Abstract
This month’s issue of the Australian and New Zealand Journal of Psychiatry focuses on child & youth mental health. This includes influences on developmental pathways such as adverse childhood experiences and digital environments, as well as barriers to subsequent care.
The developmental roots of suicidality and self-harm
Developmental pathways to suicidal ideation and behaviour are explored by Witt et al. (2025), who analysed data from the 2020–2022 National Study of Mental Health and Wellbeing (n = 14,753). Their findings indicated a ‘generational effect’’, where ‘Generation Z’ reported the highest hazards and the youngest age of onset for suicidal ideation, plans, self-harm and attempts compared to older cohorts. While adverse childhood experiences and lifetime mental health diagnoses remained important across all generations, their relative effects differed. For instance, in ‘Generation Z’ participants, exposure to suicide in others and witnessing parental violence were more strongly associated with early onset than in previous cohorts, with childhood sexual abuse being less strongly associated. Early onset of suicidal ideation and behaviour was especially associated with mental disorders in ‘Baby Boomers’.
Compounding these risks is the role of digital environments. Gillespie et al. (2026) conducted a systematic review and meta-analysis of 61 studies involving over 338,000 participants. They found that frequent screen use, particularly of smartphones at night, was associated with higher odds of non-suicidal self-injury (NSSI) and suicidal behaviours. Internet addiction and gaming disorders also emerged as correlates, although the possibility of bidirectionality could not be excluded for any of these associations. The picture was further complicated by the influence of sleep quality, psychological distress and lifestyle behaviours, all of which were associated with both screen time and suicidal ideation or behaviour. It is therefore possible that screen time may exacerbate existing vulnerabilities rather than uniformly causing new harm.
Environmental stressors and systemic vulnerability
The Australian context introduces unique environmental stressors, specifically the impact of climate-related disasters. Toit du et al. (2026) investigated the longitudinal effects of bushfire harm on adolescent mental health in a sample of 2967 participants aged 13–14 years old. Just over 5% reported bushfire-related harm, including evacuation, property damage or injury. Encouragingly, this was not a predictor of psychological symptoms at 24-month follow-up. Factors that were associated with poorer outcomes included the presence of baseline symptoms or a history of mental health problems, as well as adverse childhood experiences and gender or sexual diversity.
In terms of pathways to psychiatric care, Cheung et al. (2026) used a longitudinal population cohort of 9510 children to map mental health service use from birth to age 18. Approximately 50% had received care in primary, ambulatory or inpatient settings, with service use occurring more frequently in adolescence.
The quality and cultural rigour of care
The effectiveness of interventions depends on the quality of clinical guidelines and the cultural appropriateness of assessment tools. McKinlay et al. (2026) surveyed clinical practice guidelines published between 2019 and 2025, finding variable methodological quality across 20 guidelines. While high-quality guidance existed for conditions like attention deficit, neurodevelopmental, depressive, anxiety and eating disorders, major gaps remained for bipolar, trauma-related and neurocognitive conditions.
Finally, mainstream biomedical constructs often fail to reflect First Nations conceptualisations of health. O’Gradey-Lee et al. (2025) addressed this by developing the First Nations Cultural Validity Assessment Tool. This tool uses 10 criteria across three domains (psychometric properties, cultural validity and competency) to evaluate whether assessment measures aligned with First Nations frameworks of social–emotional wellbeing, representing a significant advance towards culturally safe mental health practice. The tool was designed by First Nations experts and piloted by clinicians. It demonstrated good inter-rater reliability, suggesting utility in the evaluation of assessment measure appropriateness in this context.
