Do our young people really have mental health problems?

Mental health problems are the largest single source of ill health in our young people.

International figures from the World Health Organisation (WHO) indicate that one in five (20%) of adolescents experience psychological problems; one in 10 (10%) will have a mental illness with some impairment; and one in 20 (3 to 5%) have a major psychiatric disorder.

Irish young people experience mental health disorder with no less frequency than their international cousins. A study by Fitzpatrick, Lynch, Mills and Daly (2003) showed that up to 4.5 % of school-going adolescents in Ireland experience a clinical depression.

Fitzpatrick and her colleagues studied 12 to 15 year olds in Dublin, finding that 15.6% had a mental health disorder (depression 4.5%; suicidal thoughts 1.9%; anxiety disorder 3.7%; attention deficit hyperactivity deficit disorder (ADHD) 3.7%; conduct disorder/oppositional defiant disorder (CD/ODD) 2.4%; tics 1.1%; eating disorders 0.2%).

About 5% of adolescents are suffering from major depression at any given time and 30% of adolescents also develop a substance abuse problem.

75% of all mental illness begins before 25 years of age (Kendall and Kessler 2002), and research indicates that only 29% of those affected contact a professional service of any type (Sawyer et al, 2000). Given the poor prognosis for adolescents and adults with untreated psychiatric symptoms these low rates of access and treatment are particularly concerning (Hickie et al 2001) (Weissman et al 1999).

Eight signs that a young person may be experiencing mental health difficulties

1. Recent drop in school grades or new behaviour problems in school.
2. Fatigue or changes in sleep patterns.
3. Loss of enjoyment of previously enjoyable activities.
4. Self-harming behaviour.
5. Social isolation.
6. Loss of attention to appearance.
7. Extreme sensitivity to rejection or failure.
8. Suicidal thoughts.

Mental health problems at any age arise due to a combination of genetic, environmental and sometimes early adverse experiences. They may be triggered by stressful life events such as bullying, abuse or parental separation. These precipitants for depression may also occur in a person who is already predisposed to becoming depressed. Much depends on the context for the young person, it’s meaning for the young person and what happens after it.

“Adolescence is a key stage of psychological development. It is a time of increased risk of poor mental health with anxiety, depression, psychosis, eating disorders and substance misuse becoming more prevalent as well as an increasing risk of deliberate self harm and suicidal behaviour.” Department of Health 2004

Six ways to promote and foster positive mental health in young people

We could start by valuing the qualities needed for mental health in children and adolescents and working together to promote these qualities. These include:

1. developing the ability to initiate, develop and sustain mutually satisfying personal relationships
2. to become aware of others and empathise with them
3. to use and enjoy solitude
4. to have fun and to learn
5. to develop a sense of right and wrong
6. to resolve problems and setbacks and learn from them.

Young people tend to be reluctant to seek help for mental health problems and this is a challenge to effective early intervention approaches. Early treatment and intervention is vital during adolescence and young adulthood (12 to 24 years) because of the high prevalence of mental health problems at this stage of life. Lack of recognition of mental health problems among young people (Zachrisson et al, 2006) and their parents (Logan and King, 2001) is a major factor delaying help-seeking.

Help-seeking is facilitated by increased capacity for emotional literacy and emotional intelligence. There is compelling evidence that these faculties are less well developed in young men compared to young women.

Many factors are protective for our young people and we need to support protective factors. These include family involvement with positive family relations and strong attachments; affectionate child-parent bonds and a commitment to education; also parental support developing good coping skills and positive peer groups.

Tags:   CAMHS