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.研究背景：澳大利亚农村地区青少年的心理健康结局普遍更差，且多数青少年未主动寻求心理援助，这凸显了当前学界对其求助行为认知的显著缺口。本研究旨在探讨澳大利亚农村青少年的心理健康求助模式及相关影响因素。 研究方法：本研究分析了《澳大利亚儿童纵向研究（Longitudinal Study of Australian Children）》第8波的调研数据，纳入4837名14至19岁的青少年。研究人员依据澳大利亚统计局（Australian Bureau of Statistics）制定的偏远程度分级标准，估算了整体人群及不同偏远程度群体的心理求助率。采用聚类调整多因素logistic回归模型（Cluster-adjusted multiple logistic regression models），分析与心理求助行为相关的影响因素。 研究结果：相较于城市青少年，农村青少年的心理求助行为整体占比更低。与城市地区（12.20%，95%置信区间（95% CI）：10.97~13.54）相比，外区域及偏远地区青少年寻求面对面心理健康专业援助的比例显著更低（7.72%，95%置信区间（95% CI）：5.39~10.93）。此外，在外区域及偏远地区，男性青少年的专业心理求助率（2.76%，95%置信区间（95% CI）：1.33~5.63）显著低于女性青少年（13.53%，95%置信区间（95% CI）：9.08~19.70）。非面对面求助（如互联网、电话求助）同样存在类似的性别差异。心理求助行为最常见的预测因素为持续性焦虑或抑郁，以及良好的亲子关系。其余具有统计学意义的预测因素包括自杀意念与行为（suicidal thoughts and behaviours）、单亲家庭、社区参与、社交媒体接触及物质使用（drug use）。另有两项预测因素在城乡环境间存在显著统计学差异：即寻求正式援助时面临的经济困难，以及非正规求助相关的社区参与度。 研究结论：针对澳大利亚农村男性青少年心理求助率偏低的问题，相关干预策略应兼顾地域特异性障碍，并贴合其独特需求。面向青少年的数字化干预手段，以及强化家庭与社区参与，对保障澳大利亚农村青少年公平获取心理健康服务至关重要。