Mental ill-health in rural and metropolitan dwelling Australian youth during the first COVID-19 wave

The onset of the COVID-19 pandemic and associated mitigation measures have been associated with significant levels of psychological distress. Published research on Australian youth has highlighted poor mental health in this population during the pandemic; however, no studies have reported data using clinical self-report measures from the first pandemic wave, and no data exist that compare rural versus metropolitan populations, despite notable preexisting vulnerabilities in rural youth. Data were collected from 718 residents of New South Wales between 16 and 25 years of age (M_age = 21.1 ± 2.80 years, 78.3% female). Participants were subdivided into “rural and remote” (n =66) to compare against “inner regional” (n =243) and “major metropolitan” (n =409) dwellers. Mental health measures assessed depression, anxiety, stress, adjustment disorder, posttraumatic stress disorder, substance misuse, and psychological resilience. Results indicated that irrespective of location, high levels of distress were reported. Rural/ regional participants reported higher adjustment disorder symptoms and lower trait resilience than metropolitan participants. Inner regional participants also reported higher depression, stress, and problematic drug and alcohol use symptoms. Rural and remote dwellers had an increased likelihood of extremely severe depression (_adjOR 1.79, 95% CI [1.00, 3.18]) and stress (_adjOR 2.54, 95% CI [1.24, 5.20]) compared to metropolitan dwellers. The inner regional dwellers were at a 48% increased likelihood of problematic drug or alcohol use (_adjOR 1.48, 95% CI [1.05, 2.10]). Results underscore the prevalence of mental ill-health in Australian youth at the start of the pandemic, as well as the relatively higher mental health burden in rural youth.