Australia's youth mental health crisis, unfolding in tandem with a cost-of-living crisis, has placed Gen Z at a dangerous crossroads: pay the bills or pay for mental health treatment.

University student Katie Grant, who asked to use a pseudonym for privacy reasons, was attending therapy fortnightly for a year and a half to treat anxiety and post-traumatic stress disorder, until it was no longer financially sustainable for her to continue with therapy.

“I wasn’t even getting rebated half of it, it just wasn’t enough. I couldn’t afford it as a student only working one casual job,” she said.

This year, 194,000 young peopleaged between 15 to 24 are working more than one job, the highest it has ever been, according to the Australian Bureau of Statistics. Casual work is the most unstable type of employment and when your hours fluctuate it can make it difficult to budget.

“I didn’t have a set amount of hours each week. I didn’t have a consistent enough income to ensure I could keep paying every session out of my own pocket. I didn't have anyone to really pay it for me,” Grant said.

Dr Magenta Simmons is the head of Youth Involvement Research at Orygen and has worked at the University of Melbourne's Centre for Youth Mental Health for the past 18 years. She explained the cost of living has always been a significant problem for young people.

'I didn’t have enough income to keep paying out of my own pocket. I didn't have anyone to really pay it for me.'

“The cost-of-living has always been very difficult for young people as they are at a less financially established part of their lives, juggling study, work, and key developmental milestones. The recent sharp increases in the cost of living exacerbate this already significant problem.”

In 2022, when Headspace, the national youth mental health foundation, conducted a survey with people aged 18 to 25 years old, it found 54 per cent identified financial instability and cost-of-living as their biggest concern.

The ramifications of Gen Z having to sacrifice mental health treatment can be lethal. Data released by the Australian Institute of Health and Welfare in 2022 showed the leading burden of disease for males aged 15 to 24 was suicide, with 14.1 per cent of males suffering self-inflicted injuries. For females aged 15 to 24, the leading burden of disease was anxiety, with 10.2 per of young women experiencing it.

For Grant, having to cut out mental health treatment has been a difficult challenge. “I think as someone whose mental health condition is anxiety, I usually relied on those therapy sessions to keep me grounded and to learn coping mechanisms and implement those coping mechanisms, that would help me when the anxiety and pressure got too much. I’ve struggled with the process of phasing therapy out of my life.”

The latest data from the ABS showed 40 per cent of Australians aged 16 to 24reported experiencing a mental health disorder between 2020 and 2022. It shows youth mental health is at a crisis point.

Accessing treatment

The current Medicare system entitles Australian citizens to up to 10 individual and 10 group sessions with a mental health professional per year. To access these sessions a person must visit a GP and create a mental health care plan which needs to be updated every six months.

There is an issue between supply and demand for mental health services with access for some hard to come by. “A significant gap [exists] between the demand for psychological services and what is available," Simmons said. "This is not only to do with how much it costs to see a psychologist and whether there is a rebate available but also in terms of availability. There are long waiting lists in many areas of the country, and this is worse in regional, rural, and remote areas.”

Cost of treatment

If you can access mental health treatment the next question becomes, can you afford it? Psychologists can set their own rates with the Australian Psychological Society recommending psychologists charge an average cost of $280 per session.

Simmons said, in an email interview with Newsworthy, while $280 per a session may be a disadvantage for young people, psychologists like any other business owner must factor in their business expenses.

“Private psychologists have significant costs themselves in terms of obtaining qualifications, receiving regular supervision (which they have to pay for usually), maintaining their professional development and ongoing training needs, paying for overheads such as leasing offices, maintaining their insurance and registration costs and the additional work they undertake outside of sessions for their clients," she said.

There is a trend of young people spreading out their 10 Medicare-covered session due to the high costs. “I have certainly heard of young people saving their rebated sessions to spread them out rather than having more regular sessions which they feel that they need. This rationing is not going to optimise mental health outcomes," she said.

Australia has made significant strides in recognising the importance of taking care of our mental health since the first ‘R U Ok Day’ in 2009. However, workplace events and social media posts alone will not solve the youth mental health crises.

Looking ahead, Simmons believes young people themselves need to be brought into the conversation. “The action I would like to see is for stronger youth involvement in decision making about the design, testing, implementation, and scaling up of mental health interventions.”

If you or anyone you know needs immediate support contact Lifeline on 13 11 14.