Australia built a national youth mental health system after 2006; youth distress did not improve
"Despite a large increase in the provision of mental health services to Australian youth, there has not been a detectable reduction in the prevalence of psychological distress."
Suggestive but preliminary. Not settled. how we score evidence
Caveat on this rating: Ecological before-and-after design with no comparison country. Supporters of headspace point to evaluations of people who used the service; this paper measures the whole youth population, most of whom did not.
Australia is the closest thing to a national experiment. In 2006 and 2007 it put psychology on Medicare (Better Access) and opened a chain of youth centres (headspace). The authors asked what happened to the young people.
Significant findings
Jorm and Kitchener (Australian and New Zealand Journal of Psychiatry, 2021) tracked, for ages 12 to 25, Medicare mental health services per 100,000, per capita use of headspace, and the prevalence of high and very high psychological distress on the K10 in three population surveys "between 2001 and 2018".
"There has been a large increase in use of mental health services since the introduction of Better Access and headspace. No significant improvement in youth mental health was evident following the introduction of these schemes. Rather, there appeared to be a worsening of youth mental health from around 2015 onwards."
The authors do not blame the services: "There may be other factors that have worsened youth mental health in recent years."
Worth asking
A before-and-after comparison of a whole country cannot say what youth distress would have been without the new services. It can say that a large, well funded expansion of access did not bend the population line, which is the claim usually made for such programmes when they are funded. The authors' own reading of the worsening from about 2015 is that something outside the clinic changed.
Source
Increases in youth mental health services in Australia: Have they had an impact on youth population mental health? — Jorm AF, Kitchener BA (2021)
Reputable peer-reviewed journal
Read the source: https://doi.org/10.1177/0004867420976861
DOI: 10.1177/0004867420976861
How this was scored
- Study design
- Cross-sectional study / survey
- Funding
- Funding not disclosed
- Published in
- Reputable peer-reviewed journal
- Sample size
- not recorded
- Preregistered
- not recorded
- Conflicts disclosed
- not recorded
- Independent of proponent
- not recorded
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published September 21, 2026.
Questions
How strong is the evidence behind this?
veisund rates this source "early signal". Suggestive but preliminary. Not settled. It scores 40 out of 100 on our published rubric. One caveat travels with that badge: Ecological before-and-after design with no comparison country. Supporters of headspace point to evaluations of people who used the service; this paper measures the whole youth population, most of whom did not. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Increases in youth mental health services in Australia: Have they had an impact on youth population mental health? — Jorm AF, Kitchener BA (2021). Published in: Reputable peer-reviewed journal. DOI: 10.1177/0004867420976861. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Cross-sectional study / survey. Funding: Funding not disclosed. Independence from the proponent is not recorded. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.