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

Abstract Background 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. Methods 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. Results 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. Conclusion 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.