Young people today face a world of multiple crises and uncertainties. Young people born in 2006 will experience the Great Recession and subsequent austerity measures, the disruption of schooling and social isolation caused by the pandemic, the cost of living crisis, wars in Europe, and a world that is experiencing severe climate change. There have been many turbulent times in history, but little evidence of the mental health of young people at the time. In these uncertain times, how should we view the mental health of young people?
In this week’s issue of The Lancet, Anita Thapar and colleagues point out that in Seminar on Depression in Young People The importance of treating mental illness as a spectrum. At one end is the “emotional state during normal mood swings,” which does not meet all diagnostic criteria, but affects quality of life and may be a risk factor for depression later in life. At the other end is a heterogeneous group of symptoms that can constitute depression or mood disorders (including anxiety). Prevalence across the spectrum has risen dramatically over the past decade, even before the COVID-19 pandemic, especially among younger female populations.
Most mental disorders are rare in childhood, but become more common in adolescence that lasts until age 24. Although the incidence varies from country to country, in high-income countries the peak incidence is shown between the ages of 17 and 19 years. Estimates suggest that one in three to five children or adolescents worldwide suffers from an anxiety disorder at some stage. Rates of suicidal ideation, suicide planning, and suicide attempts remain relatively low among adolescents, but together they constituted the fourth leading cause of death for 15- to 19-year-olds globally in 2019. A systematic review and meta-analysis recently published in The Lancet Psychiatry estimated that the overall prevalence of suicidal ideation in children under 12 years of age was 7.5% (95% CI 7.5%). 5.9-9.6). This situation is undoubtedly worrying. It also represents a challenge for medicine and society. In medicine, there are few treatment trials to guide clinicians for severe psychological disorders in children and adolescents, and a severe lack of access to services means that too many people do not receive appropriate support or treatment. On the less severe end of the spectrum, to what extent is the increased burden of mental illness among young adults a normal response to a range of abnormal circumstances?
It is clear that unhappiness, lack of worth, or social anxiety among young people may be a reasonable response to more than two years of social isolation during a pandemic, especially when such social isolation occurs During adolescence – a period of critical importance to the development of young people. Peer support, real-world companionship, and learning from each other’s social cues and behaviors are critical to future mental health. One report states that young people in Europe are more likely to “experience unemployment, financial insecurity and mental health problems than older people. Associated with stay-at-home requirements and school closures, young people report higher levels of life satisfaction and mental health. dropped”. Anxiety about climate change is also a factor. In a survey of 10,000 children in 10 countries, more than 50 percent of respondents reported feelings of sadness, anxiety, anger, powerlessness, helplessness and guilt. It’s hard not to be disheartened when the future of all living things is in jeopardy. This reaction permeates the unhelpful generational stereotype that young people are awakened, or that they are a sensitive, spoiled generation. These are all appropriate responses when the vision for a better future is at stake.
This week’s issue of The Lancet also announced the establishment of the second adolescent health and wellbeing Commission, whose The mission is to ensure that “teenagers today have the means to meet the unique challenges of their generation”. Recently, an important signal is being sent about the increasing burden of mental illness among adolescents. Mental health problems in children and adolescents are neither uncommon nor unexpected—they need to be addressed. Clearly, there is a need for improved treatments and better, more accessible services, but this need goes beyond health services. For example, schools should not only be centers of academic achievement, but should be places to foster mental health. Governments and policymakers must also act in concert on young people’s concerns. Building systems in which young people live and interact, from the family to the community, is the key to promoting mental health. Here young people can be supported and laid the foundation for a healthier future. END
For the Eurofound report see
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