Patterns of Youth Mental Health Service Use and Discontinuation: Population Data From Australia’s Headspace Model of Care
Abstract
OBJECTIVE: Young people (ages 12-25) experience the highest risk of developing mental disorders; however, their uptake of and engagement with treatment is low. The study explored sociodemographic predictors of attendance and discontinuation of mental health services in a large, population-based sample. METHODS: Data were from the minimum data set collected from young people (ages 12-25) who attended headspace, Australia's National Youth Mental Health Foundation, from 2013 to 2017 (N=80,502). Data on key demographic and clinical variables and practitioner ratings of need for ongoing care were analyzed. Cox regression was used to examine the association between sociodemographic factors and rates of discontinuation based on practitioner-rated need for ongoing treatment. RESULTS: The mean±SD number of sessions attended during the first episode of care was 4.6±4.4 sessions (median=3). Session-by-session discontinuation rates ranged from 14% to 19% across 10 sessions. The proportion discontinuing treatment before session 11 was 71.2%. Analysis of a subgroup (N=40,039) showed that 24% of those who discontinued treatment later returned to the same headspace center for a second episode of care. Those who were most at risk of discontinuation were older (ages 18-25), male, heterosexual, Aboriginal or Torres Strait Islander, and living in a rural location. CONCLUSIONS: Sociodemographic factors were found to be associated with treatment discontinuation, and some young people followed a pathway in and out of mental health treatment. Further exploration is needed to determine the appropriate length and type of care for specific sociodemographic groups and how best to tailor treatment accordingly.
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Current treatments for youth mental ill-health remain limited, with small treatment effect sizes, poor engagement, and high relapse rates.
“current treatments remain limited, with small treatment effect sizes, poor engagement, and high relapse rates [11-13]”
From A Virtual Reality–Based Cognitive Defusion Application for Youth Depression and Anxiety: Mixed Methods Experimental Study. (2025) · cites this paper as [12]
Attrition rates are high, with a large study reporting a 42% drop out of treatment by one's third therapy session.
“with a large study reporting a 42% drop out of treatment by one's third therapy session. 233”
From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [233]
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“However, adolescents who experience social exclusion and mental ill-health typically also experience a multitude of social issues that negatively impact treatment engagement and service accessibility (Brown et al., 2016; Filia, Menssink, et al., 2022; Gao et al., 2023; Seidler et al., 2020).”
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“Models being trialed in the Australian context include Head to Health hubs and youth mental health hubs such as headspace [27,60].”
BackgroundNo Dramas: Using applied theatre to explore youth health issues in regional Central Queensland
Lorenza, L. M., Pascoe, V. A., Price, L., McCartney, F., McEwan, A., Bloomfield, C., Suzuki, M., Power, D., & Stanton, L. (2023) · Australian Journal of Rural Health · doi:10.1111/ajr.13043 · Cited by 6 · see citing works
Wittevrongel, E., Kessels, R., Everaert, G., Vrijens, M., Danckaerts, M., & van Winkel, R. (2024) · Early Intervention in Psychiatry · doi:10.1111/eip.13584 · Cited by 6 · see citing works
“Even if service characteristics are adapted to young people's preferences or needs, it is possible that internal barriers will still impede help-seeking behaviour in early stages of mental ill-health (Seidler et al., 2020).”
Early Interventions in High Risk Groups for Psychotic Disorders
Erzın, G., & Gülöksüz, S. (2021) · Nöro Psikiyatri Arşivi · doi:10.29399/npa.27404 · Cited by 6 · see citing works
Flies, E. J., Pryor, A., Henderson‐Wilson, C., Turner, M., Roydhouse, J. K., Patrick, R., O’Shea, M., Norris, K., Martin, A. J., Marsh, P., et al. (2023) · Journal of Outdoor and Environmental Education · doi:10.1007/s42322-023-00143-3 · Cited by 6 · see citing works
“Further, since the COVID-19 pandemic, increasing demand for services (Bower et al., 2021; McGorry, 2022) has compounded existing workforce and capacity pressures (headspace, 2021) resulting in long waitlists for distressed young people (Seidler et al., 2020).”
Ratheesh, A., Gates, J., Hammond, D. A., Shelton, C. L., Macneil, C. A., Hasty, M. K., Dhar, A. K., D’Alfonso, S., Schmaal, L., Kessing, L. V., et al. (2025) · Early Intervention in Psychiatry · doi:10.1111/eip.70060 · Cited by 5 · see citing works
“…(300 mg) and lurasidone (60 mg). a Two participants started the depression specific journeys, but both did not complete 50% or more. both arms, attendance rates for those in ESC were lower than expected but broadly in line with Australian norms for similar settings (Seidler et al. 2020).”
Self-citationMughal, S., Alègre, M.-P., Sanchez-Allakhverdieva, A., Amoura, L., Liu, Y. S., Iyer, S. N., Capon, W., Iorfino, F., & Shah, J. L. (2025) · Psychiatric Services · doi:10.1176/appi.ps.20250050 · Cited by 5 · see citing works
Moran, P., Moreno-Betancur, M., Coffey, C., Spry, E., & Patton, G. (2022) · British Journal of Psychiatry · doi:10.1192/bjp.2022.3 · Cited by 5 · see citing works
“Such policies may reap wider social and health benefits, but our data suggest that intervening on these mediational targets would not, in their own right, significantly change the course of CMD.”
InfluentialKhan, J., Khan, J., Kumari, S., & Charan, D. (2024) · Cureus · doi:10.7759/cureus.54495 · Cited by 5 · see citing works
“In another study, by the end of one year, 71.2% of individuals had stopped receiving treatment for their mental illness [17].”
BackgroundMethodInfluentialExpectations versus reality: psychology trainees’ experiences working with men
Scaffidi, J., Wilson, M. J., Seidler, Z. E., & O’Shea, M. (2024) · Counselling Psychology Quarterly · doi:10.1080/09515070.2024.2373474 · Cited by 4 · see citing works
“Men are also significantly more likely to drop out of therapy early compared to women (Seidler et al., 2020).”
Self-citationWannan, C., Scott, I., Dwyer, D., Clark, S. R., Hartmann, S., Ye, R. R., Amminger, G. P., Yuen, H. P., Lavoie, S., Markulev, C., et al. (2024) · Schizophrenia Bulletin · doi:10.1093/schbul/sbae204 · Cited by 4 · see citing works
“47 Thus, basing intervention decisions solely on a transition/ non-transition binary may result in a large proportion of UHR individuals not receiving the required level of care.”
Fordham, E., Gao, C. X., Filia, K., O'Donoghue, B. N., Smith, C. L., Francey, S. M., Rickwood, D., Telford, N. R., Thompson, A. D., & Brown, E. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115478 · Cited by 4 · see citing works
“Previous studies have investigated elements of our findings, including the relationship between social disadvantage and engagement with early intervention services (Reynolds et al., 2019; Seidler et al., 2020).”
Self-citationHelp-seeking for young rural males disengaged from education
Clark, J. C., Bartik, W. J., Smith, P., & Rice, K. (2024) · Australian Journal of Psychology · doi:10.1080/00049530.2024.2430624 · Cited by 4 · see citing works
“Further, young rural males are at increased risk of premature disengagement from mental health treat-ment (Seidler et al., 2020).”
Bell, I. H., Li, C., Thompson, A., Ellinghaus, C., O’Sullivan, S., Reynolds, K. A., Wadley, G., Liu, Y., Bendall, S., Gleeson, J., et al. (2025) · JMIR Mental Health · doi:10.2196/70160 · Cited by 3 · see citing works
Evaluating the acceptability of ATMAN intervention for self-harm in youth in India: A pilot study
Aggarwal, S., Berk, M., Shah, N., Shah, A., Kondal, D., Patton, G. C., & Patel, V. (2023) · International Journal of Mental Health · doi:10.1080/00207411.2023.2230041 · Cited by 4 · see citing works
“A large, population-based sample of young people (12 – 25 year-old) attending mental health services in Australia showed session-by-session discontinuation rates of 14% to 19% across 10 sessions (Seidler et al., 2020).”
BackgroundSzkody, E. M., Chang, Y., & Schleider, J. L. (2023) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2023.2272935 · Cited by 3 · see citing works
“Due to these barriers, even adolescents living in rural areas who do access care are likely to end treatment earlier than their peers living in urban areas (Seidler et al., 2020).”
Garay, J. (2024) · International Journal of Indigenous Health · doi:10.32799/ijih.v19i1.41297 · Cited by 3 · see citing works
Boerma, M., Beel, N., Neill, J. T., Jeffries, C. H., Krishnamoorthy, G., & Guerri-Guttenberg, J. (2024) · Australian Psychologist · doi:10.1080/00050067.2024.2378119 · Cited by 2 · see citing works
“Neither have worked for, or are affiliated with, Menslink, yet align with their ethos to assist young Australian men to receive therapeutic support that is compatible with their preferences and relational styles.”
InfluentialSawrikar, V., Hodgins, M., Leung, S., Ardill‐Young, O., Curtis, J., & Lingam, R. (2025) · BMJ Open Quality · doi:10.1136/bmjoq-2024-003280 · Cited by 2 · see citing works
Burton, A. L., Hatoum, A. H., Berry, S. L., & Hamilton, B. A. (2024) · Discover Psychology · doi:10.1007/s44202-024-00122-9 · Cited by 2 · see citing works
“The average duration of care for a young person’s first episode of care is 17 weeks (119 ± 111.18 days), with engagement in services consisting of an average of 4.6 treatment sessions (± 4.4 sessions) [36].”
InfluentialOladeji, O., Simmons, J., & Baitwabusa, A. E. (2024) · Journal of Advances in Medicine and Medical Research · doi:10.9734/jammr/2024/v36i65457 · Cited by 2 · see citing works
Everson, G., Spring, B., Middleton, J., Richardson, A., & Gardiner, F. W. (2023) · Acta Psychologica · doi:10.1016/j.actpsy.2023.104122 · Cited by 1 · see citing works
Wallis, A. K., Westerveld, M. F., & McKenzie, M. L. (2025) · International Journal of Speech-Language Pathology · doi:10.1080/17549507.2025.2460589 · Cited by 1 · see citing works
“This cohort of adolescents can be a challenging group to engage in intervention across clinical settings, with many disengaging early from services (Seidler et al., 2020).”
Grenyer, B. F. S., Day, N. J. S., Denmeade, G., Ciarla, A., Davy, K., Reis, S. L., & Townsend, M. L. (2025) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-025-00281-8 · Cited by 1 · see citing works
“In a remote/rural area, these challenges are well known as families are often under stress and needing to move to seek work or escape from conflicts that are not easy to ignore in small towns (e.g., Humphreys et al., [32, 33].”
Help-Seeking for Australian Youth who experience Disadvantage: A Systematic Review
Clark, J. C., Bartik, W. J., Davies, R. L., & Rice, K. (2025) · Child & Youth Care Forum · doi:10.1007/s10566-025-09864-6 · Cited by 1 · see citing works
“Successful help-seeking relies on culturally responsive practice (Colucci et al., 2015; Seidler et al., 2020), yet mainstream mental health services are recognized to consistently disappoint (Malatzky et al., 2022; Posselt et al., 2017), which inhibits help-seeking (Saberi et al., 2021).”
Iorfino, F., Scott, E. M., & Hickie, I. B. (2022) · The Medical Journal of Australia · doi:10.5694/mja2.51425 · Cited by 1 · see citing works
Delivering Men’s Health Webinar
Health, G. A. O. M. (2022) · International Journal of Men s Social and Community Health · doi:10.22374/ijmsch.v5i1.78
Filia, K., Teo, S. M., Brennan, N., Freeburn, T., Baker, D. G., Browne, V., Ziou, M., Menssink, J. M., Watson, A., Brown, E., et al. (2023) · doi:10.31234/osf.io/nceuk
Self-citationLoneliness and Rurality: Important Risk Factors for Young Australians' Mental Health
Kaspar, M. C., Usher, K. J., & Rice, K. (2025) · International Journal of Mental Health Nursing · doi:10.1111/inm.70047
Does youth-friendly mental health care improve therapeutic engagement and psychosocial outcomes?
Allison, S. C., Bastiampillai, T. J., Kisely, S. R., & Looi, J. C. (2025) · Australasian Psychiatry · doi:10.1177/10398562251351445
Hobden, B., Pollock, L., Lau, V., Leask, S., & Fakes, K. (2025) · Behaviour Research and Therapy · doi:10.1016/j.brat.2025.104875
Seidler, Z. E., Wilson, M. J., Toogood, N., Oliffe, J. L., Kealy, D., Ogrodniczuk, J. S., Owen, J. J., Mackinnon, A., Le, L. K.-D., Mihalopoulos, C., et al. (2022) · Figshare · doi:10.6084/m9.figshare.20326443
Self-citationSeidler, Z. E., Wilson, M. J., Toogood, N., Oliffe, J. L., Kealy, D., Ogrodniczuk, J. S., Owen, J. J., Mackinnon, A., Le, L. K.-D., Mihalopoulos, C., et al. (2022) · Figshare · doi:10.6084/m9.figshare.20326452
Self-citationGregory, L., Dutton, T., Osuagwu, U. L., & Vines, R. F. (2024) · Figshare · doi:10.6084/m9.figshare.26592044
Seidler, Z. E., Wilson, M. J., Toogood, N., Oliffe, J. L., Kealy, D., Ogrodniczuk, J. S., Owen, J. J., Mackinnon, A. J., Le, L. K.-D., Mihalopoulos, C., et al. (2022) · Figshare · doi:10.6084/m9.figshare.20326449
Self-citationSeidler, Z. E., Wilson, M. J., Toogood, N., Oliffe, J. L., Kealy, D., Ogrodniczuk, J. S., Owen, J. J., Mackinnon, A., Le, L. K.-D., Mihalopoulos, C., et al. (2022) · Figshare · doi:10.6084/m9.figshare.20326446
Self-citationGregory, L., Dutton, T., Osuagwu, U. L., & Vines, R. F. (2024) · Figshare · doi:10.6084/m9.figshare.26592047
Tissera, T., Levitt, E. E., Boyd, J. E., Hewitt, J., Ip, J., Rosenau, F., & Hatchard, T. (2026) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2026.100636
Active counselling for child and adolescent mental health: A qualitative investigation
Marshall, P., Rozsas, V., Milner, C., Armstrong, T., Simpson, A., Jackson, B., & Dimmock, J. A. (2026) · Psychology of sport and exercise · doi:10.1016/j.psychsport.2026.103109 · Cited by 1 · see citing works
Ar, Y. (2026) · Psikiyatride Guncel Yaklasimlar · doi:10.18863/pgy.1823478
Service Use and Engagement in Youth Mental Healthcare: National Trends in Jigsaw (2017–2022)
Moore, J., Ryan, N., & O’Brien, S. (2026) · Early Intervention in Psychiatry · doi:10.1111/eip.70171
“…with males attending fewer sessions than females, echoing wider evidence that young men are less likely to seek and sustain mental health support (Seidler et al. 2020 Further research should also assess the effectiveness of targeted engagement strategies for males and other underrepresented…”
March, S., Hayixibayi, A., Rowe, A., Stevens, J. M., Zieschank, K. L., Donovan, C. L., & Spence, S. H. (2026) · Journal of Medical Internet Research · doi:10.2196/97810
Wright, D. A., Nguyen, T. P., Tollit, M. A., & Pang, K. C. (2026) · International Journal of Transgender Health · doi:10.1080/26895269.2026.2709506
Süren, S., & Baskiran, D. Y. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1927279
Vella, S. A., Liddelow, C., Lim, A., Swann, C., Arnold, E. R., Hufton, J. R., Goddard, S. G., O'Brien, V., Kelly, P., Mackinnon, A. J., et al. (2026) · Psychology of sport and exercise · doi:10.1016/j.psychsport.2026.103259
Croak, B., Lombardi, L., McGee, M., Wainwright, H., Rogers, B., Wilson, M. J., & Seidler, Z. E. (2026) · BMC Health Services Research · doi:10.1186/s12913-026-15647-z
Self-citation
- Authors
- Seidler, Z. E., Rice, S. M., Dhillon, H. M., Cotton, S. M., Telford, N. R., McEachran, J., & Rickwood, D. J.
- Affiliations
- The University of Sydney (AU)
- ORCID
- Venue
- Psychiatric Services
- Published
- 2020-11-01
- Volume
- 71
- Issue
- 11
- Pages
- 1104-1113
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W3049565971
- Cited by
- 83
- References
- 49
- Citations by year
- 2026: 9 · 2025: 13 · 2024: 18 · 2023: 16 · 2022: 13 · 2021: 10 · 2020: 4
- FWCI
- 11.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- youth mental health, treatment discontinuation, mental health service utilization, sociodemographic predictors, Aboriginal and Torres Strait Islander youth, rural youth, young men, treatment engagement, return to care
- MeSH terms
- Adolescent, Adult, Australia, Mental Disorders, Child, Humans, Male, Mental Health, Mental Health Services, Young Adult
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