Adolescence is a time of rapid brain development. It’s also when health problems like mental illness and substance use disorders often emerge.
But youth are resilient, and protective factors can help them stay well. And healthcare professionals are uniquely positioned to promote good mental health. They have long-term relationships with families and can help destigmatize mental health care.
Risk Factors
A wide range of risk factors can contribute to the development of mental health problems in youth. These can be either environmental or biological in origin. Some of these risk factors may be more prevalent in certain groups of people than others, such as being female (for example, depression is more common in girls), having a parent with depression, or experiencing childhood trauma or abuse. Other risk factors may be more long-lasting or influential over a lifetime, such as being exposed to frequent and/or prolonged stress, being involved in the child protection or youth justice system, having a disability, or being from a refugee family.
Some of these risk factors are preventable, such as feeling connected to school and family, practicing positive coping skills, and having healthy relationships. Other risk factors are more difficult to control, such as living in poverty, witnessing violence, having harsh parenting, and drug or alcohol use. The more risk factors a person has, the greater their chance of having a mental illness.
Symptoms
Youth who experience mental health issues can exhibit a variety of symptoms. Some warning signs of mental illness can look like typical adolescent angst, such as difficulty in school, trouble with friends or a change in appetite. Others may experience more severe symptoms, including hallucinations or a feeling that they are not human. These are serious signs that should be evaluated by a mental health professional immediately.
Teens who are experiencing a mental health crisis should be seen at the emergency room to be stabilized. A therapist or other professional can help a young person to manage their symptoms and prevent them from becoming more severe in the future.
If a teen is concerned about their mental health, they should be encouraged to talk with their healthcare provider and other trusted people such as family friends, teachers, coaches, guidance counselors or even their friends’ parents. They should also be reassured that their feelings are normal and that it is okay to have them.
Treatment
The COVID-19 pandemic exacerbated the anxiety, depression and behavioral problems that had long plagued many young people, resulting in a mental health crisis as described by the U.S. surgeon general last year. Psychologists are working to address the problem at all levels — from training clinical professionals and developing new interventions to rethinking public policy to better support children, youth and their families.
Individual therapy, also known as psychotherapy or counseling, helps children and youth work through their feelings and behaviors in a safe environment. The goal is to help them find ways to cope with and manage their condition so they can lead healthy and productive lives.
Normative developmental data should be integrated with neuroimaging, peripheral and digital health and genomic information as well as knowledge about sensitive periods to develop stage- and risk-adapted interventions for youth mental health. A model that incorporates pluripotentiality, clinical staging and transdiagnostic lessons from early psychosis would be an important step in this direction.
Prevention
The good news is that many youth mental health challenges can be prevented. This is especially true if young people have the resources they need to manage stress, develop healthy coping strategies and avoid unhealthy behaviors.
State leaders can make a difference by addressing the social drivers of health, including disparities in economic security, access to education, healthcare and housing. They can also promote positive youth development, including social and emotional learning.
It is important to identify and respond to suicide risk. This includes screening adolescents for depression and anxiety, promoting resilience and protective factors and ensuring that they have safe and supportive relationships with adults. Parents, family members and educators can also be proactive by building strong connections, encouraging honest communication, establishing discipline policies that are consistent and fair and monitoring their adolescents’ activities and health behaviors. They can also work with their adolescent to build self-efficacy and resilience by encouraging them to practice healthy coping skills.