Poor mental health in adolescents can have a significant impact on their school and work performance, social life and even their decisions about health and risky behaviors. It can lead to depression, anxiety and thoughts of suicide. These feelings are more common among girls, LGBTQ+ youth and students from minority ethnic and racial groups.
Risk Factors
Many risk factors can lead to mental health problems, including frequent or long-term stress, abuse or trauma, poor living conditions and family instability. These factors can contribute to low self-esteem and a lack of hope. Moreover, adolescents who have these issues are at greater risk for addictions, social dysfunction and poorer outcomes in life.
In addition, adolescence is when the foundations of mental health are established that last through adulthood. This is why it’s critical that teens feel connected to their school and families.
This study used latent class analysis (LCA) to identify four distinct groups of adolescents with different levels of risk for poor mental health. It also demonstrated the impact of multiple risk factors from three domains – individual, family and community – in influencing mental health. However, several limitations must be taken into account when interpreting this research. For example, the reliance on self-reports for some measures (e.g., breastfeeding, LBW) raises the possibility of recall bias.
Early Detection
As with many health challenges, early detection is essential. The best time to identify and treat mental health problems is when they first occur, rather than allowing them to worsen.
Adolescents with mental health problems are at increased risk for engaging in high-risk behaviours like substance abuse, self-harm and sexual activity that increases the risks of HIV infection and unintended pregnancy. These risk behaviours often go hand in hand with poor academic performance and difficulties at school or work.
Screening tools, like those available in most health care settings, can help to identify young people who are at risk. Moreover, early diagnosis and treatment can reduce long-term disability and prevent years of suffering. A recent cluster-randomised trial found that shared care with mental health professionals located in GP offices contributed to a greater detection of anxiety symptoms among youth, particularly when the physician was the patient’s regular GP, and a decrease in the use of International Classification of Primary Care 2 diagnoses of unspecified symptom.
Treatment
A large proportion of adolescents experience mental health difficulties. These include anxiety, mood disorders, substance use disorders, and disorders in which psychosis can develop. Adolescents may also be at risk of suicide. For these reasons, it is important to provide support and treatment options to ensure that young people are not excluded from society.
Developing and improving where necessary youth mental healthcare models that implement prevention and early intervention strategies is an urgent imperative. These should be based on normative developmental data that take into account sensitive periods as well as knowledge of known risk factors.
This could be achieved by implementing clinical staging models that better fit with youth-onset symptoms and addressing the nonspecificity and pluripotential nature of these early-stage phenomena. New technologies that combine digital phenotyping with human assistance, such as MindLAMP, offer great promise for changing developmental trajectories in young people.
Prevention
The good news is that many of the same preventive strategies that support mental health also reduce a wide range of negative experiences like drug use and violence. These include helping youth feel connected to school and family. Such experiences can help them establish healthy patterns that will carry into adulthood.
A large proportion of mental disorders occur in young people and most develop during adolescence [1, 2]. In the decade before 2019, rates of ED visits with a principal diagnosis related to mental health among youth ages 12-17 increased 70%. This increase was even more pronounced for females and LGBTQ youth.
Preventive interventions that address social, environmental and biological risk factors can have a significant impact on reducing the incidence, prevalence and severity of targeted mental health conditions. Meta-analytic work supports the effectiveness of multimodal prevention programs addressing child abuse, parental mental illness, substance abuse and school-related problematic behaviors. However, for some risk factors it is impossible or unethical to implement preventive measures (e.g. childhood adversities, vitamin D deficiency, infections, season of birth, urban environment), and others are still developing (e.g., psychosis).