The National Surveys of Mental Health and Wellbeing (NSMHWB) are Australia’s largest life-course epidemiological surveys of mental disorders to date, the most recent of which was carried out between 2020 and 2022 (N=15,893).

These surveys are instrumental in defining the scope of mental disorders in the general population, the distribution of these disorders among subgroups in the population and the severity, impact and service use associated with these disorders.

Research from these surveys has shown that “nearly half of the Australian population (45.5%) met criteria for an anxiety, affective and/or substance use disorder at some stage in their lifetime”.

The Matilda Centre leads a program of work using data from these surveys to publish and disseminate the epidemiological evidence necessary to catalyse change in mental health service delivery.

Major areas of investigation include: reporting the overall prevalence of mental and substance use disorders, exploring demographic factors related to mental and substance use disorders, investigating changing trends over time, and examining extent and type of services used by people experiencing mental and substance use disorders.

Effective prevention is built on accurate risk factor identification. Identifying changing patterns of risk for mental health and substance use holds enormous potential to improve prevention outcomes in Australia and globally.

Existing research has advanced our understanding of the way in which single risks contribute to single mental or substance use outcomes, typically at static points in time.

However, there is scant research into the complex interplay between individual, community and societal risk factors in explaining the development of multiple outcomes over time.

Only by considering individual and broader macro-level determinants of mental health and substance use problems, at the same time, can we accelerate the identification of maximally predictive risk factor combinations.

Complementing the search for macro-level risk factors is the growing recognition that individual differences in the developing adolescent brain can be powerful contributors to risk.

This project brings together multiple datasets and takes a comprehensive, socio-ecological approach to investigate how these micro (brain)- to macro (society)-level factors uniquely and synergistically predict the development of mental and substance use disorders.

There are specific periods across the lifespan when the brain appears to be particularly sensitive to the impacts of alcohol exposure. During gestation, exposure to heavy alcohol use can result in severe neurodevelopmental consequences, including fetal alcohol spectrum disorder (FASD).

Heavy alcohol use in adolescence alters the trajectory of brain development, particularly in the prefrontal areas responsible for planning, judgement and decision-making.

In older adults, alcohol use disorder is the strongest modifiable risk factor for dementia when compared with established risk factors such as hypertension, diabetes and smoking.

This project uses data harmonisation, robust epidemiological methods, and novel statistical techniques to better understand the relationship between alcohol use and the brain across the lifespan.

Contributing studies from around the globe include the Adolescent Brain Cognitive Development (ABCD) Study, the National Consortium on Alcohol and Neurodevelopment in Adolescence-Adulthood (NCANDA-A), the IMAGEN Consortium, the UK Biobank, the LIFE Study, and the Sydney Memory and Ageing Study (MAS). 

This project provides a unique opportunity to use data from large population-based neuroimaging datasets to robustly model the neurobiological predictors and consequences of alcohol use at key periods across the lifespan within a unified framework.

This research will generate critical new knowledge to drive innovative, efficient, and targeted prevention, early intervention, and treatment approaches to risky alcohol use, one of the most critical health areas internationally.

Mental health problems are the fourth leading cause of disability in Australia accounting for 12% of the total burden of disease and injury and estimated to cost the Australian community approximately $43.5 billion per year. 

To address the high level of personal, societal, and economic burden, there is a need for novel and innovative research that aims to better understand changes in mental health over time, identify particularly vulnerable populations, and generate evidence to better plan for future levels of mental ill health.

Psychological distress is a broad construct that is linked to mental and substance use disorders. Evidence supports the utility of measures of psychological distress to screen for and monitor trends in mental ill health among the general population, facilitating the detection of early warning signs and enabling limited resources to be directed to where they are needed the most. Australia has an extensive amount of population-based data on psychological distress, yet it remains substantially underutilised and often unused. 

One limitation to utilising existing data is the use of different psychological distress scales across surveys that hinder the ability to combine and jointly analyse data. However, recent advances in statistical equating and data harmonisation (derived from the field of educational research) can substantially overcome this limitation and generate rich and robust estimates of change.

The current project applies state-of-the-art techniques for scale equating and data harmonisation to repurpose existing datasets and estimate age-period-cohort trends in psychological distress.

The study will identify significant demographic and lifestyle moderators of changing trends, map significant breakpoints in psychological distress across time, and provide valid forecasts of psychological distress in the coming years. The study will provide much needed data to improve service planning and targeted interventions to generate the greatest improvements in mental ill health in the future.