One in three Aussie youths on mental health drugs

4 minute read


The numbers don't necessarily reflect a high prevalence of illness but a system that’s underresourced and not meeting children’s needs, according to one expert.


One in three young Australians has been prescribed a mental health drug, according to new research suggesting our medication rates are higher than global peers.

For example, stimulants were prescribed to young people seven times more than in Denmark, according to the analysis of PBS prescription and health data from 87,000 kids and teens in NSW.

“While it is well known that the mental health of young people is declining globally, there is little evidence that the mental health of young Australians is any worse than other countries, so this is unlikely to explain these higher rates of prescribing,” said author Professor Melissa Green, psychiatrist and director of research at the school of clinical medicine at the University of NSW.

The study found that in the first two decades of their life, 24.1% of young Australians had been given script for antidepressants, 10% for stimulants, 4.3% for antipsychotics, 3.8% for anxiolytics and 1.4% for a hypnotic or sedative.

“Danish population register data show the cumulative incidence of psychotropic drug prescription by age 20 years to be 5.1% for antidepressants, 4.4% for anxiolytics, 2.0% for antipsychotics and 1.4% for ADHD medications,” the authors wrote.  

While the Australian researchers found repeat prescriptions for anxiolytics and hypnotics or sedatives weren’t common here, “Just over two-thirds of psychotropic prescriptions were repeat prescriptions (66.4%), with the highest rates of repeat prescriptions evident for stimulants (70.0%), antidepressants (66.5%) and antipsychotics (57.7%)”.

Dr Shannon Morton, Brisbane child and adolescent psychiatrist, said the figures were concerning, particularly considering the paucity of long-term data on the use of these psychotropic medications in critical periods of brain development.

The gap between Australia and countries like Denmark was likely multifactorial, driven by “critical” shortages in the mental health workforce, geographic disadvantage and a public mental health service that was reserved for the most complex and high-risk cases, she said.

Parents and the education system were under pressure and underresourced, Dr Morton said, which “puts greater stress and strain on parents, which then also flows down to greater stress or strain on kids”. 

Meanwhile, shorter care sessions were better remunerated than longer mental health consultations, creating funding pressure towards a quick assessment of mental health problems and prescribing over talking therapies and psychotherapies, said Dr Morton, clinical director of Brisbane’s Kooky Clinic and The Hype! ADHD Centre.

“There’s no doubt that child psychiatrists feel pressure to prescribe medications for kids every day where there’s a significant mismatch between the needs of that child and the environment that they’re in. So if the school is not equipped to be able to manage the child in a child-focused, supportive way because of staffing pressures or resourcing issues, then there’s pressure on us to prescribe.”

But better access to early interventions and psychosocial support would “absolutely” help many young people avoid taking medication, she said.

Some of this pressure and burnout among caretakers may explain the study’s finding that one in 10 young people had been prescribed a stimulant, which Dr Morton noted was higher than the estimated 7% prevalence of ADHD in this age range.

But rather than being a first-line intervention, these medications and other psychotropics should be used once psychosocial interventions have been tried and exhausted, she said.

The study found that one in three young people prescribed a medication was also prescribed a second. This equated to one in 10 total children or teens being prescribed two or more types of medication.

An overreliance on medication could lead to polypharmacy through incorrect diagnoses and formulation, Dr Morton said. “And actually, the medications aren’t working full stop, because we’ve got psychosocial determinants that aren’t being addressed.

“A lot of the kids I see need family therapy; the kid is the ticket of entry for a family that’s in trouble and struggling, but there’s very limited access to family therapy interventions or psychologists that do that work,” she said.

The study also found differences in the age young people were prescribed different medications. Stimulants accounted for half the prescriptions from age four to around mid-adolescence, whereas antidepressant use rose sharply between ages 12 and 16 and became the most common prescription from age 15 onwards.

Australian & New Zealand Journal of Psychiatry, 3 January 2025

End of content

No more pages to load

Log In Register ×