Shu Mei Teo

Objective: To examine the rates of suicidal ideation, self-harm, and symptoms of depression and anxiety among Australians aged 12 to 25 years, and covariates.Design: A multi-wave national cross-sectional survey.Setting and participants: Participants were recruited online from research panels, boosted through convenience sampling. Data were weighted by age, gender, and location.Main outcomes: Rates of suicidal ideation, self-harm, depressive and anxiety symptoms. Population-weighted descriptive statistics were used to examine prevalence; logistic and linear regressions identified demographic, clinical and social covariates.Results: N=2,863 participants were included in analysis. Mean age was 18.6; 50.7% (1439/2840) were cisgender men/boys; 4.5% (127/2840) were trans and/or gender diverse. One in three (32.1%, 859/2680) reported lifetime suicidal ideation, 26.8% (748/2787) lifetime self-harm and 8.0% (210/2631) lifetime suicide attempt. Twelve-month prevalence rates were 14.6% (387/2655) for suicidal ideation and 12.5% (347/2779) for self-harm. 38.9% (1107/2847) reported at least moderate depression symptoms, and 34.6% (988/2857) reported at least moderate anxiety symptoms. Rates of suicide-related behaviour, depression and anxiety were highest in trans and/or gender diverse young people followed by cisgender women/girls. Covariates for suicidal ideation and self-harm included loneliness, younger age, depressive symptoms, >2 adverse childhood experiences, and suicide bereavement. Covariates associated with depression and anxiety outcomes also included social exclusion/withdrawal, sleep problems, and alcohol or other drug problems.Conclusions: Suicidal ideation, self-harm and mental ill-health in young Australians appear higher than previous estimates, and are particularly high among young women/girls and trans and/or gender diverse youth. Findings highlight the need for urgent responses that extend beyond individual-level intervention to address the broader social conditions shaping young people’s mental health. The study also points to the need for timely and robust data that can inform practice and policy and help evaluate new initiatives. Future waves of this survey will help these efforts.

Young people are especially vulnerable to the mental health impacts of climate change. Yet the mechanisms linking climate change to mental health remain unclear. This study explored how climate change shapes the emotions, thoughts, and behaviours of young people from Australia, and the implications for wellbeing.Data were drawn from Mission Australia’s 2023 Youth Survey. Participants were asked to describe how climate change impacts their thinking, feelings, and behaviour. Free-text responses from 3,272 participants were analysed using inductive thematic analysis, with relational analysis identifying interconnected patterns across emotional, cognitive, and behavioural domains.Young people from Australia reported diverse responses to climate change, including feelings of anxiety, sadness, and hope; thoughts about future impacts, personal responsibility, and systemic failure; and behaviours ranging from pro-environmental actions to disengagement. Based on overlapping feelings, thinking, and behaviour, seven archetypes of response were identified: the Hopeless Helper, Nervous Navigator, Furious Fighter, Guilty Guardian, Wounded Witness, Detached Drifter, and Determined Doer.Findings highlight the complex and interconnected ways young people respond to climate change across emotions, thoughts, and behaviours. Archetypes provide a framework for understanding both risks and resilience, emphasising that distress often stems from systemic inaction. They underscore the need for nuanced measures, tailored interventions, and policies that systematically integrate climate and mental health.

Cluster analysis is an explorative analytical method, serving as a critical tool in psychology, psychiatry and related fields to map heterogeneous data into meaningful subgroups. Despite their extensive historical use, traditional clustering techniques suffer from a lack of stability, robustness, and generalisability. These issues stem from the inherent difficulties of the clustering optimization problem as well as the stochastic nature of algorithm optimizers. To address these challenges, we demonstrate the use of methods utilising ensemble learning techniques to combine clustering results from different algorithms, model specifications, and/or sampled sub-datasets to form a single, more reliable consensus of clustering solutions. We detail ensemble clustering principles, variations in base clustering generation models, and consensus methods. Detailed introductions in existing R libraries and practical examples using R code are provided to guide users in both implementing and optimising ensemble clustering models. We then include simulation studies of real-world data to demonstrate the substantial benefit of ensemble clustering compared with single-run clustering models. The resources presented here will enable researchers to apply advanced clustering techniques to decompose heterogeneous and complex psychological data into stable subgroups.

Climate distress is widely reported among young people and increasingly recognised as a mental health concern. While prior research has documented its prevalence and emotional impacts, less is known about how young people prefer to be supported. We analysed data from a nationally representative online survey of 1,000 Australians aged 16-25 years conducted in 2023. Survey-weighted descriptive analyses and multivariable logistic regression models examined associations between support preferences and age, gender, geographic location, and experience of extreme weather events (EWEs).Young people rated as most helpful those responses that validated climate concerns, fostered agency, and recognised shared and institutional responsibility, with visible government climate action ranking highest overall. Friends, family, digital resources, and mental health professionals were preferred sources of support, whereas doctors, helplines, and some school-based services were less frequently endorsed. In clinical contexts, participants prioritised acknowledgement and action-oriented guidance while rejecting minimisation or denial.Support preferences varied even amongst young people. Younger participants favoured visible leadership and school-based supports, whereas older youth showed greater preference for self-directed strategies. Female and gender-diverse participants more consistently support relational and multi-level supports and were less likely to support responses that dismissed or minimised climate change. Those with EWE experience showed stronger support for systemic and relational responses and lower tolerance for such dismissive framing.These findings underscore the importance of aligning climate-related mental health responses with young people’s lived experiences and expectations, highlighting the need for relational, institutional, and policy-level approaches alongside individual support.

Introduction: Recent years have seen growing recognition of the mental health toll that climate change imposes on younger generations. In response, researchers, clinicians, and practitioners are increasingly seeking to address climate-related distress through a range of clinical, community and school-based approaches. There now exists emerging evidence supporting a cumulative effects relationship between exposure to climate-related disasters and overall population mental health outcomes. However, it is unclear whether this applies specifically also for young people, or towards non-pathological intermediary factors influencing climate-related distress.Methods: Using cross-sectional, nationally-representative online survey data of young Australians (aged 16-25 years), we fitted logistic regression models exploring associations between cumulative extreme weather exposure, and five outcomes of interest: (1) climate concerns, (2) climate concern’s impact on mental health, (3) self-reported overall mental health, (4) climate-related factors impacting mental health, and (5) perceived helpfulness of climate anxiety supports. Secondary stratified analyses of these regressions were conducted exploring model variations by gender, age sub-groups, and geographic remoteness. Results: Weighted analyses demonstrated clear cumulative effects relationships between cumulative exposure to extreme weather events and higher likelihood of climate concern, reporting increased concern within 12 months of survey completion, and self-reporting poor mental health. Event-specific effects were most consistent for heatwaves and bushfires/bushfire smoke, which were associated with heightened climate concern and stronger perceptions that factors such as government inaction, environmental policy uncertainty, and worry about the planet negatively affecting young people's mental health. Cumulative exposure showed the strongest and broadest associations, with those exposed to more types of events more likely to view all proposed supports (clinical, educational, and structural) as helpful. Stratified analyses suggested stronger cumulative effects patterns for female/other gender groups and for young people aged 22–25, though precision was limited by small subgroup sizes.Conclusion: Extreme weather exposure is now a near‑normative experience for Australian youth and is associated with measurable impacts on climate concern, perceived drivers of mental health burden, and preferred support pathways. The consistent cumulative effects patterns observed highlight the cumulative mental health burden of living through multiple climate hazards, with heatwaves and bushfires/smoke showing particularly salient associations. These findings reinforce the need to integrate mental health into climate adaptation and emergency management strategies and policies, and emphasise the importance of institutional and upstream responses alongside targeted supports for highly exposed young people.

Introduction: Mental disorders are a leading cause of disease burden in 10-24-year-olds. In Australia, fragmentation within and across sectors (health, mental health and human services) results in gaps in service provision and increases this disease burden. There is an urgent need for reform; however, we need comprehensive and robust methodologies to identify gaps and inefficiencies in service provision to shape policy, ensure efficient allocation of resources and support those most in need. Here we describe the protocol for a population-based data linkage study involving evaluation of health, mental health, and human service use among Victorian young people with the goal of identifying subgroups experiencing unmet mental health needs. Methods and analysis: Our primary cohort includes youth aged 12-25 years in the period January 2018 to November 2023. For comparative purposes, we also include data from children aged 5-11 and adults 26-53 for this timeframe. We outline data sources and linkage methodology. Traditional statistical methods coupled with contemporary machine learning and natural language processing techniques will be used to identify subgroups with unmet mental health needs.Study outcomes: Ongoing consultation and engagement with young people and key stakeholders will inform interpretation, dissemination and translation of findings. We will provide a comprehensive examination of the clinical characteristics of young people, their service use behaviours, and typical pathways through care, that cannot be gleaned from examining datasets in isolation. Findings will inform ongoing mental health service reform that will lead to improvements in healthcare delivery and outcomes for Victorian youth.

Data linkage is a powerful tool for understanding the multifaceted needs and priorities of mental health care from the perspective of users and providers. Its potential remains underutilised in Australian settings – the Productivity Commission Inquiry into Mental Health in 2020 highlighted a significant gap: routinely collected administrative data are seldom leveraged in mental health research and service evaluation. In this manuscript, we provide insights into how data linkage has been used in mental health research, the type of questions that can be addressed, the steps involved in conducting data linkage research and the benefits and limitations of the use of this methodology. We propose crucial recommendations for advancing this field including: enhancing education for stakeholders (including the public, data custodians, ethics committees and policy makers); fostering stronger collaborative relationships with individuals with lived experiences throughout the research journey; improving infrastructure and resources for data linkage activities and linking data across sectors to address complex meaningful research questions. Data linkage is not just a method but a critical strategy to transform mental health research and service evaluation, ensuring more informed, effective and holistic mental health care.

Data linkage is a powerful tool for understanding the multifaceted needs and priorities of mental health care from the perspective of users and providers. Its potential remains underutilised in Australian settings - the Productivity Commission Inquiry into Mental Health in 2020 highlighted a significant gap: routinely collected administrative data are seldom leveraged in mental health research and service evaluation. In this manuscript, we provide insights to how data linkage has been used in mental health research, the type of questions that can be addressed, the steps involved in conducting data linkage research, and the benefits and limitations of the use of this methodology. We propose crucial recommendations for advancing this field including: enhancing education for stakeholders (including the public, data custodians, ethics committees, and policy makers); fostering stronger collaborative relationships with individuals with lived experiences throughout the research journey; improving infrastructure and resources for data linkage activities; and linking data across-sectors to address complex meaningful research questions. Data linkage is not just a method, but a critical strategy to transform mental health research and service evaluation, ensuring more informed, effective and holistic mental health care.