Youth mental health rebounds, but don’t declare victory yet

Australian doctors are used to hearing that youth mental health is continually getting worse, despite ever increasing provision of face-to-face and digital services. The last national diagnostic survey in 2020-22 found that 38.8% of Australians aged 16 to 24 had a 12-month mental disorder during and just after COVID-19. Other Australian studies also show rising psychological distress and a generational decline in mental health among younger cohorts. Clinically, none of this would have surprised GPs, paediatricians, psychiatrists, psychologists or emergency clinicians who have watched demand rise over the past decade. That was true, but things may be changing.

In our paper, published in in the Australian and New Zealand Journal of Psychiatry, we used 24 waves of the Household, Income and Labour Dynamics in Australia (HILDA) Survey, from 2001 to 2024, to describe long-run trends in mental health by age group. Similar to most large community-based studies, we used a self-reported measure of psychological wellbeing, the 36-Item Short Form Health Survey (SF-36) mental health scale. This is not a clinical diagnosis, but it captures trends in large populations.

The COVID-19 impact

The mid COVID-19 year of 2021 represented a low point for all but the oldest Australians, but the impact was more age specific, with steep declines from 2019 to 2021 in those under 35, especially in those under 25. There have been three years of improving youth mental health since, such that by 2024, although not back to pre-pandemic levels, the nadir around COVID-19 had dissipated, leaving the long-term trend only.

Older age groups moved less, and the mental health of people aged 65 and over remained comparatively stable with no observable effect around the pandemic. The story is therefore not simply that “all Australians suffered” during COVID-19 and then improved. Some groups didn’t suffer as much, and the largest changes were concentrated among adolescents and young adults.

A challenging post-pandemic world

These “green shoots of recovery” in youth mental health have been seen elsewhere (eg in the Mission Australia national survey of high school students, and in large US cohorts: the Youth Risk Behavior Surveillance System, and the National Survey on Drug Use and Health) but have gone under the radar of the public discourse. This is despite the purported impact of mega-trends post-pandemic: our climate continues to deteriorate, global conflict has spread, AI is radically changing employment prospects, and we are into the third year of a “cost of living crisis”.

Given the current policy focus on cost of living and intergenerational inequity, we examined whether the post-2021 rebound in youth mental health was confined to more advantaged areas. It was not. As expected, young people in more socio-economically advantaged areas, as defined by the Socio-Economic Indexes for Areas (SEIFA), tended to report slightly higher mental health levels overall, but they have always done so, and the rate of improvement did not differ by SEIFA. Within the limits of area-level measures, the improvement looked broad-based rather than restricted to better-off communities.

Moving beyond crisis narratives toward long term policy

Still, three implications seem clear.

First, the youth mental health crisis is not over. A rebound from a very low point is not the same as full recovery. Under-25s mental health in 2024 was still below 2019 levels, and in adolescents appeared to be recovering more slowly than that of young adults.

Second, as frequently observed, the decline predates COVID-19. That matters because “returning to normal” is the wrong benchmark if the pre-pandemic trajectory was already negative. The pandemic may have intensified the problem, but it did not create it from nothing. Future work needs to separate what drove the longer mid-2010s deterioration from what drove the 2019-2021 trough and the subsequent rebound.

Third, the most useful reading is not “still bad and worsening” but “still bad, but improving”. This suggests that primary, secondary and tertiary prevention systems may be working to enhance post-pandemic youth mental health in the face of what seems to be a more difficult world. We need to determine which of these are more effective, as evidence suggests some approaches with broad public support may not be as effective as proposed when scaled in Australia, eg, school-based universal screening and primary prevention funded by the Federal Government through its Student Wellbeing Boost. This is a complex area, and the evidence behooves us to work out how best to support these green shoots.

These findings should also be examined more closely across developmental stages, since adolescence, emerging adulthood and young adulthood may show different recovery patterns. Future work building on this emerging evidence base can help clinicians and policymakers move beyond broad crisis narratives toward a more precise understanding of who is recovering and where support is most effectively targeted.

Epidemiologists and people working in public health seem only to report that things are getting worse, but for once, after years of bleak youth mental health headlines, the data now contain some good news. This is not a victory lap. It is a sign not to waste the first clear sign of recovery, and to identify and keep supporting the services and programs that have enabled it.

Dr Sergey Alexeev is a Senior Research Associate at Nura Gili: Centre for Indigenous Programs, UNSW Sydney, and an Adjunct Senior Lecturer at the University of Sydney. He uses large-scale Australian datasets to evaluate population health trends and policy.

Dr Eyal Karin is a statistician and epidemiologist at Central Clinical School, Faculty of Medicine and Health, University of Sydney, and is affiliated with the ARC Centre of Excellence for Children and Families over the Life Course. His research focuses on mental health measurement and clinical evidence using large-scale Australian datasets including the Mission Australia Youth Survey.

Professor Nick Glozier is Professor of Psychological Medicine at Central Clinical School, Faculty of Medicine and Health, University of Sydney, and a Chief Investigator at the ARC Centre of Excellence for Children and Families over the Life Course.

No competing interests declared. The underlying research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.