The kids are not all right: Australia’s mental health system is struggling and so are our young | Omar Khorshid

Although we've all been affected, there are warning signs that a mental health crisis is brewing among young people.
According to the Australian Institute of Health and Welfare, 20% of Australians experience mental illness in any given year.

However, the past 18 months have not been a given year. We don't need any new stats to see that it is far worse under Covid.

Our young people are the ones who are most in trouble, facing challenges that are unimaginable for their parents.

Their world has become a restricted and unpredictable place due to a global public-health emergency

Before the pandemic, almost three quarters of Australians suffering from mental illness were below 25 years old. Our 16- to 24-year-olds had a higher rate of mental illness than their family members and friends. Covid has made the problem worse.

Children and young people are being locked down at an important time in their development. They suffer a loss of freedom and extended social isolation. There is also a lack of connection with peers via remote learning. Screen use has increased and there is a denial to celebrate milestones like the end of year 12. Their world is becoming a restricted and unpredictable place due to a global public emergency.

It's not surprising that anxiety and fear reign; it's understandable. This generation will inherit the post Covid world that we have created, which is also affected by climate change and an increase in Australia's public debt.

We owe it our descendants to take care of their mental health.

To combat the rising demand from all Australians, we must repair and prepare the mental health system. This is especially important for young people who will have to deal with the effects of the pandemic more than anyone else.

Our mental health services struggled to meet demand even before Covid-19 was introduced. However, its arrival has shed light on the inequalities in our system. The fastest-growing hospital admission category is mental health. People who are admitted to mental health facilities can stay for up to two times as long as people with heart diseases. This is a sign that there are not many options for care.

Not only are these inequalities and inadequacies being addressed (repair), but also to support prevention and early intervention (prepare) is a serious investment imperative.

The recent funding announcement by the federal government for 10 mental health clinics in pop-up locations in Covid-affected regions in and around Greater Sydney was a recognition that we are now in crisis.

Although it is a welcomed response to an emergency, emergency announcements can cause more chaos in the system. Resources are diverted to manage them, which often means that carefully planned programs and plans are lost. Although this was an emergency response, it is important to make it the beginning of a repair and prepare plan. This will include a long-term financial commitment for a system reform.

The budget for 2020-21 provided a significant investment of $2.3bn in mental health and suicide prevention. While the funds are welcomed, the AMA feels that the money is not being used in the right places. We would like to see investments that address the fragmentation of mental health care.

This budget also included substantial investment in new digital mental health assessment platforms and referral platforms. The AMA is concerned that this shift to digital self-assessment/referral ignores evidence-based clinical mental health care.

While a digital platform cannot replace the face-to-face attention of a physician, it can help to identify those who are more tech-savvy than others.

The AMA believes that funds should be used to support existing mental health services and community support services like drug and alcohol support services and domestic violence support services. These services will see an increase in demand due to the pandemic, but they also support mental health.

Also, we must urgently invest in mental health clinicians.

Although psychiatrists are in limited supply in rural areas and in public hospitals, the demand for their services will not end after the pandemic. It is also becoming harder to find appointments with psychologists.

Australia is also experiencing a shortage of child and adolescent psychiatrists. We need to increase this workforce of mental health professionals, but it takes time.

It is unacceptable that $11 million has been allocated for 30 new psychiatry training positions by 2023. This means that these places will take two years to create and then it will take up to nine years to train. This is a significant generational delay in delivering the services we need now. To meet the demand for training, funding must be committed long-termly to increase the number of places in training by 3.3% per year. This would result in 269 new places by 2025.

The AMA frequently reiterates the importance of having GPs as the core of the health system. The same is true for mental health. This is because we know what works and we call to fund it. Integrative mental healthcare can be delivered by GP clinics, which have the potential and ability to coordinate with psychiatrists, psychologists, mental health nurses; counsellors; gambling support staff; and other services if they have the right resources.

The presence of GPs in the centre of Australia's mental health response helps patients get the care they need faster and more efficiently. It also relieves pressure from other parts of the health system. It can also prevent young people from becoming more severe and needing hospitalization or specialist mental care.

Federal government has the opportunity to reform the wider mental health system. This reform will place GPs at the forefront of that reform, while also improving access to psychiatrists and psychologists.

We are facing a mental health crisis among young people. It is best to repair and prepare. For the benefits to flow down to our future, it must be done now. It is necessary for our own sakes, but also for our children's. We need to help them build resilience, strengthen their mental health, and ensure that they, and future generations, thrive in a world shaped irrevocably by this latest pandemic.


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