Adolescents can face mental health problems during puberty, especially when their relationships and support systems are challenged. Prevention strategies that promote youth mental health, such as helping teens feel connected to school and family, can help.
Many teens are uncomfortable talking about their mental health. That’s especially true for girls, kids of color and LGBTQ+ youth.
Social determinants of mental health
A wide range of social factors can contribute to mental health, influencing exposure to risk factors and protective factors. These include childhood adversities, poverty and inequality, discrimination and marginalization, housing disadvantage, and ongoing economic and environmental stressors (e.g. food, energy and economic crises, global conflict and racial injustice, climate change).
The duration and severity of socioeconomic disadvantage during early life is particularly important for later mental health outcomes. For example, in longitudinal studies, children growing up in relative poverty are more likely to experience mental health problems by age 12 than children from wealthier families. This is associated with increased exposure to adversities, including racial stigma and structural racism 158.
The physical environment also plays an important role, with research supporting a link between the quality of neighbourhood environments and mental health. For example, cross-sectional and longitudinal research suggests that living in deprived neighbourhoods is associated with depression and psychotic symptoms, independent of material disadvantage and education level 256.
Adolescents and young adults
Adolescence is a critical time for acquiring social and emotional habits that are important for mental well-being. A good diet, regular exercise and a supportive environment in the home and school are key to adolescents’ mental health.
Adequate treatment for mental illness can make a huge difference to teen health and wellbeing. Unfortunately, many young people don’t get the help they need.
Many adolescent mental illnesses, such as depression and post-traumatic stress disorder (PTSD), are treatable with cognitive therapies and medication. Treatment can also improve adolescent functioning and lead to better outcomes in school, work and relationships.
Adolescents who have a mental illness, such as bipolar disorder or anorexia nervosa, are at risk for poor school performance and behaviour. They are also at higher risk for substance use and unsafe sexual behaviours that can result in pregnancy, STIs and other health complications. Adolescents with psychiatric disorders who are pregnant or breastfeeding may experience adverse effects of psychopharmacologic drugs on the hypothalamic pituitary-gonadal axis, including anovulatory cycles and galactorrhea.
Children and young people with mental health disorders
Adolescence is a critical time for mental health because certain conditions can impact the brain in a permanent way. For example, substance use can disrupt the creation of essential pathways in the brain. This can lead to psychosis. Adolescents also face high rates of suicide, making it the second leading cause of death for this age group.
Children can experience mental distress for a variety of reasons, including changes at home or school and trauma. Their experiences and behaviors may superficially indicate a psychiatric disorder, but it is important to consider the developmental context and other factors.
Support youth and families by ensuring access to quality, comprehensive mental health care through universal screening and integration of treatment into primary care. Address the economic and social barriers that contribute to poor mental health for youth and their caregivers, including addressing how technology impacts their wellbeing. Provide educational resources for families and youth about mental health to raise awareness and encourage help-seeking behaviours.
Prevention
A major priority is preventing mental health problems from occurring in the first place. Meta-analytic work has shown that multimodal preventive programs targeting childhood trauma, parental stressors, substance abuse and family discord have the most enduring benefits.
Promote socially adaptive behavior and coping skills, and target modifiable life-style factors that can have a strong impact on mental health, including sleep, healthy eating, activity, sunshine and light, and media use. Address the needs of groups at high risk of developing mental health challenges, such as adolescents living in humanitarian and fragile settings; adolescents with a chronic illness or developmental disability; adolescent parents and those in early or forced marriages; and racial/ethnic minority youth.
Promote open dialogue about mental health and reduce negative stereotypes, bias and stigma. This should be especially focused on populations with outsized influence over young people, such as families, faith leaders, health care professionals, and online influencers. Increase access to comprehensive and affordable mental health services through integrated healthcare models, such as those developed in Ireland (‘Headstrong’ and ‘Jigsaw’) and elsewhere.