Navigating anxiety, depression and antidepressants for young people
More young people are experiencing mental health problems than ever before.
Results from the 2021 HILDA survey estimated that 45% of Australians aged 15–24 years received a serious mental illness diagnosis during their life – up from 15% in 2009. Similarly, the 2020-22 National Study of Mental Health and Wellbeing survey reported that almost 2 in 5 people aged 16-24 experienced a mental health disorder in the previous 12 months, with anxiety (26%) and depression (17%) being the most common mental health and behavioural chronic conditions.
The consequences of untreated or undertreated mental health disorders can have far-reaching impacts on all parts of a young person’s life; including education, work, relationships and physical health. They can also lead to an increased risk of suicide, which accounted for 1 in 3 deaths among young Australians in 2023. This age group also has the highest rates of hospitalisation for intentional self-harm in Australia. The evidence also tells us that for most adults living with a mental health disorder, symptoms started before the age of 24 years. This emphasises the importance of early diagnosis and optimal management1.
Caring under pressure
Non-pharmacological interventions should be the first-line approach for managing depression and anxiety in teens and young adults. Yet, barriers such as limited availability to care providers, cost of access, long waiting times for psychological services and regional inequities often push both patients and clinicians towards pharmacological options.
This misalignment between best practice and real-world care may help explain why PBS data shows antidepressant use among Australians under 18 years doubled between 2012 and 2023. This trend is concerning, given the limited evidence base for medicine efficacy in this age group, the associated potential for harms and lack of long-term safety data.
Rethinking our approach
Current Australian guidelines recommend a stepped-care approach for the management of anxiety and depression in young people, with education, lifestyle strategies and psychological therapies forming the foundation of this care.
Use of medicines such as SSRIs may be appropriate for some individuals. If introduced, they should form part of a broader, holistic treatment plan.
This approach provides care that is beyond symptom control, helping to build resilience and coping skills while strengthening the social and emotional support in a young person's environment. For general practice, this means integrating clinical judgment, context, and patient-centred discussion, to ensure the young person’s mental wellbeing remains the key focus.
Nationally supporting quality use of medicines
In recognition of these challenges, the latest program from the Quality Use of Medicines Alliance (available here on QHUB) will be providing an expert interpretation of the latest evidence and guidelines to support health professionals in this complex and recurrent area of practice, through a range of opportunities such as educational visits, webinars, online learning and more.
Pivotal to these clinical conversations are point-of-care tools, including a 2-page clinical guide designed to improve clarity around medicine use and raise awareness regarding the role of non-pharmacological options for this cohort.
This latest Australian Government-funded program from the Quality Use of Medicines Alliance has been developed in conjunction with consumers and carers, as well as experts from across the mental health sector, including the Black Dog Institute. This collaborative approach helps ensure that these resources and learning opportunities will assist health professionals to make safe, informed clinical decisions with greater confidence.
References
- Kessler R, Berglund P, Demler O, et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005;62:593-602.
Youth Mental Health: Life changing tools beyond the scriptJoin this practical, case-based webinar to build confidence and competence in managing mental health consultations with young people aged 13–24.
The Quality Use of Medicines Alliance a consortium of eight health and consumer organisations, will align their work across the two grants, awarded under the Australian Government’s Quality Use of Diagnostics, Therapeutics and Pathology (QUDTP) Program.
Quality Use of Medicines Alliance
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Quality Use of Medicines Alliance
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Quality Use of Medicines Alliance
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