Findings
Thematic analysis of focus group and interview discussions revealed complex perceptions of systemic challenges within healthcare, education, and social systems. Participants expressed their frustration and a sense of disconnection, feeling these systems often failed to address the nuances of their lived experiences. These challenges reflect deep-rooted structural and operational issues that undermine the accessibility, responsiveness, and inclusivity of services designed to support young Australians. This section explores the systemic barriers across these interconnected systems, with thematic categories presented below. Participant voices are used to illustrate underlying issues and emphasise the need for more integrated, empathetic, and youth-centred approaches.
Healthcare system
Youth participants described various barriers to accessing mental healthcare within the health system. These barriers not only delayed participants from receiving appropriate support but also contributed to feelings of helplessness and frustration in seeking care. Key issues included, fragmentation of care, prolonged wait times, high costs, and a lack of youth-specific expertise among providers resulted in weak therapeutic relationship between patients and providers, and ineffective and inefficient referral pathways.
Fragmentation and lack of integrated care
Participants highlighted a systemic lack of integration in the current mental healthcare system, with services often operating in silos that utilise poor mechanisms for patient follow-up. This fragmentation led to young people feeling as though they had to repeatedly retell their stories to different healthcare providers, an emotionally taxing process that eroded trust and delayed treatment interventions. Participants suggested solutions such as implementing electronic health records to improve communication and continuity of care. For example.
I’ve had a really bad experience where I was like bounced back and forth from clinician to clinician. And just the reiterations of having to go through the different professionals and having to restart my file again, it was quite exhausting. Um, so then I actually stopped seeking professional help for a while and then it kind of got to another crisis point again. [FG2P2]
Referral processes were often described as confusing and inefficient. GPs, who were often seen as being unsure how to manage complex mental health cases, tended to “brush aside” patients, referring them to other professionals without clear guidance or follow-up.
So, I found it was hard to find like a suitable psychologist or psychiatrist because the GP didn’t really have any connections professionally so they weren’t really able to recommend anyone I guess that would maybe be more suitable […] [FG7P1]
GPs might just not know what to do with that thing…like ‘I’m not the one to handle this. You can go somewhere else’. [FG2P2]
These inefficiencies in referral pathways contributed to delays in receiving appropriate care and added to the overall frustration experienced by participants.
Prolonged wait times
Delays in care access was one of the most frequently cited issues. Youth participants reported waiting weeks or months for appointments, with wait times for specialists such as psychiatrists or counsellors, often exacerbating their mental health struggles. This lack of timely intervention created feelings of abandonment and discouraged further help-seeking behaviour.
[…] it took me a really long time to, to get another appointment at the psychiatrist cause there was another wait time. [FG2P2]
There’s such a huge wait to like, even be able to see [a psychiatrist] and I feel like this like a sort of stress. [FG7P2]
This barrier is especially concerning for young people experiencing acute mental health issues, as prolonged delays can exacerbate symptoms and increase the risk of crisis events from presenting. The perception that mental health services are inaccessible when needed discourages youth from pursuing help, reinforcing a cycle of unmet mental health needs.
Cost of specialised mental healthcare
The financial burden of accessing mental healthcare, particularly for secondary and tertiary students, as well as recently independent youth who may be on a lower income, emerged as a significant barrier to getting sufficient care. Participants described being unable to afford ongoing care, medications, or therapy due to the financial burden.
I stopped seeing professionals because it was getting too expensive. [FG7P1]
The inadequacy of government support and private insurance in covering mental health costs further compounded this issue, with participants expressing frustration at the financial strain of seeking care.
Without private health insurance, which doesn’t cover a lot, and being a [University] student, I can’t really afford to keep seeing them regularly. [FG7P1]
Knowledge gaps in youth-specific mental health
Participants noted that they often felt that providers lacked an understanding of the unique challenges and stressors faced by young people, and that healthcare providers lacked adequate preparation to address complex mental health issues among youths. Many felt that healthcare providers, particularly in the primary care system, were unprepared for the depth and breadth of their needs and lacked the nuanced knowledge necessary to address the unique developmental, social, and emotional burdens faced by young people, leading to a superficial or inadequate treatment approach.
[…] only like recently after like 4 years, they gave me something good. So, a lot of time wasted trying to find the right, yeah. […] I also find them very like under…prepared. [FG2P1]
Participants also noted that some providers appeared unsure about how to manage younger patients effectively.
[…] from what I could recall, I think at that time they weren’t really sure what to do? They didn’t know how to support me because I think at that time, I was underage, and I think they weren’t sure about […]. [FG2P2]
Limited therapeutic relationship
Many participants reported feeling dismissed or undervalued by their GPs, citing a lack of empathy and inadequate communication. These negative experiences diminished their trust in their GP’s guidance and treatment plan and deterred them from seeking further help.
I’ve only ever met one GP who seemed to care what happened to me. [FG2P3]
In another case, a participant recounted feeling as though their mental health concerns were trivialised:
When I went to my GP in Year 12, she was really dismissive of my mental health and made me feel like I was exaggerating. [FG7P2]
This participant believed that the GP dismissed their mental health struggles by suggesting they were exaggerating or influenced by what they saw in the media. The participant felt invalidated and “shocked”, explaining that this experience made them feel “so stupid” and discouraged them from returning to his GP or seeking help from another.
These narratives suggest that a perceived lack of empathy can lead to disengagement, particularly in the context of mental healthcare, where trust and rapport are foundational to effective treatment.
Another recurrent problem in this study was participant frustration with the quality of communication received from GPs. Participants often reported feeling inadequately informed about their diagnoses, treatment options, and the potential side effects of medications. Though many participants understood the brevity of consultations, this lack of comprehensive communication contributed to feelings of disempowerment and dissatisfaction with the care they received.
I think, like obviously there’s time restraints in GP appointments, but a bit more of a conversation, not just like ‘here you go, see ya. Try it out. Good luck.’ [FG3P2]
Another participant stated that their GP failed to explain the potential side effects of their medication, leaving them to return later with a constant headache. They noted that they would have preferred to be informed upfront, which would have helped manage their expectations and build trust in their GP’s care.
I don’t know why they don’t tell you the side effects beforehand. Especially when it’s your first time trying a new thing. [FG7P3]
One participant described a lack of adequate discussion regarding their mental health. After being prescribed medication, they were given printouts about their condition but felt this method was inadequate for truly understanding their treatment. They indicated that more conversation was needed, rather than just “pages and pages” [FG3P2] of printed information.
Despite the overall trend of dissatisfaction, several participants recounted positive experiences with GPs who provided attentive and empathetic care. These accounts serve as important counterpoints, illustrating the potential for GPs to foster trust and improve patient experiences through thoughtful engagement. For example, one participant highlighted the benefit of the continuity of care that their GP provided:
In fairness to her, she did make me book follow-up appointments so she could check in on me. [FG1P1]
Another participant appreciated the comprehensive approach their GP took:
I saw another GP in my first year of university, and she was less dismissive. She suggested a blood test to check if it was something like low iron or another issue. [FG7P2]
These examples suggest that limited communication within time-pressured appointments can significantly diminish the quality of care and leave patients feeling unsupported during their treatment journey. However, the positive experiences underscore the significant impact that thorough consultations and follow-up care can have on young people’s perceptions of their care, particularly when dealing with sensitive mental health concerns. This is particularly important to youth accessing support for mental health issues.
Education system
The education system plays a pivotal role in shaping youth experiences with mental health, with 14 of our 17 participants starting their mental health journey during high school years. However, participants identified significant shortcomings, including inadequate mental health literacy among educators, insufficient resources, and pervasive stigma within schools. These gaps often left students feeling unsupported and isolated, particularly during periods of heightened stress.
Mental health awareness and training
Many participants expressed concerns that the high school environment lacks adequate mental health literacy and that teachers are often underprepared to address student mental health needs. This gap results in young people feeling misunderstood or unsupported. Participants express a strong desire for teachers to receive mental health training to improve awareness and support for students facing emotional challenges.
[…] for schools to have more information. Whether that’s like actual [classes] they do on mental health or whether it’s just teachers having better understanding so they can spot signs and symptoms. [FG4P1]
This participant also recommended incorporating mental health literacy into school curricula to normalise discussions around emotional wellbeing and equip both students and staff with the tools to recognise and respond to challenges.
You learn about physical health and yeah, the at least when I was in school, there was nothing on mental health. Yes. So that needs to change. [FG4P1]
[…] it can be quite a difficult thing to ask for help and to seek information. So having like information like even pamphlets or whatever like more available. […] Especially for kids who literally cannot, there is no other way for them to get help, […] education, even from like, forced education, like from a teacher, classes, like pamphlets given out to each kid, yeah… [FG1P1]
[…] school is like for a lot of kids, it’s the only safe space. Yeah, and having mental health resources, there is incredibly important. [FG6P1]
Participants also highlighted the variability in teacher engagement, with some educators taking proactive steps to support students, while others appeared indifferent or unequipped to help.
I had like one teacher who I just had a good relationship with, so she was but the school in general, I don’t think really was. I saw the school counsellor like twice and then she kind of, you know, referred me to my, back to my GP and then to other services. And so kind of when it went outside of the school, the school kind of lost interest or forgot… [FG4P1]
Participants also mentioned the lack of trained mental health professionals within schools. Participants reported that many schools relied on underqualified staff to manage mental health services, reflecting broader underfunding and resource constraints.
My school had someone random’s mum do an online course on youth mental health…but she was also the admin assistant. [FG1P1]
Some participants stated a lack of awareness around available resources as a barrier to students seeking or accessing help for their mental health challenges.
[…] not even the school psychologists cause I didn’t know if they had. I don’t know why I didn’t know if they had a school psychologist. [FG2P2]
This theme reflects a broader issue of awareness and insufficient mental health resources in educational and community settings, with significant gaps in support for young people.
Stigma and peer-related issues within the school environment
Mental health stigma in schools discouraged many participants from seeking help. They noted that stigma often led to feelings of shame and isolation and reinforced a culture of silence around mental health struggles.
Yeah, that it was like ‘ohh, you know you’re that kid.’ So it was very like hush hush kinda like, why you getting pulled out of class all the time then you just like, doesn’t nothing that’s going on. [FG6P1]
This stigma was particularly pronounced in smaller communities, where mental health struggles were often dismissed or ridiculed.
Um a lot of the help I got was external out of school because it was just like kind of separated. Um, but especially where I went to school, I went to school in like small town, middle of nowhere-Western Australia. So, there was very much still the stigma around mental health. [FG6P1]
These findings highlight the critical need for systemic reforms in education to address mental health challenges comprehensively. By improving teacher training, increasing access to resources, and actively combating stigma, schools can create more inclusive and supportive environments for young people.
Societal system
Some participants described a persistent stigma within their social networks and families, significantly hindering their willingness to seek help or discuss mental health challenges. This section explores the dual impact of societal stigma and family attitudes on youth mental health, illustrating the urgent need for cultural and systemic changes to foster supportive environments.
Stigma and social support
Stigma around mental health remains pervasive within social networks, causing youth to hesitate in seeking help or discussing their struggles with peers and family. Participants report feeling judged or misunderstood when they try to open up, leading to isolation and reinforcing negative perceptions about mental health. This stigma acts as a barrier to accessing available support and sharing their experiences.
when I was in high school, […] I was forced to go see a youth psychiatrist or whatever, um, but the stigma surrounded it, not only for my family, um, which I couldn’t get any medications or anything at that time cause my family would have said no, um, but also the school I went to, the community that I was in. […] Then when I finally had the capacity to go myself that stigma remained and I couldn’t quite uh, like get the proper help I needed. [FG1P1]
For some, stigma extended beyond their immediate social networks to encompass broader cultural attitudes. Participants from culturally diverse backgrounds often faced compounded challenges due to entrenched negative views on mental health.
[…] growing up in an obviously Asian family, I had a lot of stigma, um around mental health, um, challenges and, and, um illness, in general […]. [FG2P2]
I think […] the country where I come from, there’s so much of negativity around the term [mental health disorders]. [FG4P2]
Family attitudes and support: Family resistance to mental healthcare emerged as a critical barrier for dependents under the age of 18 years, with participants describing opposition to therapy and medication. This resistance often stemmed from misconceptions, lack of awareness, or cultural beliefs, leaving many young people to navigate their mental health journeys alone.
[…] both my parents were really against anything to do with mental health […]. So, Mum didn’t want me to like see anyone […] and Dad was even worse than that. [FG2P3]
[…] I couldn’t get any medications or anything at that time cause my family would have said no. [FG1P1]
For those recounting times when they were underage, parental resistance created additional challenges, as consent was required to access professional help. Participants emphasised the importance of increasing family awareness and education to foster more supportive home environments.
[…] because you’re still a minor and without parental support to go through […]. It wasn’t until I was 18, an adult, and that’s when I took over my own health because there wasn’t really support. [FG7P1]
Privacy concerns were also highlighted, with some participants expressing the need for discreet ways to access care without family interference or judgment.
[interviewer: And were your parents…[aware]? ] They didn’t know. They still don’t. [FG4P2].
Despite these barriers, a few participants described moments when family involvement eventually became a turning point, albeit late in their mental healthcare journey.
Eventually my parents had to bring me to go see a, like, seek professional help. [FG7P3]
These narratives underscore the critical role of social and familial environments in shaping mental health experiences. Addressing stigma and fostering understanding within these spheres is essential to breaking down barriers and supporting young people in their mental health journeys.