A promising future for youth mental health

Prof. Patrick McGorry

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. [3] 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. [4] 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.


[1] Public Health Group. Victorian Burden of Disease Study: mortality and morbidity in 2001. Melbourne: Victorian Government Department of Human Services; 2005.

[2] Australian Bureau of Statistics. National Survey of Mental Health and Well-being. Summary of Results. Canberra: Australian Bureau of Statistics; 2008.

[3] 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.

[4] Access Economics. The economic impact of youth mental illness and the cost-effectiveness of early intervention. Canberra: Access Economics; 2009.


The Australian Medical Student Journal is born

A group of AMSJ staff members at a meeting in Febuary, 2010

It is a delight to welcome you to the inaugural issue of Australia’s new national medical student journal.

As you will no doubt discover, this first issue of the AMSJ really is a showcase of the talent, passion and achievement of medical students from across the country.

In recent times, medical education in Australia has seen a paradigm shift to self-directed learning and evidence-based medicine, and medical students themselves have become an increasingly diverse cohort with a wide range of backgrounds and interests. The AMSJ is in many ways a response to the corresponding need for avenues of expression.

In less than a year, the AMSJ has developed from an idea to a reality of previously unimaginable quality and scale. Every stage in the journal’s development has been somewhat of a leap into the unknown. One of the critical hurdles for the concept was always going to be the response in terms of submissions. We were overwhelmed with both the quality and quantity of what was received, with the vast majority of Australia’s twenty medical schools being represented among the submissions. The only regret is that only a small proportion were able to be published in the inaugural issue. Ultimately, it is the authors who have made the AMSJ a success, and will continue to do so.

The AMSJ has been a challenging balancing act in many respects. While we wanted to steer well away from being another student magazine, we did not want to be constrained by all of the typical expectations of a biomedical journal. We are not the first such journal in the world, however we found that the whole concept of a ‘student medical journal’ still needed to be defined; such a journal needs to be student-friendly for both authors at one end, and readers at the other.

From the perspective of student authors, we aimed to provide an unintimidating forum that could be a stepping-stone into the world of academia. While all academic articles underwent rigorous internal and external review processes, being anonymously peer-reviewed by at least two experts in their particular field, a central concern was to be as constructive as possible with any author feedback. A student journal needs to avoid the type of harsh uninformative rejections that are sometimes met with in existing journals. The AMSJ offers opportunities for a wide variety of styles, and for more general-interest articles that may not find a place elsewhere. As such, in this issue, you will find what you are familiar with in existing journals, such as review articles, original research, and case reports. However, you will also find many pieces that traverse the traditional boundaries, such as reviews of student resources, career pieces, and a host of feature articles.

From the perspective of you, our readership, the central concern was to be relevant and interesting. There is little use in publishing articles, regardless of the excellence of the research behind them, if they are of an extremely specialised nature and of no appeal to the vast majority of medical students. By the same token, we needed to publish articles that could extend students beyond the limits of standard medical curricula.

None of this would have been possible without our extremely dedicated volunteer staff of twenty-two students, to whom I offer heartfelt thanks and congratulations. As we all quickly learned, being involved in a totally new professional organisation is no easy task – every single process has to be designed from the ground up, without the luxury of a predecessor to lean on for advice. But at the same time, this has imparted an amazing degree of creative freedom that everyone found most rewarding.

There are a host of other people who have made this venture possible, including the generous and dedicated academics and clinicians who became peer-reviewers, our sponsors, medical societies from around the country, and the UNSW Faculty of Medicine, particularly Dr. John Hunt.

If what follows in the next seventy or so pages represent what is possible for an inaugural issue, then the future for the AMSJ certainly seems bright. I would encourage any student who reads this issue to take inspiration from their colleagues’ work published in these pages and think of how they could contribute to future issues, and indeed to the field of medicine in general.