We tracked Australian teens’ mental health. The news isn’t good, and problems are worse for girls

We know young people in Australia and worldwide are experiencing growing mental health challenges.

The most recent national survey from the Australian Bureau of Statistics found that nearly two in five (38.8%) 16- to 24-year-olds have experienced symptoms of a mental disorder in the previous 12 months.

This was substantially higher than the last time the survey was run in 2007, when the figure was 26%.

We’ve recently published a new study looking at the rates of mental health problems among Australian high school students. We found that almost one in four high school students reported mental health problems by Year 10, and things were worse for girls and gender-diverse teens.

Tracking teens’ mental health

In our study, published in the Australian and New Zealand Journal of Public Health, we looked at mental health symptoms in more than 6500 Australian teens, and how these symptoms changed over time.

We surveyed high school students annually from 71 schools from Year 7 (age 12/13 years) to Year 10 (age 15/16 years). Our sample, while not nationally representative, includes a large cross-section of schools in New South Wales, Queensland and Western Australia.

We found that symptoms of mental health problems increased steadily over time.

• In Year 7, 17% of students we surveyed reported symptoms that met the criteria for probable depression, increasing to 28% by Year 10.
• 14% of students reported high psychological distress in Year 7, rising to 24% in Year 10.
• The proportion reporting moderate-to-severe anxiety grew from 16% in Year 7 to 24% by Year 10.

Which teens were hardest hit?

We looked at how mental health symptoms over time were linked to different social factors, such as gender, cultural background and family affluence. We also looked at school factors, such as how advantaged a student’s school is.

We found clear differences in mental health by gender, affluence and school advantage. Girls and gender-diverse teens had higher symptoms in Year 7 and a steeper rise in symptoms over the four years, when compared to their male peers.

By Year 10, compared to males, females had average symptom scores that were 88% higher for depression, 34% higher for anxiety, and 55% higher for psychological distress (in models that adjusted for other factors).

Again compared to males and in adjusted models, gender-diverse teens had symptom scores at Year 10 that were 121% higher for depression, 55% higher for anxiety, and 89% higher for psychological distress.

Teens from the least affluent families had 7% higher depressive symptoms than those from the most affluent families in adjusted models, while teens attending the least advantaged schools had 9% higher anxiety symptoms than teens attending the most advantaged schools.

We then examined how gender and affluence interacted to influence mental health. Girls in the lowest affluence group experienced heightened anxiety and depressive symptoms over and above the effects of affluence or gender alone.

This shows how multiple factors can stack up, creating greater risk of poor mental health for certain young people.

While we were able to explore a wide range of factors, a limitation of our study was that we could not examine all social factors that may impact mental health. For example, we couldn’t ascertain the potential differences experienced by Aboriginal and/or Torres Strait Islander teens or those living in remote and very remote areas.

How does this data compare to other studies?

Recent Australian data from similar-aged adolescents are scarce. However, the 2015 Young Minds Matter study found that 14.4% of 12- to 17-year-olds experienced a mental disorder in the prior 12 months.

The higher rates of mental health challenges observed in our study are likely consistent with suggesting “cohort effects” – where each generation has worse mental health than the one before it. Ongoing research is investigating the reasons behind these trends, with avenues of inquiry spanning everything from social media to climate change. But it appears that no single factor is to blame.

The coronavirus disease 2019 pandemic also played a role, with young people seeming to be hit particularly hard by mental health impacts of the pandemic.

Notably, the gender differences between girls and boys are supported by data from global studies, showing that this is not a uniquely Australian phenomenon.

What can we do about the gender divide in mental health?

With a mental health care system stretched beyond capacity, it’s crucial that we prevent and address mental health problems early. While this requires a multilayered approach, aiming to reduce these gender inequities in mental health is an important place to start.

While outside the scope of this study, a growing field of research is interrogating why there are gender differences in mental health. Factors identified include:

• experiences of gender-based violence;
• gender differences in lifestyle behaviours (for example, diet, physical activity and screen time);
• gendered norms that place pressure on girls to meet unrealistic gender standards;
• gender differences in family and social relationships; and
• biological differences related to hormones and menstruation.

These areas indicate avenues for potential solutions, but addressing these factors requires wraparound investment.

Promisingly, many of these factors are mentioned in the National Women’s Health Strategy. With women’s health a central platform for the Albanese government’s election campaign, hopefully we will see more investment in research and policy to address these issues.

Importantly, our study found that gender inequities in mental health were even more stark for gender-diverse teens, so focus should not solely be on girls and women.

GPs play a vital role

GPs play a vital role in preventing, screening for, and treating adolescent mental health concerns. The high prevalence of mental health challenges across our general population sample suggests the importance of symptom observation and screening among all adolescent patients. However, GPs in another Australian study highlighted the need for more training on identification, treatment and referral pathways for adolescent mental health disorders. For the prevention of mental health disorders — or even as part of treatment — GPs can promote healthy lifestyle behaviours, such as regular physical activity and good sleep, particularly among gender-diverse and female teens. They can also encourage social connection as a protective factor. Finally, there are systemic barriers that prevent adolescents from accessing a GP in the first place (cost, transportation, opening hours), or from feeling comfortable discussing sensitive matters. These barriers require structural change, meaningfully co-designed with young people.

This article is a modified version of an article originally published in The Conversation.

Scarlett Smout is a Postdoctoral Research Associate at The Matilda Centre, University of Sydney.

Dr Katrina Champion is a senior research fellow at The Matilda Centre for Research in Mental Health and Substance Use and School of Public Health at the University of Sydney.

The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated. 

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