Australia’s young people are not failing to access health support – the system is failing to reach them.

Young people do not need to be reimagined. Our systems do.

 “My closest psychologist is two hours away” 

 “Young people can’t all afford therapy”

 “Everyone should be able to talk to someone and feel safe”

What becomes clear very quickly is this – Whether it is mental health care or life-saving medication, the message young people are receiving is the same. Access depends on circumstance, not need. 

When we talk about youth health, we often separate mental health and physical health. For young people, the line between physical and mental health care does not exist. Because the same young person struggling to access a psychologist is often the same young person struggling to see a GP,  manage a chronic condition, or access basic physical healthcare. And when those systems don’t speak to each other, young people are left to navigate them alone. 

The Problem – 3 Key Issues 

Across both 2025 and 2026, a consistent pattern has emerged.

There are three key issues shaping young people’s experiences of physical and mental health care in Australia. 

1. The Access Gap: Geography and cost. 
2. The Reach: Marginalised Australians 
3. The Trust Deficit: young people don’t seek help when services exist.

The Access Gap

For many young Australians, particularly those in regional, rural, and remote communities, access to health care is not shaped by one barrier. It is shaped by layers of barriers that build on each other.

So when young people disengage from healthcare, we should not ask why they didn’t show up. We should be asking what we built that made it so hard to.

Distance: For some young people, support is not nearby. It can be hours away, which makes regular care difficult to maintain. After a few sessions, they stopped going. Not because they were better. But because it wasn’t sustainable.

Cost: One young person described healthcare as something that“leaves our families in years of debt and potential bankruptcy.” Even when young people access care, they often cannot afford to stay in it. We are seeing stop-start patterns of care, where support is interrupted not because it is no longer needed, but because it is no longer affordable. This is happening in cities too, with many unable to access consistent support. And underneath all of this is a structural assumption that young people can access a GP to enter the system. For many, that assumption simply does not reflect reality.

This leads to a clear conclusion. Young people are not failing to access support. The system is failing to reach them and they are reaching points of crisis with no support.

The Reach

Where levels of distress are highest, access to care is often lowest. Young people from marginalised communities consistently reported higher levels of need, alongside greater barriers to accessing support, including sexual health, chronic illness management, and preventative care.

For example, LGBTQIA+ young people are significantly more likely to experience high or very high psychological distress compared to the general youth population.

First Nations young people experience disproportionately high rates of mental ill health and suicide, yet access to culturally safe services remains limited.

Young people from culturally and linguistically diverse backgrounds spoke about language barriers, stigma, and a lack of culturally appropriate care.

Young people with disabilities described systems that are difficult to navigate and not designed with their needs in mind.

Across these groups, a common theme emerged. It is not just about whether services exist. It is about whether those services feel safe, inclusive, and relevant.

If a young person does not feel understood, they are unlikely to engage. Access without safety is not meaningful access.

The Trust Deficit

When young people have negative experiences in any part of the healthcare system, it shapes how they engage with all of it. 

Trust is not built separately in mental and physical health. It is built once and lost once.

We know that mental health is consistently one of the top concerns for young people. And yet, a significant number do not seek professional help. That gap tells us something important. It tells us that the system has not earned their trust.

When a young person engages with a system and feels dismissed, unsupported, or excluded, that moment carries forward. It influences whether they seek help again.This is how the trust deficit builds.

And by the time they do reach out again, their needs are often more complex and more urgent. Rebuilding trust requires more than increasing services. It requires changing how those services respond to young people, and ensuring that when they do seek help, they are met with understanding, flexibility, and respect.

Trust is not built in theory. It is built in the systems you design, fund, and deliver.

 

What needs to change?

We must move away from siloed care models. Mental health, primary care, and specialist physical healthcare must be integrated.

Because young people do not need to navigate systems. They need systems that navigate around them.

1. The GP Gatekeeper Problem: Remove Referral Friction

Requiring a GP referral as the entry point to mental health care adds a barrier for access, especially for young people in regional and rural areas. It adds time, cost, and complexity at the very first step. It also assumes that young people have access to a trusted GP which they can afford, and that is not always the case.

The 2026 Medicare Mental Health walk-in reform is a step in the right direction, because it recognises that this first barrier exists. But it has not yet been scaled in rural and remote Australia, where the need is often greatest.

If we are serious about improving access, we need to go further.

Access should not depend on navigating a system. It should respond to need.

2. Service Gaps: Invest in Early Intervention and Complex Care

Young people are recognising they need support and want to access it.

They are not waiting until crisis point to identify that something is wrong. They are trying to engage earlier, which is exactly what we want from a preventative system.

But the system is not consistently meeting them at that point.

Accessible early intervention services are limited, and there are significant gaps for young people with complex, persistent, or co-occurring needs.

For young people in regional areas, the concern remains the same. Access depends on where you live. And even when young people do enter the system, many struggle to stay in it. Care can be short-term, fragmented, or difficult to navigate once needs become more complex.

Because access is not just about getting in. It is about being able to stay supported over time.

3. Services Not Designed for Those Most in Need: Design for Inclusion

Services are often designed for the majority, but neglect those most in need.

First Nations young people, LGBTQIA+ young people, and young people from culturally and linguistically diverse communities have consistently said that they will not engage with services they do not feel safe in, regardless of proximity or cost.

It shows that access is not just about whether a service exists. It is about whether that service feels safe, inclusive, and relevant to the person using it.

So when we talk about access, we need to expand how we define it. Access without cultural safety is not meaningful access.

To address this, services must be designed with these communities in mind from the beginning, not adapted after the fact. 

4. Youth Absent from Design: Mandate Co-Design and Invest in Peer Support

Young people are often consulted, but current models remain consultative and lack true youth involvement.

There is a difference between asking young people for feedback and involving them in decision-making. Right now, many systems are still designed without young people at the centre, which means they miss key aspects of how young people experience care.

To address this, we need to mandate co-design in all health service funding, ensuring that lived experience is centred from the beginning, particularly for communities that are currently underserved.

Because when young people see themselves reflected in the system, trust begins to rebuild.

 

Summary

If we get this right, the outcome is clear.

Young people will be able to access support earlier, without unnecessary barriers. Care will be more consistent, not dependent on postcode or capacity. Services will be more inclusive, safer, and designed with the people who actually use them. And peer-led and lived experience models will sit at the centre of care, not on the margins.

Most importantly, young people will not have to wait until crisis point to be heard or supported. They will be able to seek help when they first need it, and stay connected to care in a way that actually works for them.

This is what is possible if we act on what we already know.

 

 

This blog post is an adapted version of a keynote delivered at the 2026 AAAH Youth Health Conference by the 2026 Australian Youth Representative to the United Nations, Janice Rodrigues. We extend our thanks to the following volunteers for their contributions:

• Grace Harkins (Chief Youth Representation Officer)
• Nicholas Brown (Impact Intern)
• Cleo Melrose (Impact Intern)