Australia’s housing crunch is no longer just an economic issue. Research clearly shows people who face housing insecurity are more likely to experience mental ill-health.

For this reason, secure housing must sit at the heart of any mental health plan.

Australia’s housing shortfall

Rents rose so fast in 2024 that Australia’s Rental Affordability Index now labels all major cities and regional areas “critically unaffordable” for people relying on benefits such as JobSeeker or a pension.

Vacancy rates hover near 1%, the lowest in decades. Mortgage costs chew the biggest slice of income since the mid-1980s.

On Census night in 2021, 122,494 Australians were homeless. Of these, more than 7,600 people slept rough, and nearly one-quarter were aged 12–24.

Data from homelessness services and headcounts of rough sleepers since 2021 suggest today’s figure is higher.

Housing stress quickly turns into mental distress

In a national survey, four in five renters said they spend more than 30% of their income on housing.

This 30% threshold is important. A 2025 study that followed more than 10,000 Australian renters found mental health drops fast once housing costs exceed the 30% mark. Missing a rental payment was linked to a further drop in mental health.

Earlier research has similarly found that among low- to moderate-income households, when housing costs exceed 30% of income, mental-health scores fall compared with similar households who spend less than 30%.

Another recent Australian survey found 38% of private renters feel their housing circumstances harm their mental health, versus 23% of owner-occupiers. This is driven by a mix of housing insecurity (such as short leases and eviction risk) and poor housing conditions (for example, cold homes or mould).

Meanwhile, helplines have reported cost-of-living pressures, including housing insecurity and homelessness, are driving an increasing number of calls.

Who is at highest risk?

In a sense, the housing ladder doubles as a mental health ladder.

Homeowners, with long-term security, sit on the top rung.

Private renters arguably ride the roughest road. Six-month leases, “no-grounds” evictions and “rent bidding” (where applicants may feel compelled to offer above the advertised rent to beat other applicants) keep people on edge.

Social housing residents often start with bigger challenges (43% live with mental health issues), but low rent and fixed leases steady the ship.

People with no stable home face the steepest climb. One review looking at people experiencing homelessness in high-income countries found 76% had a current mental illness.

This is likely linked in a large part to a feeling psychologists call “learned helplessness”. After the tenth rejected rental application – or the 15th, or the 20th – people ask “why keep trying?”. Motivation drops, and depression rises.

What’s more, a stable home makes it easier to do things like hold down a job or finish TAFE. Housing insecurity can therefore compound other problems such as unemployment, which are also linked to poor mental health.

What can we do about it?

Mental ill-health already drains roughly A$220 billion from Australia’s economy each year in lost productivity and health-care costs.

Housing stress piles extra costs onto the health-care system: more GP visits, more ambulance call-outs, more pressure on emergency departments.

Meanwhile, homeless shelters turn people away daily because beds are full.

This is without even accounting for the physical health effects of poor quality housing, including illnesses caused or exacerbated by problems such as mould, damp and cold.

All this means fixing the housing crisis is likely to generate savings for the health-care budget.

There are several ways we can do this.

1. Build more social housing

As of June 2024, about 4% of Australian households lived in social housing, equating to roughly 452,000 dwellings nationwide.

The National Housing Supply and Affordability Council’s State of the Housing System 2025 report recommends boosting social housing to 6%, with a long-term target of 10% of all homes. This would be a major step to cool the market and cut mental distress.

2. Protect renters

This should include ending no-grounds evictions, capping rent hikes to wage growth, and lifting Commonwealth Rent Assistance.

3. Link housing to health policy

On this point, Australia can take lessons from abroad. Finland, for example, has made “Housing First” national policy. This approach gives people experiencing long-term homelessness a permanent apartment and access to support. It has cut rough sleeping significantly.

Meanwhile, Aotearoa New Zealand’s Homelessness Action Plan aims to make homelessness “rare, brief and non-recurring” by funding Housing First in every region.

A trial in Canada gave more than 2,000 participants across several cities experiencing homelessness and mental illness a permanent home plus access to voluntary support.

Evidence from Canada shows Housing First keeps people housed and reduces demand on emergency and hospital services. Pilots in the United Kingdom are indicating similar benefits.

While there have been some promising programs in parts of Australia, there’s more to do.

Secure housing targets should sit inside the National Mental Health and Suicide Prevention Agreement. On the flip side, Australia is currently drafting a National Housing and Homelessness Plan. Mental health goals should be incorporated into that plan.

Just as clean water prevents disease and seat belts cut road deaths, a stable, affordable home is vital for mental health. Without bold action, we face a long-term social crisis.

This article is part of a series, Healthy Homes.

Ehsan Noroozinejad, Senior Researcher and Sustainable Future Lead, Urban Transformations Research Centre, Western Sydney University; Greg Morrison, Professor, Director of the Urban Transformations Research Centre, Lang Walker Endowed Chair in Urban Transformation, Western Sydney University, and Shameran Slewa-Younan, Associate Professor in Mental Health, Western Sydney University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition that affects around 2.5% of adults and 7% of children. It causes difficulties with attention, impulsivity and hyperactivity.

If unrecognised and untreated, ADHD can significantly impact educational and work achievements, and social and emotional wellbeing. It can also increase the risks of serious accidents and injuries, offending, mental illness and substance abuse.

When accurately identified and appropriately treated, these negative outcomes can be significantly reduced.

But as a recent article in the Medical Journal of Australia highlights, some people struggle to access and afford diagnoses and treatment the disorder.

Meanwhile, some popular social media channels that provide online “tests” for ADHD are sponsored by private clinics that, once you have screened positive, direct you to their sites for an online assessment. This has raised concern about potential over-diagnosis.

So, what is ADHD diagnosis actually based on? A key component is functional impairment. Let’s take a look at what that means.

Why a brief assessment isn’t enough

In Australia, there are reports of business models where clinics are charging several thousand dollars for a quick, brief online assessment and diagnosis.

These brief assessments don’t comply with evidence-based guidelines and are problematic because they:

• focus solely on ADHD and don’t attempt to assess other aspects of a person’s difficulties
• rely heavily on information from the person being assessed and don’t seek the opinions of significant others
• rely heavily on information about symptoms, gathered through questionnaires, and don’t assess their impact on day-to-day functioning.

This is important because a core requirement for a diagnosis of ADHD is evidence that the:

symptoms must interfere significantly with social, academic, or occupational functioning.

No matter how many symptoms you have, if they’re not having an impact on your day-to-day life, a diagnosis of ADHD shouldn’t be made.

So what is a comprehensive assessment?

To make an accurate diagnosis of ADHD, a comprehensive assessment is needed. This includes a clinical interview to evaluate the current and past presence (or absence) of each of the 18 core ADHD symptoms and associated impairment.

While there are scales such as the Weiss Functional Impairment Rating Scale and the World Health Organisation Disability Assessment Schedule that can aid assessment, these are best used as conversation starters rather than stand-alone tools.

A comprehensive assessment also includes a broader assessment for current mental and physical health problems, developmental history, personal and family mental health, substance use, addiction and, where appropriate, interactions with the justice system.

This interview shouldn’t be conducted as a simple tick-box exercise, with yes and no answers. A detailed interview is needed to explore and identify symptoms, and evaluate their impact on functioning.

It’s also strongly recommended the clinician hears from one or more people who can speak to the person’s childhood and current functioning.

What counts as ‘functional impairment’ is very individual

The diagnostic manuals don’t give detailed accounts of what counts as significant enough impairment to be diagnosed with ADHD.

This has led some commentators to complain that lack of a standardised definition could lead to over-diagnosis.

But the impacts of ADHD are so broad it would be very difficult to formulate a clear, comprehensive and encompassing list of valid impairments.

Such a list would also fail to capture the very personalised nature of these impairments. What is impairing for me may not be for you and vice versa.

So a rigid definition would likely result in missed as well as mis-diagnoses.

How do clinicians determine if someone is impaired?

Clinicians are very used to assessing the impact of symptoms on functioning. They do so for many other mental and physical health conditions, including depression and anxiety.

Research has identified several common themes in ADHD:

• impaired romantic, peer and professional relationships
• parenting problems
• impaired educational and occupational achievements
• increased accidents and unintentional injuries
• driving offences
• broader offending
• substance use and abuse
• risky sexual behaviours.

ADHD symptoms are often associated with:

• emotional dysregulation
• exhausting levels of mental and physical restlessness
• low self-esteem
• fatigue
• high stress levels.

One caveat is that some people are receiving a lot of support and scaffolding or have found ways to compensate for their difficulties. Whether or not this should count as impairment depends on the circumstances and requires considerable thought.

However, ADHD shouldn’t be ruled out on the basis of high levels of achievement in certain aspects of life like school or work. A person may be under-achieving relative to their potential, or having to put in extreme levels of effort to keep afloat.

An adult with ADHD, for example, may be excelling at work but by the end of the workday is too exhausted to do anything but sleep. They may also be experiencing impairments in other aspects of their lives that aren’t obvious unless specifically asked about.

Others will present multiple impacts that, when explored, aren’t true functional impairments.

So it’s crucial clinicians drill down into the details until they’re confident that it is or isn’t a genuine impairment related to the core ADHD symptoms.

Clinician training is essential

The skill of accurately assessing impairments in ADHD is not difficult to train or learn. This is done by observing experienced clinicians and practising with structured protocols.

Newly trained clinicians quickly become confident in assessing impairment and there is generally close agreement between different professionals about whether an ADHD diagnosis should be made.

However, few health professionals currently get high-quality training in ADHD either during their core or more advanced training. This must change if we’re going to improve the accuracy of assessment and reduce missed and mis-diagnoses.

David Coghill, Financial Markets Foundation Chair of Developmental Mental Health, The University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.

We often use the word vagina to describe everything “down there”, but that’s not actually anatomically correct.

The vagina is the stretchy, muscular tube that connects the external genitalia, or vulva, to the cervix, which is the entrance to the uterus (womb).

Because it’s barely visible from the outside, many vagina owners wonder how long theirs is, or should be.

Worried teenagers going through puberty regularly asked “Dolly Doctor” – the medical advice column Melissa wrote for over 20 years in Dolly magazine – whether their vaginas were too small or short.

Often they were asking because inserting a tampon was difficult or painful.

The vagina is an incredibly adaptable part of the body and its length can change – across your lifetime, within the month, and with hormonal changes and sexual arousal.

Length at different life stages

Before puberty, the vagina usually measures between 5.5 and 8cm in length.

During puberty (usually between 8–13 years old), not only does the length of the vagina increase, but hormones also change the vaginal lining.

In the time of life between puberty and menopause, oestrogen levels rise and cause the lining of the vagina to thicken and soften. This is what makes the vagina moist and responsive to stimuli, such as when aroused.

By adulthood, the vagina is typically between 6.5cm and 12.5cm. This varies greatly from person to person and continues to change at different times during our lives.

What else can change the vagina’s length?

When someone has their period, generally the cervix sits in a lower position, meaning the vaginal canal is shorter. Then, after menstruation, the cervix lifts upwards again and reaches its highest point during ovulation.

The length of the vagina also changes during different reproductive stages. For example, in pregnancy the cervix sits higher up, meaning the vagina is longer.

On the other hand, menopause, along with many other impacts such as vaginal dryness, can shorten the vaginal canal.

A pelvic organ prolapse can also make the vagina shorter. This is when the pelvic floor becomes weakened and organs such as the womb or bladder bulge into the vagina.

There are also some very rare conditions that can affect the development of the vagina before birth, such as vaginal atresia, which can cause the vagina to not fully form.

What about sex?

Sex also has a large impact on vaginal length.

When someone with a vagina becomes aroused the vagina gets longer and moves the cervix further from the vaginal opening, which allows for sexual penetration.

Despite this lengthening of the vagina, contact with the cervix can still occur during sex, for example with a sex toy, finger or penis. Some people will find cervical stimulation painful or sensitive, while for others it may be pleasurable.

How sex feels can also change depending on your menstrual cycle.

Remember, when you have your period, the cervix is likely to be sitting lower, so this can increase the chance of contact with the cervix during sex, especially during certain sexual positions.

Touching the cervix during sex is very unlikely to cause any damage, although sometimes with vigorous sexual intercourse it can cause bruising. This is not usually dangerous and heals on its own.

Ongoing communication with your partner is crucial to check in and see what feels good for both of you.

So, how long is my vagina?

It can be useful to feel the length of your vagina and the position of your cervix.

For example, if you want to use a menstrual cup during your period, some brands will have different sizes. If you have a shorter vaginal canal, then a shorter or smaller cup may achieve a better fit.

However, other factors – such as your age and how heavy your periods are – can also impact what size is right for you.

To feel the position of your cervix, first wash your hands with soap and water. This is best done around the time of your period, when the vaginal canal will be shorter.

Find a comfortable position, such as sitting, squatting or having one leg bent up on a chair. Then insert your finger into the vagina aiming up and back.

The vagina feels soft and squishy, whereas the cervix is smooth and firm, with a tiny divot in the centre – imagine a mini doughnut.

If you have to really stretch to feel the cervix, you may opt for a longer cup, whereas if you don’t need to insert your whole finger, it is probably sitting a bit lower and you may be more comfortable with a smaller size.

Keep in mind, this will just give you a rough idea of your vagina’s length and where your cervix is sitting (although it may change tomorrow).

Does the length of your vagina matter?

All of our bodies are unique and there is a wide range of “normal”. Generally, having a “short” or “long” vagina doesn’t make any real difference.

For example, a 2009 study of women over the age of 40 found vaginal length doesn’t affect sexual activity or function.

The vagina is extremely elastic and can stretch and mould to accommodate a variety of needs, before returning back to its baseline.

There are some symptoms that would be worth discussing with your GP though, such as pain during sex, difficulty inserting tampons or menstrual cups, or if you are concerned about a prolapse.

Keersten Fitzgerald, Lecturer in General Practice, University of Sydney and Melissa Kang, Professor of Adolescent Health, Co-Head of the General Practice Clinical School, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.