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. 2026 Jan;60(1):67-79.
doi: 10.1177/00048674251385365. Epub 2025 Nov 5.

Mental health and substance use conditions among emerging adults in Australia 2020-2022: Prevalence, severity and psychosocial correlates within geographic regions

Julia Macauley  1 , Marlee Bower  1 , Maree Teesson  1 , Emma Webster  2 , Cath Chapman  1
Affiliations

Mental health and substance use conditions among emerging adults in Australia 2020-2022: Prevalence, severity and psychosocial correlates within geographic regions

Julia Macauley et al. Aust N Z J Psychiatry. 2026 Jan.

Abstract

Objective: This study presents estimates of the prevalence, severity and correlates of mental health conditions in Australian emerging adults within geographic regions.

Methods: We analysed data from 16- to 24-year-olds (N = 1620) of the 2020-2022 Australian National Study of Mental Health and Wellbeing, a national cross-sectional household survey. Estimated prevalence, population counts and unadjusted odds ratios of the 12-month Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) mental and substance use disorders (mental health conditions) are presented for Modified Monash Model categories (geographic region). Multivariable logistic regression models explored correlates of any mental health condition in the full sample, metro subgroup and regional, rural and remote subgroup.

Results: Over one-third of emerging adults met criteria for a mental health condition. Anxiety disorders were most prevalent (29.2%), then mood disorders (13.7%) and substance use disorders (7.8%). Prevalence was high across metro areas (36.1%); regional centres (35.4%); large rural towns (38.4%) and medium rural towns, small rural towns and remote communities (38.1%). Lifetime exposure to suicide or sexual assault was associated with mental health condition in all regions. In metro but not regional, rural and remote areas, female sex, neighbourhood disadvantage, household financial hardship, no engagement with education/employment, lifetime physical domestic or family violence, less social support and bodily pain were associated with mental health condition.

Conclusion: Mental health conditions are prevalent among Australian emerging adults in metro, regional, rural and remote regions. Equitable solutions bringing together the full continuum of care in mental health, suicide prevention, sexual violence and bodily pain are needed to reduce their significant impact.

Keywords: Epidemiology; mental health; prevalence; rural; young people.

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Conflict of interest statement

Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

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