Canberra teens consistently report some of the highest rates of psychological distress in the country, according to a new survey released on Wednesday
Now in its seventh year, the study by Mission Australia and the Black Dog Institute is the largest of its kind, drawing on input from almost 27,000 Australians aged 15 to 19.
Of the 321 surveyed in Canberra last year, more than a quarter said they were struggling with their mental health, a majority of whom were girls. In that same period, almost half of Indigenous teens reported psychological distress - the highest proportion of any jurisdiction for the seventh year in a row.
Black Dog said the ACT results, which were down from 2016 and 2017 but remain among the worst in the country, reflect increasing rates of psychological distress among young people Australia-wide.
Chief scientist Helen Christensen said teens mentioned difficulties coping with school stress, family conflict, bullying and body image but said it was unclear what exactly was behind the alarming figures.
"We're still in the dark as to why their suicide risk is going up but it's not unique to Australia," Professor Christensen.
The ACT, like the NT and WA, had a smaller sample size than some jurisdictions, she said, but had returned consistently high results over the life of the survey and warranted further investigation.
Those on the ground in the ACT say it reflects what they're seeing at the coalface - in support services and emergency departments, as well as other data
Justin Barker at the ACT Youth Coalition said waiting lists were still months long for services like headspace while GPs in Canberra remained notoriously expensive.
"At the moment the system's still not working particularly well," he said. "Young people say they are struggling, they're worried about more than just school, it's will they be able to buy a house, or get a job, what's going to happen to the planet?"
Dr Barker welcomed the government's recent commitments to open a dedicated eating disorder unit as well as a second headspace for Canberra, this time in the city's south. But he said more work needed to be done to address the "nuts and bolts" of the problem - from crisis beds to early intervention.
"Another headspace is great but it's not going to stem the tide of mental health problems, it'll only make a dent, school psychologists are all booked up too," he said.
Year 12 student Matilda Webb said she waited months to see a counsellor after finally working up the courage to approach her school for help this year. She and her classmates said the pressure on young people was intense, particularly during their final year of school, but support was uneven.
"I've just moved out of home, I'm juggling work and study, I'm transgender and transitioning and I've been really sick," said student Remus Douglas.
"I ended up having to drop out of my [Year 12 certificate]. There needs to be more education in schools about mental health and where to go for help, and better sex ed."
While more young people are seeking help online, many still face major barriers to getting support. Some surveyed said they were too embarrassed. One in five felt they had no one to turn to and those in psychological distress were less likely to ask for help.
Leila Craemer-Banks, 17, said even once treatment arrived it was often costly and time-consuming, difficult to juggle on top of school commitments. She's spent the past year juggling premiere league soccer, international band gigs, injury and Year 12.
"We don't get mental health days, all we get is one day a year RUOK? day," she said. "It's not enough."
Matilda said that while adults often encouraged students to "prioritise" by putting study before extracurricular commitments, volunteering or school social clubs were important for their mental health.
"We need that time too," she said. "I feel like we're not heard, not at school or by our families, certainly not by politicians."
A government spokeswoman said the ACT often had higher levels of self-reporting than other jurisdictions due to increased "levels of community awareness".
Dr Barker said research showed that often, paradoxically, places of high socioeconomic advantage like Finland or Canberra did see increased mental health problems. But he stressed the service system was still a bottleneck in need of reform.
The government said it was reviewing mental health supports for young people to identify gaps.
On Tuesday, Mental Health Minister Shane Rattenbury revealed the ACT will also roll out a targeted mental health program for Year 9 students in 2020. Adapted by Black Dog for Australian schools, the five session program has already been in place over the border for the past two years, and will be delivered through Commonwealth funding by external experts.
Professor Christensen said more jurisdictions should follow the lead of NSW, which had also begun mental health screening in schools.
"About 50 per cent of kids who are flagged aren't known to their counsellor," she said. "We can prevent a lot of depression if we do this kind of early intervention and it can be really soft stuff, maybe they use a mindfulness app, maybe they see their school psychologist."
The ACT government has so far stopped short of committing to calls for more school psychologists or social workers in schools - a key recommendation of a recent inquiry into schoolyard violence and bullying - but said it was considering ramping up its number of youth workers. In this year's budget, extra money was also set aside to fund a mental health nurse at Indigenous youth service Gugan Gulwan.
Suicide remains the leading cause of death among young people and about 75 per cent of mental illness develops before the age of 25.
Mission Australia state director Nada Nasser described the 2018 ACT results - in which nearly half of 17-year-olds reported psychological distress - as deeply concerning.
"Youth mental challenge is a serious challenge here in the ACT, and across the country, and it must be addressed as a priority," she said.
Elizabeth Moore, coordinator-general of the ACT Office for Mental Health and Wellbeing, agreed early intervention was crucial.
"We need to let our children and young people know that we can hear them, that we're here for them," Dr Moore said.
Find a headspace centre or chat online at headspace.org.au