Using longitudinal data from a large cohort of Australian adolescents, this study examines changes in depression, psychological distress and anxiety symptoms; associations between symptoms and social determinants (gender, cultural/linguistic diversity, family affluence, school socio-educational advantage, and geographic remoteness); and interactions between social determinants and effects on symptoms.

Among this cohort, elevated mental disorder symptoms were common and were associated with key social determinants. The study highlights the need to address adolescent mental health in public health policy, research and practice. Responses should proportionately target groups experiencing disproportionate burdens, including female and gender diverse adolescents; particularly those experiencing low affluence.

Key findings

• Cisgender females and gender diverse participants experienced heightened baseline symptoms and an increased growth in symptoms compared with cisgender males.
• Females in the lowest affluence group experienced compounded adversity, with heightened anxiety and depressive symptoms over-and-above the effects of affluence or gender alone.