Suicidality, mental disorder and the utilization of mental health services among Australian adolescents

Suicidality, mental disorder and the utilization of mental health services among Australian adolescents

Introduction: Suicidality among adolescents continues to be a serious public health concern worldwide, and suicide is the leading cause of death for young Australians. However, to develop effective preventive interventions, it is essential to understand the types and rates of mental health service utilization among adolescents. This study investigated the association between suicidality and mental health service utilization among Australian adolescents, and to test whether service use is affected by the simultaneous presence of suicidality and mental disorders.

Method: Adolescents aged 13–17 years (n = 2134) were used in this study from The Second Australian Child and Adolescent Mental Health and Wellbeing Survey – Young Minds Matter (YMM), which is a nationwide cross-sectional survey. Data were collected through face-to-face interviews with parents using a structured-questionnaire, while, adolescents completed a computer-based self-reported questionnaire privately. The YMM reported four types of mental health service: (1) health services – any services provided by a qualified health professional, regardless of where that service was provided; (2) school services – any services such as counseling or support programs provided by school or any educational institution; (3) telephone counseling services; and (4) online services. Both bivariate and multivariate analyses were used to assess the relationships between independent variables (suicidality, mental disorder) and their distributions over outcome variables (mental health services), adjusting for relevant sociodemographic and potential risk factors such as age, gender, remoteness, household income, family type, family functioning, parents' education, parents' employment, substance use by the child. An interaction between mental disorders and suicidality were included in the regression to examine whether and to what extent service use is affected if an adolescent has both suicidality and a mental disorder.

Results: Overall, 168 (8%) adolescents reported suicidality and prevalence of suicidality (ideation, plan and attempt) was higher in adolescents with mental disorders (P < 0.01 for all). Suicidality was high among girls irrespective of mental health condition. Both bivariate and multivariate analyses using child data and parent data showed a strong and significant association between suicidality and mental health service utilization among adolescents. Online service and health services were more likely to be accessed by adolescents with suicidality as reported in child data and parent data, respectively; while, school and telephone counselling service were less utilized within the same population. However, still, a large number of adolescents with suicidality did not access any services, even the incidence of seeking any mental health service was higher among adolescents with suicidality compared to those with a mental disorder.

Conclusion: The limited number of suicidal adolescents is using mental health services, which is alarming for prevention of suicide. Further research is warranted to understand the quality of service received by adolescents and the factors influencing service utilization due to mental health-related problems. Also, interventions to improve care, prevention and monitoring are solely required for this group of people.

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