More must be done for teens’ mental health, says Dr Michael Carr-Gregg
Around the world, adolescents from Gen Z and an emerging Gen Alpha are suffering from increased levels of anxiety, depression and other mental health conditions. But this crisis is not inevitable, according to one of Australia’s most prominent advocates for young people. Dr Michael Carr-Gregg set out two specific, evidence-based changes in education that could transform outcomes for an entire generation.
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One in seven adolescents worldwide currently lives with a mental health condition, and 40% say they need help. During and since the COVID pandemic, rates of anxiety and depression among young people have continued to surge. These are not abstract numbers. They describe the daily reality in classrooms, households and communities across the world.
We know that adolescents with mental health conditions face elevated risks of social exclusion, educational difficulties, risk-taking behaviours, and physical ill-health – consequences that often follow them into adulthood. The stakes could not be higher, and things need to change.
Speaking on Pearson’s Moments in Mind podcast, child and adolescent psychologist Dr Michael Carr-Gregg provided an unflinching view of the challenges young people face today. And he offered practical pointers for parents, educators and clinicians – as well as young people themselves.
The window of opportunity – and why the brain changes everything
What is sometimes forgotten when we talk about adolescence is that it is not just a problem to be managed. It is, neurologically speaking, a golden window of opportunity.
In the teenage years, the brain undergoes a second wave of development that rivals infancy for its intensity. It’s a period of peak neuroplasticity – a period when what teenagers think and do literally changes the structure of their brain, for better or worse.
That means adolescence is the perfect time to build the habits that underpin mental wellbeing: healthy sleep, regular exercise, emotional regulation, coping and problem-solving skills. But it also means that without the right environments at home, at school and in the community, the window closes without the opportunity being seized.
Young people want to change – adults need to let them
It is fashionable in some quarters to dismiss today’s young people as passive or disengaged. The evidence tells a different story. More than one-third of young people actively want to be part of the solution to the mental health crisis. They want support. They want to improve their own wellbeing. They want to help others.
The challenge is that many feel overwhelmed – by academic pressure, social media, economic flux and a world that keeps spinning faster. Dr Carr-Gregg uses the analogy of the oxygen mask on a plane: to help others, young people must first be equipped to help themselves.
It is up to us – the adults in their lives – to equip them.
If we fail in that responsibility, we risk something larger than individual suffering. The long-term economic and social costs of a generation under-supported in mental health are enormous: strained healthcare systems, reduced workforce productivity, and a cycle of disadvantage that compounds across decades.
Practical actions we can take
Dr Carr-Gregg believes two evidence-based changes in education would help today’s teenagers become emotionally literate and highly resilient adults. These steps could equip an entire generation with the tools to support one another: the teaching of emotional literacy and the widespread use of standardised assessments.
Treat emotional literacy like the teachable skill that it is
Dr Carr-Gregg believes emotional literacy – the ability to recognise, understand and appropriately express different emotions – belongs alongside numeracy and literacy as a core educational priority. “You can’t have learning without wellbeing,” he says. “Anger management, problem-solving, decision-making, and conflict resolution: these are not optional extras. They’re fundamental.”
In his decades of clinical work with young people, he has observed a consistent pattern: adolescents frequently struggle to distinguish between emotional states, confusing stress with anxiety, or sadness with depression. Teaching teenagers to name and differentiate their emotions does more than expand their vocabulary. It normalises the full range of human experience and equips them to process difficult feelings rather than suppress them.
Acceptance of difficult emotions won’t make those emotions disappear. But learning to tolerate discomfort is a life skill – one that allows teens to self-regulate at precisely the age when they need it most, and to understand that experiencing an emotion and choosing how to act on it are two entirely separate things.
Learning how to respond to stress is especially crucial, says Dr Carr-Gregg. Adolescents often face pressure from every direction – academic, social, familial and economic. So teaching stress management skills helps young people to not only navigate difficult moments, but also reframe “manageable stress” as a driver of growth. The parallel task is equally important: helping teenagers recognise when stress has tipped into something harmful, and giving them practical tools to steer themselves (and each other) through it.
Standardised assessments for all
Dr Carr-Gregg is also a vocal advocate for the rollout of standardised mental health assessments in all schools. If widely applied, these assessments would systematically screen for learning difficulties, mental health conditions, and undiagnosed neurodivergence – including autism and ADHD – giving educators, parents and health professionals vital information to intervene early and effectively.
The evidence for early identification is compelling: timely support significantly improves developmental outcomes and quality of life for young people. This also allows them to proceed through their schooling armed with a better understanding of their own strengths and differences, potentially reducing or even removing the mental health risks that come from undiagnosed or untreated conditions altogether.
It is important to acknowledge the concerns that tend to arise around standardised assessment: the risk of labelling, the potential for overdiagnosis, questions of cost and data privacy. While these are understandable, they need to be weighed honestly against the cost of doing nothing. An undiagnosed learning difficulty or untreated mental health condition does not simply resolve itself. It shapes a young person’s sense of self, their educational trajectory, and often their long-term life outcomes. Early, accurate identification – conducted with appropriate safeguards – is an act of care, not categorisation.
Dr Carr-Gregg believes that rolling assessments out universally – rather than relying on individual referrals, which systematically disadvantage children in under-resourced settings – would also “significantly reduce the stigma around learning difficulties, learning disabilities and mental health.” When assessment is routine, it is no longer a marker of difference.
Two changes. One generation. Many upsides.
Dr Carr-Gregg is not a pessimist. He is a pragmatist. And his argument is straightforward: we know what works, and we are simply not doing enough of it.
Embed emotional literacy into the curriculum. Make standardised assessment the norm, not the exception. Do those two things consistently, at scale, and you do not just help individual students – you raise a generation of people equipped to understand themselves, support each other, and contribute to a society in better mental health than the one we currently inhabit.
The window is open. Adolescence does not wait. Neither should we.
You can’t have learning without wellbeing. That’s fundamental.
Dr Michael Carr-Gregg
Andy McLean 00:13
Hello and welcome back to Moments In Mind from Pearson Clinical Assessment. Thanks for tuning in.
I'm Andy McLean, and in this podcast, we meet with clinicians, educators and therapists who are changing lives for the better.
We talk about landmark moments in their career – the tough moments, as well as the breakthroughs – to find out what they've learned about themselves and about others.
Our guest today is the voice the Australian media turns to when young people are in crisis, and the clinician that parents trust to decode their teenagers behaviour.
Michael Carr-Gregg is a clinical psychologist who has not only treated struggling adolescents one by one, he's also changed the systems that shape them well.
Michael, welcome to the show.
Michael Carr-Gregg
Thank you for having me.
Andy McLean
Now, usually in these podcasts, our first question for our guests is to talk about an early childhood memory, their earliest memory, in fact. However, you’ve spent your life working with teenagers. So was there a moment in your adolescence that was perhaps pivotal in your life?
Michael Carr-Gregg 01:21
Yes, there was. I was in second year university at Sydney University, and I developed a lump in my neck, which turned out to be malignant cancer, and I was told that I had eight weeks to live.
Andy McLean
Wow.
Michael Carr-Gregg
Yep. So that was pretty pivotal.
Andy McLean 01:41
Yeah. Obviously you're still here Michael, I'm delighted to say. So what happened?
Michael Carr-Gregg 01:44
Well, I had surgery. I had a delightful radiation oncologist come in to me one day, and he said, ‘Michael, you've got three choices. One, we can give you palliative care, which is where we make you feel comfortable, but unfortunately, you're going to die. The second is we can do nothing, in which case you're going to die. And the third is that we can give you a lot of head and neck radiotherapy, which may help, but it may not.’
So I opted for the third option, which wasn't particularly pleasant, as you can imagine. In 1977 it was unfractionated radiotherapy, so fairly brutal, but it saved my life. So that's good. The only casualty with was I lost hearing in my right ear. But apart from that, I'm still here. So that's good.
Andy McLean 02:32
And psychologically speaking, what was that like for you?
Michael Carr-Gregg 02:35
Well, it was devastating. It scared me, but ironically, it gave me a mission, because my mission then was to try and do something about the wellbeing and the psychological care of teenagers with cancer, which then became Canteen and my PhD and the first 10 years my professional life. So out of everything bad that happens to you, sometimes there's something good that can come from it.
Andy McLean 03:02
Tell us a little bit about Canteen.
Michael Carr-Gregg 03:05
So I was doing my PhD at the Prince Wales Children's Hospital, and there were a group of young people who were battling cancer, and it occurred to me one day, and I was actually in the bath, I had a sort of Eureka moment. And I thought, ‘wouldn't it be amazing if we had an organisation just for teenagers, which basically enabled them to support one another?’ And the idea, or the name ‘Canteen’, came into my head. And within a week, I'd written to the Australian artist Ken Done, who very kindly designed a logo, and the organisation was born.
Andy McLean 03:43
Fantastic. Wow. And of course, your whole career has been working with adolescents and teenagers as a clinical psychologist, so your teenage years really were a pivotal moment for you weren't they.
Michael Carr-Gregg 03:54
Well, I'm an adolescent psychologist because I chose to specialise only in teenagers. So for me, I think it's much easier to repair a young person than to repair a broken adult. And therefore, we really need to start in adolescence. Adolescence is where everything kind of is ‘laid down’.
So if you can make a difference there, their brain is so able to be moulded, and the neuroplasticity means you can make some fantastic changes there. So to me, there was no other population I was ever going to work with.
Andy McLean 04:32
Fascinating. Now, I have to say, as a parent of teenagers myself, they can be daunting. They can be demanding, delicate and delightful. All of those things – sometimes in the space of an hour. You've chosen to dedicate your whole life to working with people in that age group. What is it that allows you to maintain your enthusiasm and your determination through all the highs and lows that they're experiencing?
Michael Carr-Gregg 05:01
Well, I think the most important thing is to recognise that you can't save everyone, but showing up is important. So if I can show up and let them be heard and seen and understood, that's 50% of the therapy, and I really enjoy doing that. So I'm a very lucky person, because my job is something that I actually enjoy doing. So hope that comes across to them.
Andy McLean 05:28
Yeah, well, it certainly comes across just in the way you talk about it, Michael, it really does. Your care for your clinical work is obvious, and also you've chosen to amplify your impact, right? You've been involved in advocacy and education policy work. Was there a moment where you realised that you needed to become a public voice?
Michael Carr-Gregg 05:53
Well, there was a sort of hiccup in my clinical career. After Canteen, I went to New Zealand and the very same radiation oncologist who had treated me said to me, ‘I need you for two years. I need you in a role as a political lobbyist working for the New Zealand Cancer Society. And what I want you to do is lobby government for a ban on tobacco advertising and promotion, and we think you're just the right person’.
So I got this job. Didn't know anything about political lobbying, but then started to learn very quickly from experts, and I realised that if you use the media strategically, you could get policy reform, you could make a difference. And so that experience working with the New Zealand Cancer Society was pivotal in helping me understand, yep, you can have a voice, but you need to use the media.
Andy McLean 06:52
Yeah, wow. And of course, that profile that you have in the media has meant that you've sometimes been the public face responding to some of Australia's most devastating moments. I'm thinking of school tragedies, youth suicide, community crises and so forth. What's that like for you when the public is searching for answers and trying to make sense of it all? Can you maybe take us back to one of those moments?
Michael Carr-Gregg 07:19
Yeah. I mean, I think the Bali bombing is a really good example. The country was in crisis, and what was needed was really calm, reassuring advice. And I started really thinking about that back in 9/11. I remember going to Waverley College in Sydney on the morning of 9/11, and crossing the Harbour Bridge and thinking, ‘what am I going to say to these students?’
Because I was supposed to be talking about wellbeing, and my whole speech focused on one concept, and that is, ‘if you want to survive this, you have to see life as it is, but focus on the good bits’.
So I drew the attention of those students to the helpers, the police, the fire people, the ambulance officers, many of whom lost their lives on that day. And instead of talking about terrorism, we talked about the magnificence of humanity in a crisis.
So I think there are a couple of psychological principles that have guided me that's a big one.
And in crisis, I think it's very important parents want to know what to say to their little children, which is, if they're under five, nothing, because little five year olds have the right to know the world is safe. But over that, there's a developmental understanding of what they can take and I think it's very important that someone who they trust gives them clear, unambiguous, evidence-based advice, and that's what I try to do.
Andy McLean 08:57
Michael, we're going to take a short break. Afterwards. I'd like to talk about perhaps a breakthrough moment that you've experienced. We'll talk to about the impact of stress, not just on teenagers, but also on clinicians and psychologists. And we'll tackle the big one: teens and technology.
Michael Carr-Gregg 09:14
My favourite topic!
Andy McLean 09:16
Stay tuned. We'll be right back.
[Promotional break]
Andy McLean 09:49
Hello and welcome back to the show.
Michael, I'd like to talk now about a breakthrough moment that you've experienced in your clinical work, one particularly where you've learned something from the young person you were involved with.
Michael Carr-Gregg 10:03
It was on the north coast of New South Wales, and I was taking a group of kids from Canteen, and we went to the beach, and two of these kids had had their legs amputated because they'd had osteogenic sarcomas.
So they were on crutches coming off the beach, and I was walking with them, and a group of kids from a local school walked towards us as a group, and one of them shouted at one of my clients, ‘what happened to your leg mate?’ And he just pointed back at the water and said, ‘sharks’.
And I just cracked up. I thought that was the most fantastic response. And it showed to me how resilient these young people were, and that even in the depth of utter despair. And this boy passed away about three months later, and he was very sick at the time. He just had that amazing capacity to face, overcome, be transformed by adversity, and that was a wonderful lesson for me.
Andy McLean 11:15
Yeah. I've lived with family members who are amputees, and the ability to laugh about those experiences with others and almost enjoy the shock that some people have, it can be really fun, right?
Michael Carr-Gregg 11:29
Yep, yeah, oh I mean, I'm sure both of them laughed. They knew what was coming, but I didn't. I thought it was hilarious.
Andy McLean
Yeah, That's wonderful. And of course, when you're working with young people who are struggling, there can be difficult moments too. There can be cases where things perhaps don't turn out how you might have hoped. And as a psychologist, it's quite a weight to carry. How do you do that?
Michael Carr-Gregg 11:58
Look, I think all of the people who work with young people in health, education and welfare, at some time or another, have a kind of little bit of a burnout happening, because there's just so much you can take to me.
I've always prioritised self-care. So golf is very important to me. In my schedule, I take time out to play golf, and it's not so much the golf, it's who you play with that matters. So I play with my son, I play with my friends, and they know that I'm not going to talk about clinical stuff, and they know not to talk to me about clinical stuff.
But that just gives your mind, your soul, just a bit of a break and paying very close attention to sleep and diet and exercise. I don't drink alcohol. Never have and just kind of think that that's another thing that I do for self-care. It's my choice. I do it. I'm always amused at how uncomfortable it makes other people.
But no, so I think self-care is very important for anyone in the helping profession.
Andy McLean 13:08
Yeah, indeed. And it's interesting, isn't it? It's a bit like when you think of plumbers, right? You go around to a plumber's house and you find the plumbing is not very good, and it's because they're so busy plumbing in their day job, they don't have time to do their home.
And it's a bit like that with psychologists. I think sometimes that because you spend so much time helping other people with their mental health and giving them strategies and practices to cope and to thrive, sometimes you can neglect yourself.
Michael Carr-Gregg 13:34
Yes, yeah. When I first started working in adolescent psychology, a psychiatrist who is very famous in Melbourne said to me, if you're going to work with adolescents, you'll need two things: a bottle of scotch and someone to share it with. I understood the sentiment, but certainly having that peer support is very, very important.
Andy McLean 13:50
Yeah, absolutely. In fact, you've talked a little bit about that in terms of your coping strategies there. A lot of that is about people.
Michael Carr-Gregg 13:59
Very much so, and making sure that you have really good sounding boards, because you don't know everything and everybody's got a different perspective, and you've got to be open to that. So I have a group of psychologists, many of whom I mentored, who are now far cleverer and smarter than I am, but we meet on a regular basis, and we are one another's support group.
Andy McLean 14:22
Yeah, there's nothing like speaking to people who have experienced similar things to yourself. Yeah, absolutely. Let's talk a little bit about education. I'm interested in how stress and anxiety can affect cognition. How is it that you think schools and teachers can support children's mental health so that learning can still happen?
Michael Carr-Gregg 14:47
This is one of the biggest challenges, I think, for the education system in 2026 and beyond, not just in Australia, but the Western world.
And I think what we have to understand is that you can't have learning without wellbeing. That's fundamental.
Early diagnosis, early detection of problems, is associated with a much better outcome and teaching young people emotional literacy, so things like anger management, problem-solving, decision-making, conflict resolution. These are not optional extras. They're fundamental.
And I don't want any child in any school to walk out of school for the very last time and not know how to do those things. But we've got a crowded curriculum, and people are saying to me, ‘well, there's no time to teach that stuff’. And I'm saying ‘yes, there is time to teach that stuff, because it's very important. It's just as important as literacy and numeracy’.
So to me, we've got to teach people, particularly around stress. So my philosophy of stress – and I do a lot of talks to year 12 students because they're very stressed – is that stress is not necessarily a bad thing that the Yerkes-Dodson law, one of the oldest laws in psychology, tells us that a little bit of stress actually improves the efficiency of your performance.
So we've actually got to learn to manage stress, and we've also got to teach in schools the difference between stress and anxiety, which I don't think very many people know. For fun, I often talk to students about, do you know the difference between sadness and depression or stress and anxiety? And they don't, and I think this is a failure of our education system. We really need to get those messages through.
Andy McLean 16:35
Yeah, and as human beings, we've evolved because of our ability to thrive on stress. Stress is an indicator of danger to some extent, right? So the way our brains have evolved, we think about a lizard basking in the sunshine thousands of years ago, it would have been swooped down upon and eaten, right? It's the lizards that were quick to respond to the danger that we've evolved from.
Michael Carr-Gregg 16:57
Yep, yep. And I think the way I talk to, particularly my neurodiverse clients, many of whom have major problems with anxiety, is just that their threat detection system – that the lizard had – is just a bit overactive at the moment, but they're things that we can do to calm it down, and that is a really important part of my work.
Andy McLean 17:17
Yeah, and it's so interesting because we hear talk about ‘school performance’, right? And so often that is a league table of academic results, but that's just really barely scraping the surface of what development and progress looks like for teenagers.
Michael Carr-Gregg 17:34
Unfortunately, I think there's a worldwide misunderstanding by a lot of final year students that their result defines their future, whereas, in fact, it doesn't. And all their final exam does is really test how good they are at sitting exams. And my response to them is there’s many different ways to get where you need to go. This is just one route.
Andy McLean 17:59
Yeah, really important reminder, absolutely.
You mentioned early diagnosis and intervention a moment ago, I picked up on that. And I'm thinking here about conditions like ADHD, autism, dyslexia, which can impact cognitive performance and development, right? How important then are standardised assessments in the mix?
Michael Carr-Gregg 18:26
If it if it can be measured, it can be managed.
So that's my philosophy as a psychologist – when I get anyone in – my first goal is to try and get some understanding of where they come on. You know the bell curve when we're comparing this particular child to six million other children the same age, we get some really useful data.
So I think early intervention is one component. The other is that something I've been pushing for a long time, which is the introduction of standardised testing in schools.
Why would you do that? Well, just to give you one example, I work in a school which is unique to Australia, where they take bunch of year nine girls, 100 of them, and send them up a mountain for a year, no technology, just pure outdoor adventures. (There's an academic curriculum as well.) But when you put 100 girls up a mountain for a year, you just get some fairly interesting dynamics. They're 13-14, year olds.
Now what we learned is that we had to screen them to make sure that they were okay before sending them up there. And this was my first introduction to the resistance to standardised testing, because it turned out that a lot of parents didn't want their children tested, even though we were putting them in a very stressful situation. And that showed me the sort of battle we have ahead.
In an ideal world, what I would love is for every state and territory school, every private school around the world, to basically get the opportunity to do standardised testing so that we know what the potential psychopathologies are, what the potential learning difficulties are, so we can address them.
I mean, to me, it's from the University of the Bleeding Obvious, but parents are resistant to it. And I think that's part of the whole stigma around learning difficulties, learning disabilities and mental health. So look, I think we've made some very significant headway, but there's room for improvement, and I think the introduction of standardised testing would be a major move in the right direction.
Andy McLean 20:48
Let's keep talking about moves in the right direction. Perhaps you could tell me – we might end on this note, I think Michael – is there one change that you'd like to see in in the developed world that would really make a big difference for teenagers?
Michael Carr-Gregg 21:04
I think I'd like to give teenagers back their childhood, because what we did was we replaced a play based childhood with a screen based childhood, and that was a disaster.
And I think my advocacy around removing mobile phones from first bell to last including recess and at lunchtime in schools, has been a tremendous success here. And the social media ban – the whole idea of not allowing the psychological development of our children to be outsourced to Silicon Valley.
And I think that's only going to be a good thing. So I look forward to seeing how those changes impact the psychological trajectory of those children and teenagers going forward.
Andy McLean 21:49
Yeah, and what's so fantastic, Michael is the advocacy and policy work that you've done in this space in Australia is radiating out across the world now.
Michael Carr-Gregg 21:58
Yes it’s great see so many European countries following suit: the UK, Spain, France. And we hope this is a movement that takes over the world.
Andy McLean 22:09
Well, Michael, as a parent of teenagers, please, let me put on record my thanks on behalf of all parents in Australia, I think, for your work in that space. Because the discussion and the tension over social media and screens has definitely reduced in my household and in the households of many of the teenagers who I know. So thank you for that.
Michael Carr-Gregg
That’s great to hear. Thank you.
Andy McLean
And thank you so much for joining us today. It's been a great conversation.
Michael Carr-Gregg
My pleasure.
Andy McLean
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