and equitable access to mental health services, the following policy solutions should be considered:

• Remove Out-of-Pocket Costs: Fully subsidise clinical and allied mental health services for under-25s to eliminate financial barriers.
• Expand Community-Based Mental Health Hubs: Increase the number of Kids’ Hubs nationwide to provide easily accessible, local support for families.
• Strengthen School-Based Mental Health Services: Embed more psychologists and mental health professionals in schools to provide early intervention and support.
• Expand Workforce Capacity: Introduce innovative workforce solutions such as:
  • Provisional psychologists working under supervision to reduce waiting times.
  • A “Recruit to Train” model to incentivise mental health professionals to work in underserved areas.
• Invest in Digital Mental Health Services: Improve telehealth and digital mental health resources to expand access, particularly for rural and remote communities.

Public and political support

Polling conducted for MHA indicates that 75% of Australians believe the government needs to do more on mental health, and 63% of voters would be more likely to support parties that prioritise increased access to mental health services. This highlights the strong public appetite for reform in this space.

So should it be free?

The question of whether mental health care for young Australians should be entirely free remains a significant policy debate. Advocates argue that removing financial barriers would lead to early intervention, better health outcomes, and reduced long-term costs for the healthcare system. By ensuring universal access, free mental health care could help mitigate social inequities, support educational attainment, and improve workforce participation for young Australians.

However, opponents of a fully subsidised system raise concerns about financial sustainability, resource allocation, and potential strain on existing services. They argue that a targeted approach, such as a means-tested system, may ensure that resources are directed to those who need them most without overwhelming an already stretched workforce.

A hybrid of two?

Another consideration is the potential for hybrid models, where core mental health services, such as counselling for early intervention and crisis support, are fully funded, while more specialised and elective services require some level of co-payment. Additionally, expanding bulk-billing incentives and investing in mental health infrastructure could help balance accessibility with financial feasibility.

Ultimately, the decision to implement free mental health care should be guided by evidence-based policy, public support, and long-term economic analysis.

Regardless of the approach, prioritising mental health as an essential component of Australia’s healthcare system remains crucial.

What next?

With the next federal election approaching, now is the time for policymakers to commit to bold action on youth mental health. A national framework providing free mental health care for children and young people would be a transformative investment in Australia’s future.

This issue is not just about health; it intersects with education, workforce development, and economic resilience. The federal government must seize this opportunity to ensure that no family has to choose between putting food on the table and accessing critical mental health care for their children.

This federal election will be a test of priorities. If we believe our youth deserve a fair start in life, then free mental health care must be more than a promise.

It must become policy.