Introduction
Mental health problems are highly prevalent among Australian youth aged 15–24 years (Shepherd, 2022). Recent reviews of the literature reveal high rates of mental health issues and suicidal behavior among this population, with many young people receiving no help or treatment despite high prevalence, serious consequences and strong evidence for effective interventions. The aim of this essay is to critically explore the current policy framework in Australia addressing the mental health needs of Australian youth.
Policy Definition
Mental health conditions are among the most common and disabling illnesses of childhood, adolescence and young adulthood, affecting an estimated 15%–17% of Australian young people (Carlisle et al., 2019). These illnesses occur at various stages during childhood or adolescence and include subthreshold (mild) forms of mental illness as well as severe manifestations that may interfere with daily life such as hallucinations, delusions, depression and self-harm (Carlisle et al., 2019). The early identification of mental health concerns in children and adolescents can lead to a timely response system ensuring timely access to high quality treatment regimes. The term youth encompass young adults aged 15–24 years. Mental health conditions are those affecting the mind and cognitive state, such as anxiety disorders, depression, eating disorders and substance abuse (Carlisle et al., 2019). They can affect all aspects of a person’s life and may result in significant distress or disability for patients and caregivers alike.
Details About Policy Selection
The following was done to help choose the issue and make it more applicable: An online search of literature was conducted to find a health policy that addressed an issue of importance to young people. Various methods were used including Google, PubMed, and ProQuest. Searching for the health policy was easy, I just looked up the keyword that I needed – mental health, children and youth, Australian, and policy. The challenge that I faced was finding a good health policy to read about mental health. The results were overwhelming, so I narrowed my search by adding the word “policies” to my search query. Eventually I found the draft on mental health strategy for children and young people 2013-2017 which was developed by Australia’s National Health and Medical Research Council (NHMRC).
Key Policy Elements
The strategy is focused on supporting young people and families as well as building their resilience to cope with the challenges of life. The Ministerial Forward reflects the Australian Government’s commitment to supporting youth mental health and highlights the challenges young people face today including navigating a digital world and a changing education system, leaving school at an early age, financial pressures and unemployment (Shepherd, 2022). The vision statement that forms part of the strategy outlines approaches to reaching the goals and objectives, noting that these will be addressed through enhanced collaboration between all partners with significant commitments over 1-2 years being made to address priorities (Rickwood et al., 2016).
This policy is to promote mental health and prevent mental illness in Australia by encouraging community responsibility for positive mental health, identifying the needs of people with a mental illness and facilitating access to appropriate services (Carlisle et al., 2019). The Policy frames the importance of social inclusion as well as personal autonomy, and acknowledges that different people experience mental ill-health differently. The vision statement of this policy is “Every Australian enjoying a high quality of life as a result of long-term good physical, emotional and social health” (Shepherd, 2022). The goals are to ensure citizens have access to effective mental health programs that meet their individual needs and prevent further problems arising. It will achieve this by addressing inequalities in health outcomes, reducing stigma associated with accessing services, improving access to timely care and services through better coordination across sectors, promoting creative methods to enhance treatment skills (such as consultation with other professionals) while working together to develop a comprehensive approach across all levels of government bodies with specific obligations in connection with the provision of services (including primary care).
The Australian Government has chosen to focus on a ‘three streams’ approach to improving mental health and reducing suicide. This includes the policy stream, where new strategies are developed and implemented to change the way that policy is developed, supported and implemented (Rice et al., 2018). The second stream is the political stream which focuses on changing the beliefs and attitudes of politicians, civil servants and the general public. Finally the third stream includes the resources offered by professional associations, advocacy groups and other interested parties that support policy makers in bringing about change (Shepherd, 2022; Carlisle et al., 2019).
The National Youth Mental Health Policy creates a new public mental health strategy for youth, as well as improving the quality of mental health services. The Government’s vision is that “all Australians aged 15 to 24 will have access to quality mental health care and support when they need it” (Shepherd, 2022). The policy aims to improve workforce development and training by providing an adequate number of trained professionals, supporting their working conditions, improving recruitment practices and providing policies to support early career workers, among other strategies (Rickwood et al., 2016). It also aims to improve the physical environments and accessibility of relevant health services so that young people from all backgrounds get equal access. Other objectives include ensuring culturally appropriate services are available for Aboriginal and Torres Strait Islander people and supporting early intervention measures (such as the Headspace centres) (Rice et al., 2018).
The National Mental Health Policy Framework was developed by the Australian Government Department of health and Aged Care to improve mental health outcomes for Australians in the short, medium, and long term (Shepherd, 2022). The main strategy is to develop a comprehensive approach across all levels of government bodies with specific obligations in connection with the provision of services. In order to achieve this, collaboration between state/territory and local governments, as well as private sector representatives who have key roles in improving mental health services are crucial (such as doctors, nurses and social workers) (Carlisle et al., 2019).
The policy aims to improve capabilities at a local level by incorporating best practice examples into everyday mental healthcare practices. It also encourages the development of new and creative mental health experiences to give people a positive emotional experience (Carlisle et al., 2019). This includes developing services that can provide emotional support, develop emotional intelligence and emotional literacy. The policy aims to achieve successful outcomes through fostering the integration of services across different sectors and working with the community, referring to common good governance principles that all partners should work in a coordinated way (Rickwood et al., 2016: Carlisle et al., 2019). The National Mental Health Strategic Plan aims to develop long-term strategies by including local action plans. These strategies are developed by creating strategic plans which form part of the national mental health system. The health improvement strategies are developed so that they are evidence based, collaborative and practical.
Evidence-Based Recommendations
The Australian Government has made significant strides in advocating for the mental health of youth. However, there are still several areas that require further development. The first area is the lack of evidence-based recommendations that highlight policy silences or inconsistencies. This can be seen in the ministerial forward and vision statement, which both mention suicide but do not specify how they plan to address it. There are some strategies outlined in the policy that deal with suicide prevention, but they are not always consistent with the ministerial forward and vision statement. For example, one strategy states that school staff should be trained on how to identify warning signs and refer students to help, while another strategy states that schools should prioritize student mental health through curriculum shifts and training programs. These strategies appear to contradict each other; it is unclear how a school would prioritize student mental health while simultaneously prioritizing student academic achievement (which would presumably necessitate academic pressure).
Secondly, one of the most notable areas for improvement is its lack of attention to the needs of rural and remote youth. The plan only mentions rural and remote communities in passing, implying that these communities are not important or deserving of specific attention in their own right. This is a significant oversight, given that youth in these areas have higher rates of suicide than their urban counterparts (Australian Government Department of Health and Ageing).
Another area for improvement is the plan’s failure to address issues around sexuality and gender identity directly. While it acknowledges that LGBTQIA+ young people may experience more mental health issues than other young people, there are no specific strategies outlined to address this disparity. In fact, the word “transgender” appears only once in the entire document—which seems like an oversight given Australia’s record on trans rights (Equality Australia). Finally, the plan states that it will work with state governments to develop a national register for mental health services; however, there is no mention of how this register is going to be developed, what information it is going to hold, or if the register will be available to the public. There are several countries that already have national registers of mental health services, so there may be a potential role for international collaboration on this front. The National Youth Mental Health Plan has introduced many strategies that will work to improve mental health outcomes for Australian youth. There are also several areas of improvement for future iterations of the plan. It should also be noted that not all Australians aged 15-24 experience mental illness; however, due to the stigma surrounding mental illness, many young people do not seek help even when they need it (Australian Government Department of Health and Ageing). The most effective way to reduce the impact of mental illness on young people is to create a culture that does not stigmatize mental illness. Many of the strategies outlined in this plan are aimed at educating people about mental health and reducing the stigma surrounding it.
The first strategy outlined in the plan is to reduce stigma through information and education. The National Youth Mental Health Plan has also partnered with several organizations, such as The Black Dog Institute and Headspace to educate teachers, parents, families and youth about mental health through workshops, discussions, social media campaigns and schools presentations. There is also a website (www.youthmentalhealthplan.gov.au) where people can find fact sheets, resources and information on all aspects of youth mental health. The website also has a toolkit for parents and educators to intervene when mental illness is suspected (Australian Government Department of Health and Ageing). The second strategy outlined in the plan is to provide effective support for Indigenous youth. The National Youth Mental Health Plan outlines several strategies that will work to increase the availability of evidence-based programs for Indigenous youth, including developing a national Indigenous youth mental health pipeline program, developing a national Indigenous advisory group and working with community health services on their access to mental health care. The plan outlines several ways to provide effective support through these programs (Australian Government Department of Health and Ageing). The third strategy outlined in the plan is to promote education of preventative mental health and well being. The National Youth Mental Health Plan has partnered with several organizations, such as Beyond Blue and Mindframe (Australian Government Department of Health and Ageing) (Carlisle et al., 2019). These groups have created workshops on mental health, followed by fact sheets that explain the importance of healthy lifestyles, social engagement and sleep. This includes information on how to cope with stress, anxiety and depression.
Conclusion
The National Youth Mental Health Plan has many strategies that will work to support Australian youth with their mental health. However, there are some areas of improvement in future iterations of the plan, including: Development of a national register for mental health services (which is currently under development by the state governments), address issues around sexual or gender identity, and rural and remote communities, and improve strategies for Indigenous young people. By creating strategies for improving mental health outcomes for young people, the National Youth Mental Health Plan is taking an important step toward reducing stigma surrounding mental illness as well as supporting young people at a time when they are most vulnerable. This plan also emphasizes the importance of education in preventing depression and suicide. By educating the public about mental health, there will be less of a stigma surrounding mental illness. The plan has also partnered with organizations like The Black Dog Institute to educate teachers, parents and families about mental health issues among young people so they can more effectively help their children. This is a positive step because it emphasizes the importance of support networks in preventing young people from feeling like they are alone in their struggle with mental illness. Finally, the National Youth Mental Health Plan has worked with Aboriginal and Torres Strait Islander communities to create free workshops designed to address common issues in these communities as well as develop long-term strategies for helping these groups (Australian Government Department of Health and Ageing).
References
Carlisle, E., Fildes, J., Hall, S., Hicking, V., Perrens, B., & Plummer, J. (2019). Mission Australia’s Youth Survey Report 2018. http://hdl.voced.edu.au/10707/526166
Carlisle, E., Fildes, J., Hall, S., Perrens, B., Perdriau, A., & Plummer, J. (2019). Youth survey report 2019.
Rice, S. M., Purcell, R., & McGorry, P. D. (2018). Adolescent and young adult male mental health: transforming system failures into proactive models of engagement. Journal of Adolescent Health, 62(3), S9-S17. https://doi.org/10.1016/j.jadohealth.2017.07.024
Rickwood, D., Webb, M., Kennedy, V., & Telford, N. (2016). Who are the young people choosing web-based mental health support? Findings from the implementation of Australia’s national web-based youth mental health service, eheadspace. JMIR mental health, 3(3), e5988. http://www.mendeley.com/import/?doi=10.2196/mental.5988
Shepherd, T. (2022, March 21). Mental health issues more common among young Australians, national survey suggests. the Guardian. https://www.theguardian.com/society/2022/mar/21/mental-health-issues-more-common-among-young-australians-national-survey-suggests#:~:text=Almost%2019%25%20of%20people%20aged,Health%20Survey%20released%20on%20Monday.
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