Adolescent mental health help-seeking behaviours in rural Australia: cross-sectional analysis of a nationwide cohort study

TL;DR

This study explores why rural Australian adolescents, especially males, are less likely to seek mental health help and identifies factors that influence their help-seeking behaviors.

Contribution

The study provides new insights into rural-urban and gender disparities in adolescent mental health help-seeking in Australia.

Findings

Rural adolescents, particularly males, are less likely to seek face-to-face mental health help compared to urban adolescents.

Ongoing anxiety or depression and good parent-child relationships are the strongest predictors of help-seeking behaviors.

Digital interventions and community engagement are suggested as key strategies to improve mental health access in rural areas.

Abstract

Adolescent mental health outcomes are often poorer in rural areas of Australia, and most adolescents do not seek help, highlighting a critical gap in understanding help-seeking behaviours. This study examined mental health help-seeking patterns and associated factors among rural Australian adolescents.

Data from Wave 8 of the Longitudinal Study of Australian Children, including 4,837 adolescents aged 14–19 years, were analysed. The prevalence of help-seeking overall and by remoteness, as defined by the Australian Bureau of Statistics were estimated. Cluster-adjusted multiple logistic regression models were used to examine factors associated with help-seeking behaviours.

Help-seeking behaviours were generally lower among adolescents from rural areas compared to their urban counterparts. Seeking face-to-face mental health professional help was significantly less common in outer regional and remote areas (7.72%, 95% CI: 5.39–10.93) compared to urban areas (12.20%, 10.97–13.54). Furthermore, males reported significantly lower professional help-seeking behaviours (2.76%, 1.33–5.63) than females (13.53%, 9.08–19.70) in outer regional and remote areas. Similar sex disparities were observed in non-face-to-face (e.g., internet, phone) help-seeking. The most common predictors of help-seeking behaviours were ongoing anxiety or depression and good parent-child relationships. Other statistically significant predictors included suicidal thoughts and behaviours, single-parent family, community participation, social media exposure and drug use. Two predictors (i.e., financial hardship for formal help-seeking and community engagement for informal help-seeking) varied statistically significantly between rural and urban settings.

Strategies to address lower prevalence of mental health help seeking among rural male adolescents in Australia should be sensitive to context-specific barriers and designed to meet their unique needs. Adolescent-focused digital interventions and strengthened family and community engagement are vital to ensuring equitable access to mental health services for adolescents in rural Australia.

The online version contains supplementary material available at 10.1186/s13034-026-01022-7.

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