

Australia has a successful adolescent immunisation program, routinely achieving high vaccine coverage for teenagers.
However, recent data shows the number of Australian teens receiving the recommended vaccines for their age group has fallen over three years during the COVID pandemic.
So how much have adolescent vaccination rates dropped, and why might this be? And how can we get back on track?
The National Immunisation Program provides a series of free vaccinations for Australian teenagers. These are:
These vaccines are primarily delivered through school-based immunisation programs and health services such as general practices.
They protect teenagers themselves from diseases, but also help reduce the spread of these diseases in the community.
For example, 2024 has seen a surge in whooping cough (pertussis) cases nationally. Although adolescents won’t necessarily get very sick with whooping cough, they can spread the disease. So the dTpa vaccine helps to protect vulnerable populations, including young babies.
HPV is a leading cause of genital warts and cervical cancer. Giving the HPV shot to young teenagers, before they might be exposed to the virus through sexual activity, provides the best protection against cervical cancer.
And older teenagers and young adults are among those at highest risk of meningococcal disease, which can be fatal. They’re also most likely to carry meningococcal bacteria in their nose and throat, and to spread it to others.
The most recent Annual Immunisation Coverage Report from the National Centre for Immunisation Research and Surveillance (NCIRS) shows a drop in vaccination coverage among teenagers between 2022 and 2023, while the previous report shows a drop from 2021 to 2022.
For example, the proportion of teens who had received their adolescent dose of dTpa in the year they turned 15 decreased from 87.3% in 2021, to 86.9% in 2022, to 85.5% in 2023.
Meanwhile, the proportion who had received one dose of meningococcal ACWY vaccine by age 17 fell from 76.1% in 2021, to 75.9% in 2022, to 72.8% in 2023.
Vaccination coverage among Indigenous teenagers dropped by similar amounts. For example, the proportion of Indigenous teens who had received one dose of meningococcal ACWY vaccine by age 17 fell from 66.7% in 2021 to 65.6% in 2022 to 62.3% in 2023.
Overall, in 2023, around one in four 18-year-olds hadn’t received all three of the nationally recommended adolescent vaccines.
These figures show a decline in vaccination coverage among teenagers over three years. This comes after several years of generally increasing coverage before the COVID pandemic.
While the decline has been modest, the downward trend is concerning. It leaves more teenagers – and members of the wider community – vulnerable to serious infectious diseases.
There are likely to be many contributing factors.
Although extended school closures and consequent disruption to school vaccination programs at the height of the pandemic likely played a role, these occurred almost exclusively in Victoria and New South Wales. So they can’t fully explain the ongoing drop in adolescent vaccination coverage across the country.
We don’t have good published data on what influences vaccine acceptance among teenagers. But given parents or guardians need to complete a consent form for their child to get vaccinated at school, we may be able to extrapolate from some of the challenges relating to childhood vaccination uptake.
The trends among teenagers have been consistent with a fall in the rates of younger children who are fully vaccinated. In 2023, 92.8% of one-year-olds were fully vaccinated, down from 94.8% in 2020. At five years old, the coverage rate in 2023 was 93.3%, down also from 94.8% in 2020.
A recent survey into barriers to childhood vaccination in Australia indicates a high proportion of parents who choose not to vaccinate young children have concerns about vaccine safety (48%) and effectiveness (40%). It’s possible the COVID pandemic has hindered vaccine acceptance.
Practical access barriers may also be hampering adolescent immunisation coverage. These might include lack of knowledge among parents about vaccines or immunisation schedules, complicated parental consent processes, school absenteeism, and lack of awareness of immunisation services outside school-based programs.
The NCIRS report for 2023 showed low HPV coverage for adolescents living in socioeconomically disadvantaged and remote locations. This suggests logistics such as transport may also play a role, especially for teens who miss vaccination during the school-based program.
We need research to better understand the factors influencing vaccine uptake among adolescents. This can help us design and implement strategies to improve vaccination coverage in this age group.
For example, understanding the factors influencing HPV vaccination uptake among Indigenous adolescents and ensuring equitable access to targeted and culturally appropriate HPV vaccine education strategies has significantly improved vaccination coverage for this group. HPV vaccine coverage for Indigenous women aged 17 to 25 is now higher than for the general population.
Parents can support their teenagers by talking to them about the importance of immunisation, listening to their concerns and answering any questions they may have. Consent forms will generally include information about the vaccine and the disease it protects against.
If your child misses out on receiving their vaccinations at school or doesn’t attend school, families can access free National Immunisation Program vaccines from their GP, pharmacy, local council or other health services.
Specialist immunisation services are also available in most states and territories. These services are for children and adolescents who are in high-risk groups or for families who are concerned about vaccinating their children.
Teenagers are the next generation of parents, and their attitudes towards immunisation will influence coverage rates of their children in the future. This is yet another reason we need to successfully address any concerns or barriers for this group around vaccination.
Archana Koirala, Paediatrician and Infectious Diseases Specialist, University of Sydney; Bianca Middleton, Senior Research Fellow, Menzies School of Health Research; Fiona Russell, Senior Principal Research Fellow; paediatrician; infectious diseases epidemiologist; vaccinologist, The University of Melbourne; Katrina Clark, Aboriginal Immunisation Manager at Hunter New England Population Health, Indigenous Knowledge, and Sophie Wen, Senior Lecturer, Faculty of Medicine, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
One of the most popular new year’s resolutions is making a commitment to healthier eating. Whether that’s eating more fruits and vegetables, cutting down on meat consumption or even becoming a vegetarian or vegan a few days a week.
While there are many benefits that can come from following a healthier diet, it’s important that any diet changes are made carefully. This is especially true if you’re someone who takes a prescription drug, as many health food staples can negatively interact with them.
Here are some common foods and drinks interactions you should know about:
To break down some prescription drugs in the body, the liver uses enzymes called cytochrome P450. But grapefruit juice contains chemical compounds called furanocoumarins which can block the action of these enzymes. If this happens, some drugs can accumulate in the body.
This includes ciclosporin, a drug that’s commonly used to prevent organ transplant rejection and manage symptoms of rheumatoid arthritis and skin conditions such as psoriasis. A build-up of ciclosporin can cause many side-effects, ranging from mild nausea and vomiting to kidney and liver damage.
Statins, often used to treat high cholesterol levels and prevent heart attacks and strokes, can also be affected by grapefruit juice through the same mechanism. Increased statin levels in the body can raise the risk of side-effects, including muscle breakdown, which is rare but serious.
Many other drugs can potentially interact with grapefruit juice as well – including amlodipine (a common high blood pressure drug) and sildenafil (an erectile dysfunction drug). If you take any of these prescriptions drugs, it’s best to talk to your doctor or pharmacist before drinking even small amounts of grapefruit juice. It may even be best to avoid it altogether.
Many fruits and fruit juices – especially from the citrus family – can affect the breakdown of drugs in the liver.
Pomegranate juice is also shown to block the liver enzymes which break down the anticoagulant drug warfarin. The drug is used to prevent blood clots from forming in people with heart arrhythmias such as atrial fibrillation or deep vein thrombosis.
Some reported cases suggest that pomegranate juice might increase the international normalised ratio (INR – the time taken for blood to clot) in patients taking warfarin. This means patients may be at higher risk of bleeding.
Pomegranate juice may also affect other drugs, such as tacrolimus, an anti-rejection drug used in organ transplants.
Similarly, a number of case reports suggest cranberry juice can also affect warfarin. There has been one reported death of a patient from bleeding after they had drunk cranberry juice for two weeks prior while taking warfarin.
But results from various studies are mixed – with some showing cranberry affects warfarin in the body while others don’t show any effect. Because of this, it may be worth checking the INR more often if you drink these juices or consider that any fluctuations in INR may be due to fruit juices.
Spinach, broccoli and kale are often hailed as healthy foods because they’re filled with nutrients while being low in calories. However, they’re also high in vitamin K, which is needed to activate certain clotting factors (proteins in the blood which help it clot).
This may be problematic for patients taking warfarin. Warfarin works by blocking vitamin K in order to prevent blood clots from forming. But eating foods rich in vitamin K can lower your INR and increase the risk of developing a blood clot.
It’s important to have a healthy diet – but be sure to monitor your INR levels or speak to your doctor if you do introduce more vitamin K-rich foods into your diet.
Milk and dairy-rich foods such as cheese and yoghurt are all good sources of protein and calcium – a mineral required for healthy bones.
But these foods can affect the absorption of some drugs in the gut. This includes antibiotics such as some tetracyclines and ciprofloxacin. The calcium in the milk can bind to the antibiotic, meaning it cannot be absorbed into the bloodstream. This means the body will not get the full dose of antibiotic – making it harder for it to fight the infection.
Other drugs affected by dairy include levothyroxine, a drug used for patients with low thyroid levels.
But as these interactions happen in the gut, this means you can still have dairy even if you take these drugs. In most cases, you just need to leave at least a two-hour gap either before or after taking the drug before consuming dairy.
Beans are considered healthy as they’re high in fibre and vitamins and minerals. Beans are also a great source of plant-based protein.
But soybeans, broad beans (fava beans) and snow peas may be high in tyramine. While tyramine is a substance naturally found in the body and in certain foods (such as aged cheeses, cured meats and fermented foods), it can interact with the antidepressant phenelzine.
Phenelzine is a monoamine oxidase inhibitor antidepressant (MAOI), which is less commonly used nowadays. The drug blocks enzymes which break down tyramine in the body. If patients eat tyramine-rich foods, this may result in high levels of tyramine, potentially leading to a dangerous rise in blood pressure. Only MAOI antidepressants, such as phenelzine, isocarboxazid, tranylcypromine, are affected by tyramine.
A healthy diet can improve your overall health in many ways. Just be sure to consult with a doctor of pharmacist before drastically changing your diet – particularly if you take prescription medications.
Dipa Kamdar, Senior Lecturer in Pharmacy Practice, Kingston University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Drug companies are paying Australian doctors millions of dollars a year to fly to overseas conferences and meetings, give talks to other doctors, and to serve on advisory boards, our research shows.
Our team analysed reports from major drug companies, in the first comprehensive analysis of its kind. We found drug companies paid more than A$33 million to doctors in the three years from late 2019 to late 2022 for these consultancies and expenses.
We know this underestimates how much drug companies pay doctors as it leaves out the most common gift – food and drink – which drug companies in Australia do not declare.
Due to COVID restrictions, the timescale we looked at included periods where doctors were likely to be travelling less and attending fewer in-person medical conferences. So we suspect current levels of drug company funding to be even higher, especially for travel.
Since 2019, Medicines Australia, the trade association of the brand-name pharmaceutical industry, has published a centralised database of payments made to individual health professionals. This is the first comprehensive analysis of this database.
We downloaded the data and matched doctors’ names with listings with the Australian Health Practitioner Regulation Agency (Ahpra). We then looked at how many doctors per medical specialty received industry payments and how much companies paid to each specialty.
We found more than two-thirds of rheumatologists received industry payments. Rheumatologists often prescribe expensive new biologic drugs that suppress the immune system. These drugs are responsible for a substantial proportion of drug costs on the Pharmaceutical Benefits Scheme (PBS).
The specialists who received the most funding as a group were cancer doctors (oncology/haematology specialists). They received over $6 million in payments.
This is unsurprising given recently approved, expensive new cancer drugs. Some of these drugs are wonderful treatment advances; others offer minimal improvement in survival or quality of life.
A 2023 study found doctors receiving industry payments were more likely to prescribe cancer treatments of low clinical value.
Our analysis found some doctors with many small payments of a few hundred dollars. There were also instances of large individual payments.
Doctors usually believe drug company promotion does not affect them. But research tells a different story. Industry payments can affect both doctors’ own prescribing decisions and those of their colleagues.
A US study of meals provided to doctors – on average costing less than US$20 – found the more meals a doctor received, the more of the promoted drug they prescribed.
Another study found the more meals a doctor received from manufacturers of opioids (a class of strong painkillers), the more opioids they prescribed. Overprescribing played a key role in the opioid crisis in North America.
Overall, a substantial body of research shows industry funding affects prescribing, including for drugs that are not a first choice because of poor effectiveness, safety or cost-effectiveness.
Then there are doctors who act as “key opinion leaders” for companies. These include paid consultants who give talks to other doctors. An ex-industry employee who recruited doctors for such roles said:
Key opinion leaders were salespeople for us, and we would routinely measure the return on our investment, by tracking prescriptions before and after their presentations […] If that speaker didn’t make the impact the company was looking for, then you wouldn’t invite them back.
The best available evidence on the effects of pharmaceutical industry funding on prescribing comes from the US government-run program called Open Payments.
Since 2013, all drug and device companies must report all payments over US$10 in value in any single year. Payment reports are linked to the promoted products, which allows researchers to compare doctors’ payments with their prescribing patterns.
Analysis of this data, which involves hundreds of thousands of doctors, has indisputably shown promotional payments affect prescribing.
US research also shows that doctors who had studied at medical schools that banned students receiving payments and gifts from drug companies were less likely to prescribe newer and more expensive drugs with limited evidence of benefit over existing drugs.
In general, Australian medical faculties have weak or no restrictions on medical students seeing pharmaceutical sales representatives, receiving gifts, or attending industry-sponsored events during their clinical training. They also have no restrictions on academic staff holding consultancies with manufacturers whose products they feature in their teaching.
So a first step to prevent undue pharmaceutical industry influence on prescribing decisions is to shelter medical students from this influence by having stronger conflict-of-interest policies, such as those mentioned above.
A second is better guidance for individual doctors from professional organisations and regulators on the types of funding that is and is not acceptable. We believe no doctor actively involved in patient care should accept payments from a drug company for talks, international travel or consultancies.
Third, if Medicines Australia is serious about transparency, it should require companies to list all payments – including those for food and drink – and to link health professionals’ names to their Ahpra registration numbers. This is similar to the reporting standard pharmaceutical companies follow in the US and would allow a more complete and clearer picture of what’s happening in Australia.
Patients trust doctors to choose the best available treatments to meet their health needs, based on scientific evidence of safety and effectiveness. They don’t expect marketing to influence that choice.
Barbara Mintzes, Professor, School of Pharmacy and Charles Perkins Centre, University of Sydney and Malcolm Forbes, Consultant psychiatrist and PhD candidate, Deakin University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Myopia in children is on the rise. The condition – also known as shortsightedness – already affects up to 35% of children across the world, according to a recent review of global data. The researchers predict this number will increase to 40%, exceeding 740 million children living with myopia by 2050.
So why does this matter? Many people may be unaware that treating myopia (through interventions such as glasses) is about more than just comfort or blurry vision. If left unchecked, myopia can rapidly progress, increasing the risk of serious and irreversible eye conditions. Diagnosing and treating myopia is therefore crucial for your child’s lifetime eye health.
Here is how myopia develops, the role screen time plays – and what you can do if think your child might be shortsighted.
Myopia is commonly known as nearsightedness or shortsightedness. It is a type of refractive error, meaning a vision problem that stops you seeing clearly – in this case, seeing objects that are far away.
A person usually has myopia because their eyeball is longer than average. This can happen if eyes grow too quickly or longer than normal.
A longer eyeball means when light enters the eye, it’s not focused properly on the retina (the light-sensing tissue lining the back of the eye). As a result, the image they see is blurry. Controlling eye growth is the most important factor for achieving normal vision.
The study published earlier this year looked at how the rate of myopia has changed over the last 30 years. It reviewed 276 studies, which included 5.4 million people between the ages of 5–19 years, from 50 countries, across six continents.
Based on this data, the researchers concluded up to one in three children are already living with shortsightedness – and this will only increase. They predict a particular rise for adolescents: myopia is expected to affect more than 50% of those aged 13-19 by 2050.
Their results are similar to a previous Australian study from 2015. It predicted 36% of children in Australia and New Zealand would have myopia by 2020, and more than half by 2050.
The new review is the most comprehensive of its kind, giving us the closest look at how childhood myopia is progressing across the globe. It suggests rates of myopia are increasing worldwide – and this includes “high myopia”, or severe shortsightedness.
Myopia develops partly due to genetics. Parents who have myopia – and especially high myopia – are more likely to have kids who develop myopia as well.
But environmental factors can also play a role.
One culprit is the amount of time we spend looking at screens. As screens have shrunk, we tend to hold them closer. This kind of prolonged focusing at short range has long been associated with developing myopia.
Reducing screen time may help reduce eye strain and slow myopia’s development. However for many of us – including children – this can be difficult, given how deeply screens are embedded in our day-to-day lives.
Higher rates of myopia may also be linked to kids spending less time outside, rather than screens themselves. Studies have shown boosting time outdoors by one to two hours per day may reduce the onset of myopia over a two to three year period.
We are still unsure how this works. It may be that the greater intensity of sunlight – compared to indoor light – promotes the release of dopamine. This crucial molecule can slow eye growth and help prevent myopia developing.
However current research suggests once you have myopia, time outdoors may only have a small effect on how it worsens.
Research is rapidly developing in myopia control. In addition to glasses, optometrists have a range of tools to slow eye growth and with it, the progression of myopia. The most effective methods are:
orthokeratology (“ortho-K”) uses hard contact lenses temporarily reshape the eye to improve vision. They are convenient as they are only worn while sleeping. However parents need to make sure lenses are cleaned and stored properly to reduce the chance of eye infections
atropine eyedrops have been shown to successfully slow myopia progression. Eyedrops can be simple to administer, have minimal side effects and don’t carry the risk of infection associated with contact lenses.
Myopia is easily corrected by wearing glasses or contact lenses. But if you have “high myopia” (meaning you are severely shortsighted) you have a higher risk of developing other eye conditions across your lifetime, and these could permanently damage your vision.
These conditions include:
retinal detachment, where the retina tears and peels away from the back of the eye
glaucoma, where nerve cells in the retina and optic nerve are progressively damaged and lost
myopic maculopathy, where the longer eyeball means the macula (part of the retina) is stretched and thinned, and can lead to tissue degeneration, breaks and bleeds.
It’s important to diagnose and treat myopia early – especially high myopia – to stop it progressing and lower the risk of permanent damage.
Uncorrected myopia can also affect a child’s ability to learn, simply because they can’t see clearly. Signs your child might need to be tested can include squinting to see into the distance, or moving things closer such as a screen or book to see.
Regular eye tests with the optometrist are the best way to understand your child’s eye health and eyesight. Each child is different – an optometrist can help you work out tailored methods to track and manage myopia, if it is diagnosed.
Flora Hui, Honorary Fellow, Department of Optometry and Vision Sciences, Melbourne School of Health Sciences, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
When we start to go grey depends a lot on genetics.
Your first grey hairs usually appear anywhere between your twenties and fifties. For men, grey hairs normally start at the temples and sideburns. Women tend to start greying on the hairline, especially at the front.
The most rapid greying usually happens between ages 50 and 60. But does anything we do speed up the process? And is there anything we can do to slow it down?
You’ve probably heard that plucking, dyeing and stress can make your hair go grey – and that redheads don’t. Here’s what the science says.
Each strand of hair is produced by a hair follicle, a tunnel-like opening in your skin. Follicles contain two different kinds of stem cells:
There are two main types of melanin that determine hair colour. Eumelanin is a black-brown pigment and pheomelanin is a red-yellow pigment.
The amount of the different pigments determines hair colour. Black and brown hair has mostly eumelanin, red hair has the most pheomelanin, and blonde hair has just a small amount of both.
As we age, it’s normal for cells to become less active. In the hair follicle, this means stem cells produce less melanin – turning our hair grey – and less keratin, causing hair thinning and loss.
As less melanin is produced, there is less pigment to give the hair its colour. Grey hair has very little melanin, while white hair has none left.
Unpigmented hair looks grey, white or silver because light reflects off the keratin, which is pale yellow.
Grey hair is thicker, coarser and stiffer than hair with pigment. This is because the shape of the hair follicle becomes irregular as the stem cells change with age.
Interestingly, grey hair also grows faster than pigmented hair, but it uses more energy in the process.
Yes, stress can cause your hair to turn grey. This happens when oxidative stress damages hair follicles and stem cells and stops them producing melanin.
Oxidative stress is an imbalance of too many damaging free radical chemicals and not enough protective antioxidant chemicals in the body. It can be caused by psychological or emotional stress as well as autoimmune diseases.
Environmental factors such as exposure to UV and pollution, as well as smoking and some drugs, can also play a role.
Melanocytes are more susceptible to damage than keratinocytes because of the complex steps in melanin production. This explains why ageing and stress usually cause hair greying before hair loss.
Scientists have been able to link less pigmented sections of a hair strand to stressful events in a person’s life. In younger people, whose stems cells still produced melanin, colour returned to the hair after the stressful event passed.
1. Does plucking a grey hair make more grow back in its place?
No. When you pluck a hair, you might notice a small bulb at the end that was attached to your scalp. This is the root. It grows from the hair follicle.
Plucking a hair pulls the root out of the follicle. But the follicle itself is the opening in your skin and can’t be plucked out. Each hair follicle can only grow a single hair.
It’s possible frequent plucking could make your hair grey earlier, if the cells that produce melanin are damaged or exhausted from too much regrowth.
2. Can my hair can turn grey overnight?
Legend says Marie Antoinette’s hair went completely white the night before the French queen faced the guillotine – but this is a myth.
Melanin in hair strands is chemically stable, meaning it can’t transform instantly.
Acute psychological stress does rapidly deplete melanocyte stem cells in mice. But the effect doesn’t show up immediately. Instead, grey hair becomes visible as the strand grows – at a rate of about 1 cm per month.
Not all hair is in the growing phase at any one time, meaning it can’t all go grey at the same time.
3. Will dyeing make my hair go grey faster?
This depends on the dye.
Temporary and semi-permanent dyes should not cause early greying because they just coat the hair strand without changing its structure. But permanent products cause a chemical reaction with the hair, using an oxidising agent such as hydrogen peroxide.
Accumulation of hydrogen peroxide and other hair dye chemicals in the hair follicle can damage melanocytes and keratinocytes, which can cause greying and hair loss.
4. Is it true redheads don’t go grey?
People with red hair also lose melanin as they age, but differently to those with black or brown hair.
This is because the red-yellow and black-brown pigments are chemically different.
Producing the brown-black pigment eumelanin is more complex and takes more energy, making it more susceptible to damage.
Producing the red-yellow pigment (pheomelanin) causes less oxidative stress, and is more simple. This means it is easier for stem cells to continue to produce pheomelanin, even as they reduce their activity with ageing.
With ageing, red hair tends to fade into strawberry blonde and silvery-white. Grey colour is due to less eumelanin activity, so is more common in those with black and brown hair.
Your genetics determine when you’ll start going grey. But you may be able to avoid premature greying by staying healthy, reducing stress and avoiding smoking, too much alcohol and UV exposure.
Eating a healthy diet may also help because vitamin B12, copper, iron, calcium and zinc all influence melanin production and hair pigmentation.
Theresa Larkin, Associate Professor of Medical Sciences, University of Wollongong
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Mental illnesses such as depression and anxiety disorders have become more prevalent, especially among young people. Demand for treatment is surging and prescriptions of some psychiatric medications have climbed.
These upswinging prevalence trends are paralleled by rising public attention to mental illness. Mental health messages saturate traditional and social media. Organisations and governments are developing awareness, prevention and treatment initiatives with growing urgency.
The mounting cultural focus on mental health has obvious benefits. It increases awareness, reduces stigma and promotes help-seeking.
However, it may also have costs. Critics worry social media sites are incubating mental illness and that ordinary unhappiness is being pathologised by the overuse of diagnostic concepts and “therapy speak”.
British psychologist Lucy Foulkes argues the trends for rising attention and prevalence are linked. Her “prevalence inflation hypothesis” proposes that increasing awareness of mental illness may lead some people to diagnose themselves inaccurately when they are experiencing relatively mild or transient problems.
Foulkes’ hypothesis implies that some people develop overly broad concepts of mental illness. Our research supports this view. In a new study, we show that concepts of mental illness have broadened in recent years – a phenomenon we call “concept creep” – and that people differ in the breadth of their concepts of mental illness.
In our new study, we examined whether people with broad concepts of mental illness are, in fact, more likely to self-diagnose.
We defined self-diagnosis as a person’s belief they have an illness, whether or not they have received the diagnosis from a professional. We assessed people as having a “broad concept of mental illness” if they judged a wide variety of experiences and behaviours to be disorders, including relatively mild conditions.
We asked a nationally representative sample of 474 American adults if they believed they had a mental disorder and if they had received a diagnosis from a health professional. We also asked about other possible contributing factors and demographics.
Mental illness was common in our sample: 42% reported they had a current self-diagnosed condition, a majority of whom had received it from a health professional.
Unsurprisingly, the strongest predictor of reporting a diagnosis was experiencing relatively severe distress.
The second most important factor after distress was having a broad concept of mental illness. When their levels of distress were the same, people with broad concepts were substantially more likely to report a current diagnosis.
The graph below illustrates this effect. It divides the sample by levels of distress and shows the proportion of people at each level who report a current diagnosis. People with broad concepts of mental illness (the highest quarter of the sample) are represented by the dark blue line. People with narrow concepts of mental illness (the lowest quarter of the sample) are represented by the light blue line. People with broad concepts were much more likely to report having a mental illness, especially when their distress was relatively high.
People with greater mental health literacy and less stigmatising attitudes were also more likely to report a diagnosis.
Two interesting further findings emerged from our study. People who self-diagnosed but had not received a professional diagnosis tended to have broader illness concepts than those who had.
In addition, younger and politically progressive people were more likely to report a diagnosis, consistent with some previous research, and held broader concepts of mental illness. Their tendency to hold these more expansive concepts partially explained their higher rates of diagnosis.
Our findings support the idea that expansive concepts of mental illness promote self-diagnosis and may thereby increase the apparent prevalence of mental ill health. People who have a lower threshold for defining distress as a disorder are more likely to identify themselves as having a mental illness.
Our findings do not directly show that people with broad concepts over-diagnose or those with narrow concepts under-diagnose. Nor do they prove that having broad concepts causes self-diagnosis or results in actual increases in mental illness. Nevertheless, the findings raise important concerns.
First, they suggest that rising mental health awareness may come at a cost. In addition to boosting mental health literacy it may increase the likelihood of people incorrectly identifying their problems as pathologies.
Inappropriate self-diagnosis can have adverse effects. Diagnostic labels may become identity-defining and self-limiting, as people come to believe their problems are enduring, hard-to-control aspects of who they are.
Second, unwarranted self-diagnosis may lead people experiencing relatively mild levels of distress to seek help that is unnecessary, inappropriate and ineffective. Recent Australian research found people with relatively mild distress who received psychotherapy worsened more often than they improved.
Third, these effects may be particularly problematic for young people. They are most liable to hold broad concepts of mental illness, in part due to social media consumption, and they experience mental ill health at relatively high and rising rates. Whether expansive concepts of illness play a role in the youth mental health crisis remains to be seen.
Ongoing cultural shifts are fostering increasingly expansive definitions of mental illness. These shifts are likely to have mixed blessings. By normalising mental illness they may help to remove its stigma. However, by pathologising some forms of everyday distress, they may have an unintended downside.
As we wrestle with the mental health crisis, it is crucial we find ways to increase awareness of mental ill health without inadvertently inflating it.
Jesse Tse, PhD Candidate at Melbourne School of Psychological Sciences, The University of Melbourne and Nick Haslam, Professor of Psychology, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.