Adolescent Mental Health

Key facts

• One in six people is between 10 and 19 years old.
• Mental health conditions account for 16% of the global burden of disease and injury among people aged 10 to 19 years.
• Half of all mental health conditions begin at age 14, but most cases are undetected and untreated.
• Depression is one of the leading causes of illness and disability among teenagers in the world.
• Suicide is the third cause of death for people between the ages of 15 and 19.
• The consequences of not taking care of adolescent mental health ailments extend into adulthood, causing both physical and mental health impairment and limiting the chances of a satisfying life in adulthood.
• Promoting mental health and preventing mental health conditions are essential to helping adolescents grow and thrive.

 Introduction

Adolescence (10-19 years) is a unique and formative stage. While most adolescents enjoy good mental health, multiple physical, emotional and social changes, including exposure to poverty, abuse or violence, can make adolescents vulnerable to mental health problems. Promoting adolescents’ psychological well-being and protecting them from harmful experiences and risk factors that may affect their growth potential are not only essential to their safety during adolescence, but also to their physical and psychological health in adulthood.

Determinants Of Mental Health

Adolescence is a critical period for developing and maintaining social and emotional habits important for psychological well-being. This includes following healthy sleep patterns, getting regular exercise, developing coping skills, problem-solving and interpersonal skills, and learning to manage emotions. Supportive environments within the family, school, and community in the broader community are also important.

There are several factors that determine a teen’s mental health at any given time. The more risk factors adolescents are exposed to, the greater the potential impact on their mental health. Among the factors that can contribute to stress during adolescence are the desire for greater independence, pressure to conform with peers, exploration of gender identity, and increased access to and use of technology. The influence of the media and gender norms can increase the discrepancy between an adolescent’s lived reality and their perceptions or future aspirations. Other important determinants of adolescent mental health are the quality of his family life and his relationships with his peers. Moreover, violence (including cruel father and mother treatment and harassment) and socio-economic problems are recognized mental health risks. Children and adolescents are particularly vulnerable to sexual violence, which is closely linked to mental health problems.

Some adolescents are considered to be at greater risk of mental health conditions due to their living conditions, stigma, discrimination or exclusion, or lack of access to quality support and services. This includes adolescents in human and vulnerable situations, adolescents with chronic disease, autism spectrum disorder, intellectual disability or other neurological disorders, pregnant teens, teen parents / teenage mothers, or adolescents who are early and / or forcibly married, and orphans. And adolescents belonging to ethnic, sexual, or other minorities who suffer from discrimination.

Adolescents with mental health conditions are also particularly vulnerable to social exclusion, discrimination and stigmatization (which impede seeking help), education-related difficulties, risk-taking behaviors, physical ill-health and human rights violations.

Adolescent Mental Health Conditions

It is estimated that 10 to 20% of adolescents globally suffer from mental health conditions, but the level of diagnosis and treatment of these disorders is still low. Signs of poor mental health can be overlooked for several reasons, including the lack of knowledge or awareness of mental health among health workers, or the feeling of stigma that prevents them from seeking help.

Emotional Disturbances

Emotional disturbances usually appear during adolescence. In addition to depression or anxiety, teens with emotional distress may also feel irritable, frustrated or angry. Symptoms can overlap between several forms of emotional distress, and are interspersed with rapid and unexpected changes in mood and emotional outbursts. Younger adolescents may also develop symptoms of a physical nature due to psychological causes such as stomach pain, headache or nausea.

Globally, depression ranks ninth in the ladder of leading causes of illness and disability among all adolescents, while anxiety ranks eighth. Affective disorders may significantly disrupt a teen’s performance, affecting his work and school attendance. Distancing or avoiding family, colleagues, or society may exacerbate isolation and loneliness. Depression at its worst can lead to suicide.

Behavioral disorders in children

Childhood behavioral disorders are the sixth leading cause of disease burden among adolescents. Adolescence may be the stage where rules and boundaries are tested. However, behavioral disorders in children represent repetitive, excessive, and inappropriate behaviors for a person’s age, such as hyperactivity and inattention (such as ADHD) or destructive or difficult behaviors (such as behavioral disorder). Childhood behavioral disorders can affect adolescents’ education, and are sometimes caused by contacts with judicial systems.

Eating disorders

Eating disorders usually appear during adolescence and young adults, and most affect females more than males. Eating disorders such as anorexia nervosa, bulimia nervosa and binge-eating disorder are characterized by harmful eating behaviors such as caloric restriction or binge eating. Anorexia nervosa and bulimia nervosa also involve anxiety associated with food, body image or weight, as well as other behaviors such as excessive exercise or vomiting to get rid of the calories consumed. People who suffer from anorexia nervosa are thinner and have an increased fear of their weight gain. For people with BED, they may feel distress, guilt, or self-loathing when eating binge. Eating disorders are harmful to health and often coexist with depression, anxiety and / or substance abuse.

Psychosis

The stage of psychotic symptoms usually appears in adolescence or early adulthood. Symptoms of psychosis can manifest as hallucinations (such as hearing or seeing things that are not real) or delusions (including deep-rooted and inaccurate beliefs). Experiences with psychosis can significantly limit a teen’s ability to participate in daily life and learning. At-risk exposure is exposed to at-risk exposure when exposed to adolescent-at-risk risks.

Suicide & self-harm

An indication that 26,000 teenagers died in 2016 as a result of self-harm. Suicide is the leading cause of death among older adolescents (ages 15-19). About 90% of adolescents are in their teens in middle- or middle-income countries. Suicide attempts may be impulsive or be triggered by a lonely feeling of hopelessness. The risk factors for suicide are multifaceted, and turn into the harmful use of alcohol, the stigma that prevents abuse in childhood, the stigma that prevents abuse, the obstacles to obtaining the care and means you need, etc. Digital media is a communication concern about suicidal behavior.

Risk Behaviors

Many risk behaviors that pose a health risk, such as substance abuse or risky sexual behaviors, begin during adolescence. Adolescents’ limited ability to plan and manage their emotions and normalize risks affecting the health of their peers, as well as contextual factors such as poverty and exposure to violence, can increase the likelihood of a teenager engaging in risk-taking behaviors. Risk behaviors can constitute an unhelpful strategy for dealing with poor mental health, and they may have a dire impact on the psychological and physical well-being of an adolescent.

Harmful substance abuse (such as alcohol or drugs) is a major concern in most countries. Globally, the prevalence of bouts of binge drinking among adolescents between the ages of 15 and 19 was 13.6% in 2016, bearing in mind that males are more susceptible to this than others. Harmful substance abuse in teens increases the likelihood that they will engage in other risky behaviors such as unsafe sex. Sexual risk, in turn, increases adolescents’ risk of contracting sexually transmitted diseases and early pregnancy, which is one of the leading causes of death among older adolescents and young women (including during childbirth and unsafe abortions).

Tobacco and hemp use are an additional concern. In 2016, estimates based on available data from 130 countries indicated that 5.6% of children between the ages of 15 and 16 had used cannabis at least once in the previous year [1], while many adult smokers smoked their cigarettes. The first is before they reach the age of 18 years.

The commission of violence is a risky behavior and can increase the likelihood of decreased academic achievement, injury, involvement in crime, or death. Interpersonal violence was the second leading cause of death in older teens in 2016.

Health promotion and prevention

Interventions to promote adolescent mental health aim to enhance protective factors and improve alternatives to risk-taking behaviors. Promoting adolescents’ mental health and well-being helps them gain the resilience that enables them to cope well with some difficult situations or adversity. Programs to promote the health of all adolescents and prevention programs targeting adolescents with mental health conditions require a multi-layered approach involving various platforms such as digital media, health or social care institutions, schools, or the community.

Here are some examples of health promotion and prevention activities:

• Online psychological interventions either individual, group, or self-directed.
• Family-focused interventions, such as caregiver skills training, including interventions that meet the needs of caregivers.
• Interventions in schools, such as:

1. Organizational changes for a safe, secure and positive psychological environment.
2. Education about mental health and life skills.
3. Staff training in detecting and managing suicide risk cases is essential.
4. School prevention programs for adolescents at risk of mental health conditions.

• Interventions in local communities such as peer leadership or mentoring programs.
• And prevention programs that target vulnerable groups of adolescents, such as those affected by humanitarian and fragile situations, minorities or groups that suffer from discrimination.
• And programs aimed at preventing sexual violence against adolescents and managing its effects.
• And multisectoral programs on suicide prevention.
• And interventions on several levels for the prevention of alcohol use and substance abuse.
• And comprehensive sexuality education to help prevent risky sexual behaviors.
• And violence prevention programs.

Early detection and treatment

It is extremely important to meet the needs of adolescents with specific mental health disorders. Avoiding institutionalization and excessive medical interventions, prioritizing non-pharmacological approaches, and respecting children’s rights in line with the United Nations Convention on the Rights of the Child and other human rights instruments are essential factors for adolescents.

Interventions for adolescents should consider:

• The importance of early detection of mental and substance use disorders and evidence-based interventions. The WHO Mental Health Gaps Action Program (mhGAP) provides a set of evidence-based guidelines for non-specialists to enable them to identify priority mental health conditions in under-resourced countries and support better treatment.
• Comprehensive diagnostic interventions, such as those that target multiple mental health problems.
• It is carried out by supervised staff trained in managing the special needs of adolescents.
• Engage and empower caregivers, as appropriate, and identify adolescents’ preferences.
• Direct and targeted self-help methods, including online mental health interventions. Undirected self-help may be appropriate for adolescents due to stigma or limited access to services.
• Psychotropic drugs should be used with great caution and should only be given to adolescents with moderate or severe mental health conditions if psychosocial interventions have been shown to be ineffective, and when medically required and with informed consent. Treatment must be administered under the supervision of a specialist and under strict medical supervision to avoid any potential adverse effects.

WHO response

In 2017, the World Health Organization released the publication “Accelerating Global Action for Adolescent Health: Guidance to Support Implementation in Countries” (AA-HA!) With the aim of helping governments respond to the health needs of adolescents in their countries, including in the area of ​​mental health. The publication emphasizes the benefits of actively involving adolescents in the development of national policies, programs and plans.

Global Acceleration of Action for Adolescent Health: Guidance to Support Country Implementation

The Global Strategy on Women, Child and Adolescent Health (2016-2030) affirms that every adolescent has the right to enjoy physical and psychological integrity, and adolescents are considered a central issue in achieving the 2015-2030 Sustainable Development Goals.

The Mental Health Action Plan 2013-2020 constitutes a commitment from all member states of the World Health Organization to take specific measures to enhance the psychological well-being of people with mental disorders, including adolescents, prevent these disorders, provide care for them, improve their chances of recovery, enhance their human rights, and reduce the rates of death, morbidity and disability. between them.

The WHO Mental Health Gaps Action Program (mhGAP) provides evidence-based technical guidance, tools and training materials to expand service delivery in countries, particularly in low-resource settings. It addresses issues relating to adolescents everywhere, including a specific module on mental and behavioral disorders for children and adolescents.