Mental health special consideration in Victorian tertiary education applications: geographical, demographic, and socioeconomic inequities in uptake.

Introduction: Mental ill-health can disrupt young people's education and future outcomes. In Victoria, Australia, the Special Entry Access Scheme (SEAS) enables tertiary applicants to declare circumstances, including mental health conditions, that may have affected their educational achievement, yet application patterns have never been comprehensively characterised. Methods: We analysed de-identified Victorian Tertiary Admissions Centre (VTAC) data from 43,127 Victorian Year-12 applicants in the 2021/22 admissions cycle, examining mental health-related SEAS rates across individuals and Statistical Area Level 3 (SA3) regions. Area-level rates were compared with Census-reported mental health conditions prevalence and acute mental health service use among 17-18-year-olds. Relative risk regression, Spearman correlations, and tertile-based concordance analyses examined demographic, socioeconomic, and geographic factors associated with uptake. Results: Fifteen percent of applicants disclosed a mental health condition via SEAS. Female applicants were nearly twice as likely as males to apply (RR = 1.92), non-binary applicants more than three times as likely (RR = 3.47), applicants from English-speaking backgrounds twice as likely (RR = 2.01), and those with comorbid learning disability more than three times as likely (RR = 3.47). Financial hardship was associated with higher SEAS uptake (RR = 1.52), yet area-level socioeconomic advantage was also positively associated with disclosure rates (RR = 1.08 per decile), revealing a paradoxical inverse equity pattern. Geographic analysis identified substantial discordance between SEAS application rates and population-level need indicators. Discussion: SEAS provides a unique opportunity to support young people whose educational pathways have been disrupted or shaped by disadvantage, particularly, but not limited to mental ill-health. At a population level, mental health-related SEAS uptake is not determined by underlying need alone. It is also shaped by wider social and structural factors that influence young people's ability to recognise, document, and disclose mental health difficulties and their educational impacts. Cultural, geographic, and socioeconomic barriers can exclude many who would benefit, highlighting opportunities to strengthen equitable access to the scheme. Proactive school-based navigation support, targeted outreach to culturally and linguistically diverse communities, and sustained institutional support beyond the point of admission are needed to ensure SEAS fulfils its potential as an equitable access mechanism for young people with mental ill-health.