Inequalities in Access to Mental Health Treatment by Australian Youths During the COVID-19 Pandemic

Psychiatr Serv. 2023 Jun 1;74(6):581-588. doi: 10.1176/appi.ps.20220345. Epub 2022 Nov 29.

Abstract

Objective: The authors aimed to evaluate changes in use of government-subsidized primary mental health services, through the Medicare Benefits Schedule (MBS), by young people during the first year of the COVID-19 pandemic in Australia and whether changes were associated with age, sex, socioeconomic status, and residence in particular geographical areas.

Methods: Interrupted time-series analyses were conducted by using quarterly mental health MBS service data (all young people ages 12-25 years, 2015-2020) for individual Statistical Area Level 3 areas across Australia. The data captured >22.4 million service records. Meta-analysis and meta-regression models estimated the pandemic interruption effect at the national level and delineated factors influencing these estimates.

Results: Compared with expected prepandemic trends, a 6.2% (95% CI=5.3%-7.2%) increase was noted for all young people in use of MBS mental health services in 2020. Substantial differences were found between age and sex subgroups, with a higher increase among females and young people ages 18-25. A decreasing trend was observed for males ages 18-25 (3.5% reduction, 95% CI=2.5%-4.5%). The interruption effect was strongly associated with socioeconomic status. Service uptake increased in areas of high socioeconomic status, with smaller or limited uptake in areas of low socioeconomic status.

Conclusions: During 2020, young people's use of primary mental health services increased overall. However, increases were inequitably distributed and relatively low, compared with increases in population-level mental health burden. Policy makers should address barriers to primary care access for young people, particularly for young males and those from socioeconomically disadvantaged backgrounds.

Keywords: COVID-19; Community mental health services; Help-seeking; Mental health; Primary care; Self-help.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Australia / epidemiology
  • COVID-19* / epidemiology
  • Female
  • Health Services Accessibility*
  • Healthcare Disparities*
  • Humans
  • Male
  • Mental Disorders* / epidemiology
  • Mental Disorders* / therapy
  • Mental Health
  • National Health Programs
  • Pandemics
  • Young Adult

Supplementary concepts

  • Australians