Australian of the Year, 2010
Chair in Youth Mental Health,
University of Melbourne
We have good reason to be concerned about the mental health of our young people.
In Australia, mental health issues account for 55% of the total burden of disease in those aged between 15-24 years, with depression, anxiety and substance misuse being the most prevalent problems in this age group. [1,2] Furthermore, epidemiological evidence tells us that over 75% of people who suffer from a mental illness experienced their first episode by the age of 25 years.  Given the exquisite developmental sensitivity of this period of life, when psychological, social and vocational pathways are being established as part of the transition to independent adulthood, it is not surprising that mental disorders, even relatively brief and mild ones, can disrupt and disable, seriously limiting or even blocking a young person’s potential. Ample evidence shows that mental ill-health in young people is associated with high rates of enduring disability, including school failure, unstable employment, poor social and family functioning, which all too often lead to a spiral of disability and disadvantage that becomes difficult to reverse.
As a society, we cannot afford to ignore the human, social and economic consequences of this situation. A recent report by Access Economics has estimated that in 2009, the financial cost of mental illness in Australians aged between 12 and 25 years was $10.6 billion, with 70.5% of this due to the costs of lost productivity due to lower employment, absenteeism and premature death. Furthermore, the value of the loss in well-being (disability and premature death) was estimated at a further $25 billion.  We need to invest in our future, and clearly, investing in youth mental health makes good sense: a strong focus on young people’s mental health has the capacity to generate greater personal, social and economic benefits than intervention at any other time in a person’s lifespan. Put simply, mental health equates with national wealth, in the broadest possible sense.
Fortunately, there is a growing movement that aims not only to raise awareness of this crying area of unmet need, but also to redress it. In the early 1990s we began to promote the idea that intervention in the very early stages of the development of a mental illness was the most effective strategy to reduce the burden of disease created by these disorders. Intervening early to stop the progression of a mental illness should also prevent the accumulation of collateral damage to educational, social and vocational functioning associated with the evolution of the illness. Evidence supporting this proposition has been building steadily over the last decade, and with this progress, it is now accepted at both the State and Federal Government levels, as well as within the wider community, that major reform and significant investment is required in mental health care in Australia, and indeed world-wide.
As Australian doctors, present and future, we live in exciting times. We have reached the tipping point; reform is inevitable, and indeed, the first steps have been taken. A career in psychiatry has always offered benefits such as real contact with patients, rewarding work, intellectual stimulation, interesting research questions and the possibility of maintaining a good work/life balance, but now Australia’s psychiatrists have the potential to be part of a social climate change not only here in Australia, but also world-wide. The need is only too real, and the potential to address it has never been better. As Australia’s doctors of the future, an exciting career option beckons you: consider psychiatry, and make a real difference to our future.
 Public Health Group. Victorian Burden of Disease Study: mortality and morbidity in 2001. Melbourne: Victorian Government Department of Human Services; 2005.
 Australian Bureau of Statistics. National Survey of Mental Health and Well-being. Summary of Results. Canberra: Australian Bureau of Statistics; 2008.
 Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005;62:593-602.
 Access Economics. The economic impact of youth mental illness and the cost-effectiveness of early intervention. Canberra: Access Economics; 2009.