One in six people are in the 10-19 age group. Adolescence is a unique, defining period of personality formation. Physical, emotional and social changes, including living in poverty, abuse and violence, can increase adolescents’ vulnerability to mental health problems. Protecting adolescents from adversity, promoting social-emotional skills and psychological well-being, and ensuring access to mental health care are critical to their health and well-being in adolescence and adulthood.
Facts
- Mental disorders affect one in seven people aged 10-19 in the world; they account for 13% of the global burden of disease in this age group.
- Depression, anxiety and behavioral disorders are among the leading causes of morbidity and disability among adolescents.
- Suicide is the fourth leading cause of death in the 15–29 age group.
- Failure to address mental health problems during adolescence has consequences that extend into adulthood, affecting both physical and mental health and limiting opportunities for fulfilling adulthood.
Determinants of mental health
Adolescence is a critical period in the development of social and emotional skills that are important for mental well-being. These include developing a healthy sleep pattern; regular physical activity; development of skills in the field of overcoming difficult situations, solving problems and interpersonal communication; and training in emotional self-control. Safe, supportive environments in the family, school and community at large are essential.
A number of factors affect adolescent mental health. An increase in the number of risk factors affecting an adolescent exacerbates their potential consequences for his or her mental health. In particular, exposure to adverse factors, the desire to be the same as peers, and the search for identity can increase the level of stress in adolescence. The influence of media and gender norms can exacerbate the discrepancy between the reality in which the adolescent lives and his aspirations or ideas about the future. Other significant determinants of mental health are the quality of life in the family and relationships with peers. Recognized risk factors for mental health are violence (especially sexual abuse and bullying by peers),
Some adolescents are at increased risk of mental health problems due to living conditions, stigma, discrimination, social exclusion, or lack of access to quality care and services. This category includes adolescents living in humanitarian crises and precarious situations; adolescents suffering from chronic diseases, autism spectrum disorder, intellectual disabilities and other neurological disorders; pregnant teenagers, teenagers who have become parents or entered into early or forced marriage; orphans; and adolescents from ethnic or sexual minorities or other discriminated groups.
Emotional disorders
Emotional disorders are common in adolescence. The most common anxiety disorders in this age group (which may include panic or excessive worry); they are more common in older than in younger adolescence. Anxiety disorder is estimated to develop in 3.6% of adolescents aged 10–14 and in 4.6% of adolescents aged 15–19. Depression occurs in 1.1% of adolescents aged 10-14 and 2.8% of adolescents aged 15-19. Depression and anxiety share a number of common symptoms, including rapid, unexpected mood changes.
Anxiety and depressive disorders can lead to severe declines in school attendance and performance. Social exclusion can exacerbate isolation and feelings of loneliness. Depression can lead to suicide.
Behavioral disorders
Behavioral disorders are more common in younger than in older adolescents. Attention-deficit/hyperactivity disorder (ADHD), characterized by difficulty concentrating, being overly active, and acting without regard for consequences, occurs in 3.1% of adolescents 10–14 years of age and 2.4% of adolescents 15–19 years of age (1). Conduct disorder (in which symptoms such as disruptive, problematic behavior occur) occurs in 3.6% of adolescents 10–14 years of age and 2.4% of adolescents 15–19 years of age (1). Behavioral disorders can negatively affect adolescent learning, and conduct disorder can lead to offending behaviour.
Eating Disorders
Eating disorders such as anorexia nervosa and bulimia nervosa usually begin during adolescence and early adulthood. Eating disorders are characterized by abnormal eating behavior and fixation on the topic of food, which in most cases is accompanied by concerns about body weight and fitness. Anorexia nervosa can cause premature death, often due to medical complications or suicide, and has a higher mortality rate than any other psychiatric disorder.
Psychotic disorders
Disorders characterized by psychotic symptoms most commonly occur in late adolescence or early adulthood. Symptoms may include hallucinations and delusions. Psychotic conditions can seriously impair an adolescent’s ability to participate in daily life and receive education. In many cases, they lead to stigmatization and human rights violations.
Suicide and self-harm
Suicide is the fourth leading cause of death in older adolescence (15–19 years) (2). Risk factors for suicide are varied and include harmful use of alcohol, childhood abuse, stigma in seeking help, barriers to getting help, and availability of means to commit suicide. Digital media, like any other media, can play a significant role in strengthening or weakening suicide prevention efforts.
Risky behaviors
Many health risk behaviors, such as substance use and risky sexual behavior, have their origins in adolescence. Risky behaviors can be unsuccessful attempts to cope with emotional difficulties and can have dire consequences for an adolescent’s mental and physical well-being.
In 2016, the prevalence of heavy episodic drinking among adolescents aged 15–19 years was 13.6% globally, posing the highest risk for boys and young men (3).
There is also concern about the use of tobacco and cannabis. Many adult smokers try their first cigarette before the age of 18. Cannabis is the most commonly used drug among young people, with about 4.7% of 15–16 year olds using it at least once in 2018 (4).
Committing violence is a risky behavior that can increase the likelihood of poor academic performance, injury, involvement in illegal activities or death. In 2019, interpersonal violence was identified as one of the leading causes of death among adolescent boys (5).
Mental health promotion and prevention
Mental health promotion and prevention measures are designed to increase a person’s ability to control their emotions, expand the range of alternatives to risky behaviors, develop resilience to successfully cope with difficult situations and adverse factors, and promote a supportive social environment and a system of social relationships.
These programs need to be delivered at many levels using different platforms, such as electronic media, health and social care settings, educational institutions or communities, and different strategies to ensure that they reach adolescents, especially the most vulnerable.
Early detection and treatment
Responding to the needs of adolescents with mental health problems is essential. The main principles of work in the field of mental health of adolescents are to avoid referring them to specialized institutions and prescribing excessive amounts of drugs, to use non-pharmacological methods in the first place, and to respect the rights of children in accordance with the United Nations Convention on the Rights of the Child and other documents. on human rights.
WHO action
WHO develops strategies, programs and tools to help governments provide adolescents with the health care they need.
For example, the Promoting Adolescent Thriving (HAT) initiative to improve the effectiveness of adolescent mental health policies and programs is underway. Efforts under the Initiative are directed, in particular, to the promotion of mental health and the prevention of mental illness. In addition, they are designed to prevent self-harm and other risky behaviors, such as the harmful use of alcohol and drugs, which negatively affect the mental and physical health of young people.
WHO has developed a module on mental and behavioral disorders in children and adolescents for version 2.0 of the mhGAP Intervention Guide. The Guidelines include evidence-based clinical protocols for the assessment and treatment of a range of mental illnesses in non-specialized health settings.
In addition, WHO is developing and piloting scalable psychological interventions for adolescent emotional distress and guidelines for adolescent mental health services.
The WHO Regional Office for the Eastern Mediterranean has developed a mental health training package for educators to improve understanding of the importance of mental health in educational institutions and to guide the implementation of strategies to promote, protect and restore student mental health. The kit includes teaching aids and materials to help increase the number of schools doing mental health work.
