Months on a waiting list: GPs become the safety net for teens in mental health limbo

For a teenager experiencing anxiety or depression, the weeks between a referral and a first specialist appointment are not empty time. They are a period in which symptoms can deepen, school attendance can falter, family relationships can fray, and the fragile decision to seek help can quietly unravel. New Australian research has now put numbers on that limbo, and the picture it paints is one of a primary care system absorbing demand that the specialist sector cannot meet. A survey of 190 general practitioners across Australia, conducted by Flinders University and the Black Dog Institute and published in the Australian Journal of Primary Health, found that reported waits averaged nearly two months to see a psychologist and around four months to see a psychiatrist. For adolescents in acute distress, those intervals are not administrative details; they are the difference between early intervention and escalation.

The survey’s most striking finding is not the length of the waits themselves but how clinicians judge them. Most of the GPs surveyed considered delays of this magnitude unacceptable, saying that young people should ideally begin receiving care within weeks rather than months. That professional consensus matters because it comes from the very doctors who manage the consequences of the delay. More than 90 percent of respondents said long waits increased the risk that young people would disengage from treatment, experience worsening symptoms, feel abandoned by the health system, and become less likely to seek help in the future. In other words, the waiting list is not a neutral queue in which patients simply hold their place. It is an active clinical risk factor, one that can erode the motivation that brought a teenager through the clinic door in the first place.

The study arrives amid mounting national concern about access to timely mental healthcare for children and young people in Australia. Recent data from the Australian Institute of Health and Welfare have highlighted a substantial mental health burden among young Australians, while the Royal Australian and New Zealand College of Psychiatrists has warned of a growing shortage of child and adolescent psychiatrists. That workforce shortfall carries a specific danger flagged by the college: children and adolescents may only reach specialist services once their needs have become complex, meaning the system encounters them later, when treatment is more demanding and outcomes are harder to secure. The Flinders and Black Dog Institute findings give that warning a primary care dimension, showing how the shortage cascades downward into everyday general practice.

The scale of the demand shock is evident in the survey’s own numbers. Eighty percent of the GPs reported having seen an increase in adolescents presenting with depression or anxiety over the previous year. Faced with that rising tide and with specialist appointments months away, most doctors did not simply refer and wait. More than 80 percent reported increasing the number of appointments they offered and expanding the support they provided to young patients during the waiting period. General practitioners, in effect, improvised an interim mental health service, scheduling extra consultations, monitoring risk, supporting parents, and trying to keep adolescents connected to care until a specialist became available.

Professor Bridianne O’Dea, Little Heroes Professor in Child and Adolescent Mental Health at the Flinders University Institute for Mental Health and Wellbeing, framed the human stakes of the delay in blunt terms. Young people are reaching out for support, she said, but many are left waiting too long for the care they need. For a teenager experiencing anxiety or depression, a delay of several months can feel like a lifetime, with parents worried, young people struggling, and GPs doing everything they can to support them while they wait. That description captures a triad of strain, the patient, the family, and the family doctor, all carrying the burden of a gap in the service system that none of them created.

Yet the survey also exposed a capability gap at the heart of this improvised safety net. Although GPs were overwhelmingly willing to step up their care, most rated their knowledge of the most effective strategies for supporting adolescents during the waiting period as only basic or adequate. This is a crucial technical distinction. Managing a young person’s mental health while they wait for specialist treatment is not the same as routine general practice; it involves monitoring clinical risk, maintaining engagement, and applying evidence-based interim support strategies that many GPs have had little formal training in. The researchers argue this is precisely where the system can intervene, by better equipping and supporting GPs during the waiting window rather than leaving them to improvise under pressure.

O’Dea described GPs as having become a vital safety net for young people caught in a stretched mental health system, providing ongoing mental healthcare while adolescents wait for specialist services. They are managing clinical risk, supporting families, and helping adolescents stay engaged with care, she said, often under significant pressure and without enough resources. The framing is important because it reframes the waiting period as a clinical phase in its own right, one with its own evidence base, its own best practices, and its own support needs, rather than as dead time between referral and treatment. Treating it that way, the researchers suggest, is an opportunity to reduce harm even before specialist capacity expands.

The findings add to growing calls from Australia’s mental health sector for earlier and more accessible support for children and young people, and O’Dea argues the challenge must be tackled on two fronts simultaneously. The first is structural: improving timely access to specialist services and reducing the wait times themselves. The second is interim: asking what can be done during the weeks and months between referral and treatment. Until specialist access improves, she said, providing safe, effective and accessible support during that period may help reduce distress and keep young people connected to treatment, rather than leaving families and GPs to navigate the wait alone. The distinction matters for policy, because investments in interim support and investments in workforce expansion are complementary, not competing, responses.

The research, a cross-sectional survey of general practitioners’ perspectives on wait times for adolescent mental health specialists and services in Australia, was led by O’Dea with colleagues from Flinders University and the Black Dog Institute and published in the Australian Journal of Primary Health. Its methodological approach, capturing the frontline view of 190 GPs nationwide, offers a ground-level measure of a problem that is usually discussed in workforce statistics and funding announcements. What the survey reveals is a system in which the first and often only point of contact for struggling teenagers is a general practitioner with limited specialist backup, limited interim-care training, and a waiting list measured in months. The researchers are now calling on GPs to take part in a new service pilot designed to support young people while they wait, a direct attempt to convert the survey’s central finding, that the waiting period is a clinical risk window, into a structured, evidence-based response. Whether that pilot can ease the pressure on families and doctors will depend on how quickly the sector acts on what its own frontline clinicians have made unmistakably clear.

Subject of Research: General practitioners' perspectives on wait times for adolescent mental health specialist services in Australia

Article Title: Teens wait months for mental healthcare as GPs step in to bridge the gap

Article References: Teens wait months for mental healthcare as GPs step in to bridge the gap. (n.d.). Original publication

Image Credits: AI Generated

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Keywords: adolescent mental health, general practitioners, wait times, Australia, Flinders University, Black Dog Institute, psychologists, psychiatrists, primary care, anxiety, depression, health workforce shortage