Abstract
BACKGROUND: Mental health (MH) issues are the leading cause of mortality for young people, highlighting the importance of timely, high-quality, and affordable care. However, recent trends show a deceleration in the growth of youth mental health (YMH) services capacity in Australia. Meanwhile, digital interventions hold significant potential to sustain and enhance YMH outcomes. OBJECTIVE: This study aimed to evaluate (1) the comparative impact of different services capacity growth trajectories on YMH outcomes and (2) whether digital interventions can offset rising demand and declining workforce capacity, to offer insights into strategic resource allocation for sustained improvements. METHODS: Participatory system dynamics modeling was used to investigate the impact of MH services capacity growth trajectories and digital interventions on YMH outcomes, with simulation results projected for 2025-2035. The study focused on individuals aged 15-24 years from a culturally diverse, rapidly expanding urban population in Australia. Outcomes assessed included years lived with psychological distress and disorders, MH-related emergency department presentations, and self-harm hospitalizations. RESULTS: Among the services modeled, doubling the growth rates for specialized MH services had the greatest impact (8.4% reduction in cumulative years lived with symptomatic mental disorder). Doubling the growth rates for specialized MH service, headspace (headspace National Youth Mental Health Foundation Ltd), and referrals to online services, together, could significantly enhance YMH outcomes. Compared to baseline, this strategic investment approach is projected to reduce cumulative years spent with symptomatic mental disorders, cumulative MH-related emergency department presentations, and cumulative self-harm hospitalizations by 14%, 6.4%, and 4.1%, respectively, from 2025 to 2035. Digital interventions alone produced comparable impacts to specialized services, but critically, could not prevent worsening outcomes when specialized services experienced degrowth. Combining digital interventions with expansion of specialized services yielded best outcomes with reductions of 15%, 5.1%, and 4.4% in these indicators, respectively. CONCLUSIONS: The findings emphasize digital technologies as an effective interim and long-term solution to mitigate the slow and uncertain growth in the specialized MH workforce. However, simulation results showed that achieving sustained long-term improvements necessitates concurrent investment in expanding the specialized MH workforce, as digital interventions alone cannot compensate for degradation in specialized services capacity. A strategic combined approach offers the most effective pathway to improving YMH outcomes.