Beyond the Pandemic: How COVID-19 Highlighted the Need for Cross-Sector Healthcare Solutions for Young Australians Living with Adversity

Abstract We explored the perceived impacts of the COVID-19 pandemic on health and healthcare access among young people living with significant adversity in Victoria, Australia, using a convergent parallel mixed-methods design. Guided by a pragmatism epistemology, fifty-seven purposively sampled Victorian adolescents aged 15–19 years with lived experience of adversity completed a primarily quantitative online survey, and eight also participated in semi-structured interviews. Descriptive quantitative results indicated that a greater proportion of participants rated their mental health as fair or poor during COVID-19 (69%) compared to before the pandemic (40%). Similarly, more participants rated their physical health as fair or poor during COVID-19 (39%) than prior to the pandemic (29%) and also reported greater healthcare service use during this period. The qualitative interview data were analysed via inductive thematic analysis, which resulted in the construction of four key themes: (1) The Cascading Impacts of the Pandemic Across All Life Domains; (2) Falling Through the Cracks: How Service Gaps Shape Access to Care; (3) Healthcare as Inextricably Embedded Within Broader Intersecting Systems; and (4) Bridging the Gaps: Young People’s Recommendations for More Accessible, Responsive, and Equitable Support. Taken together, these mixed-methods findings demonstrate the importance of addressing specific disadvantage and providing timely, responsive, and flexible services to reduce barriers to healthcare access and better meet the needs of young people experiencing adversity. Addressing these challenges will require the unique skillset of social workers to support integrated, interdisciplinary, and cross-sector service systems that prioritise equity and are built around the complex realities of young Australians experiencing adversity.