Abstract
BACKGROUND: Australia has a high mental illness burden, especially among young women. It is known that people in urban areas, with more education and higher incomes are more likely to use Better Access services (mental health treatment plans and psychological treatments), while those in rural areas, or with lower education or incomes, disproportionately use antidepressants. During the COVID-19 period, the Australian government increased access to mental health care. Our aim was to investigate how rurality, education level and perceived ability to manage with income influenced young women's use of mental health treatment plans, psychological treatments and antidepressants separately or in various combinations (2019-2022). METHODS: Survey and linked administrative data from 7642 women from the Australian Longitudinal Study on Women's Health were used. Relative risk ratios and 95% confidence intervals for associations between sociodemographic factors and use of mental health treatment plans and treatments were estimated using multinomial logistic regression. RESULTS: Women in rural/remote areas (vs metropolitan areas) were less likely to have a mental health treatment plan (with/without antidepressants), difficulty managing with available income (vs not too bad/easy) was associated with having a mental health treatment plan and using antidepressants. High school-educated women (vs university-educated) were more likely to use antidepressants only (relative risk ratio = 1.60; 95% confidence interval = [1.24, 2.07]). Among women with mental health treatment plans (n = 3525), those in rural/remote areas (relative risk ratio = 2.00; 95% confidence interval = [1.13, 3.53]) and women not university-educated were more likely to use antidepressants without psychological treatment. CONCLUSION: Sociodemographically disadvantaged young women disproportionately used antidepressants without Better Access services. Evidence-based interventions to reduce these inequities should be a priority.