Ophélie Martin, Communications Officer at Mental Health Europe outlines the importance of early intervention and care for young people who may develop mental health issues…
Adolescence can be a turbulent and challenging period. It is a time when young people are building their identity against a backdrop of physical and developmental changes. Educational pressure can mount, and increasingly complex social interactions and relationships need to be negotiated. It is therefore, unsurprising that adolescence is a time of challenging behaviours and wide fluctuations of mood and emotion. These are, in many ways, normal reactions to various pressures and changes. However, some young people will experience more extreme distress. How can we identify what is ‘unusual’ distress, and how can parents, professionals and mental health services best support adolescents experiencing it?
Distress can take many forms. Anxiety, depression, body image issues (commonly known as anorexia nervosa and bulimia), violence or substance abuse are all problems that many young people will face. Studies show that one in 5 adolescents is affected by at least one psychological problem in any given year. Even more alarmingly, there is strong evidence to suggest that mental health problems developed during adolescence can continue in adulthood and in some cases become chronic and enduring.1 Mental health problems do not only affect young people, their family and friends but they can also therefore, have a longer-term impact on their social development and their adult lives. Addressing mental health problems during childhood and adolescence is therefore, crucial and should form part of an integrated approach to mental health through the lifespan.
That is why researchers, organisations and health professionals are calling for appropriate prevention and care for young people2, in particular adolescents. Adolescents have different care needs to adults and children as they are in a transition process and are living with constant change. Detection and prevention are even more challenging as adolescents tend to be reluctant to share their worries or feeling with adults in their family or at school.
What can we do to help without being too intrusive?
The first question is perhaps- what is ‘unusual’ distress? When should a parent or youth worker be worried? The answer to this is crucial: there is no right or wrong distress. Normalising emotions is a vital first step in opening up communication and building trust with a young person. But normalising does not mean minimising. Validating and acknowledging distress, whilst promoting hope, is how we can start conversations with young people around the causes of their distress, and ways in which it might be managed. This non-stigmatising approach, which is being delivered in some adolescent mental health care (AMHC) services in Europe, ensures that the young person is not ‘problematised’ and communication channels stay open.
In some cases, adolescents may need to access professional support. However, too many adolescents who access services are placed in child or adult services. A recent study3 has showed that many adolescents and young adults with mental health problems do not receive adequate care or get no treatment at all. It is worrying that we have failed to address this treatment gap given what we know about prevention and the development and costs involved in chronic mental health problems. It is vital that there is adequate and widespread provision of AMHC services across Europe and that more healthcare professionals are trained in delivering age-sensitive support for adolescents.
To address this treatment gap and promote youth mental health, we need to invest in appropriate programmes in schools, where adolescents spend most of their time (5 days a week, more or less 7 hours per day across Europe). Appropriate programmes could take the form of psycho-education, coaching and counselling in school settings, which may be more effective to reach out to adolescents. Sport, music and art can also be important coping strategies and give meaning to young people’s lives, and could also be used as part of an integrated support system.
The ADOCARE report4 presents very interesting findings and key recommendations to prevent and promote mental health in schools, which include basic trainings for teachers, classes on mental health in the curricula as well as the involvement of health professionals within a school setting. It is crucial to give teachers the right tools to detect early signs of mental distress, and to learn how to approach students in a non-intrusive way to improve communication and mutual understanding.
Mental Health First Aid for parents, teachers, youth workers and young people themselves could be considered as a first step in acknowledging that mental health is as important as physical health. Mental Health First Aid is an educational course teaching people how to identify, understand and help a person who may be living with distress. It can help give the right tools to family and friends to detect early signs of distress and to work with the young person to help them make sense of their experiences and develop coping strategies.
We know that young people spend an increasing amount of time online, on the internet or on their smartphone. We now live in the digital era and should seize this opportunity to improve access to mental health care and information for young people. The internet and online presence play an increasing role in the lives of millions of adolescents today.
The development of web-based interventions and mobile applications are therefore essential since they can provide appropriate help and support to young people through their screens. Mobile health (m-health) service are being developed and have proved in some cases to be very helpful. Websites and apps have enormous potential to inform adolescents about their own mental health care, access to care, but also to engage them more actively during treatment through follow-up planning and additional support. Adolescents may also look for information online before speaking up about their own experience. The sense of anonymity and community that can be found online gives room and opportunity to develop adapted support and information tools for young people.
Numerous avenues can be explored to improve the prevention and promotion of youth mental health, and this article outlines only some of them. Raising awareness is not always enough. Normalising feelings and experiences, acknowledging distress and promoting hope, thinking creatively and collaboratively about coping strategies- these are basic but powerful ways in which parents and teachers can support a young person. Adolescent mental health services need to be appropriate, flexible and integrated. Rather than placing young people as passive recipients of services, they would meaningfully consult them in the devising and delivery of services. This would ensure that mental health care provision can respond to the real needs of young people experiencing distress.
1 World Health Organization. (2005a). Child and adolescent mental health policies and plans.
2 Adocare final report. (2015) Adolescent mental health care in Europe: state of the art, recommendations, and guidelines by the ADOCARE network.
3 Copeland, Shanahan L, Davis M, Burns BJ, Angold A, Costello EJ. (2015) Increase in untreated cases of psychiatric disorders during the transition to adulthood.
4 Adocare final report. (2015) Adolescent mental health care in Europe: state of the art, recommendations, and guidelines by the ADOCARE network.
Mental Health Europe is an umbrella organisation which represents associations, organisations and individuals active in the field of mental health and well-being in Europe, including (ex) users of mental health services, volunteers and professionals. As such, MHE bridges the gap between its 73 member organisations and the European institutions, and keeps its members informed and involved in any developments at European Union level.
Mental Health Europe