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Young people often face significant challenges accessing effective mental health support as they navigate through complex healthcare systems, education pathways, and social pressures. Understanding the service-level barriers they encounter is critical to improving mental health system design and delivery. While previous studies have examined individual barriers to mental healthcare access, few have adopted a cross-sectorial, youth-informed approach which captures the interrelated structural, institutional, and socio-cultural factors influencing young people’s mental health experiences.

Seventeen participants aged 18–24 years with lived experience of depression and/or anxiety participated in nine in-person focus groups and interviews in Perth. Reflexive thematic analysis was used to identify systemic barriers and facilitators to mental healthcare, with a particular focus on access, care coordination, therapeutic engagement, and service responsiveness.

Key themes included fragmented care pathways, inadequate provider follow-up, prolonged wait times, financial constraints, lack of youth-specific mental health training among clinicians, and limited therapeutic rapport. Participants also described inadequate mental health literacy within schools and persistent stigma in social and familial settings. These intersecting barriers hindered access, disrupted continuity of care, and undermined trust in the mental health system.

Findings highlight critical inefficiencies in mental health service delivery for young Australians. Policy responses should prioritise integrated care models, investment in multidisciplinary youth mental health hubs, improved school-based mental health literacy, and culturally inclusive anti-stigma initiatives to promote access, trust, and continuity of care.