Preventing mental health problems in adolescents  

SM Yasir Arafat     | Published: May 21, 2019 22:11:33 | Updated: May 23, 2019 22:16:57

Adolescence is the time when social and emotional habits for mental well-being usually develop. Some of these habits include adopting healthy sleep patterns, regular exercise, coping, problem-solving, and interpersonal skills and learning to manage emotions.

According to the World Health Organisation, globally 10-20 per cent of adolescents experience mental health conditions. Still these remain under-diagnosed and undertreated. Signs of poor mental health can be overlooked because of a lack of knowledge or awareness about mental health among health workers, or stigma preventing families from seeking help.

Research has revealed that about 16 to 18 per cent of children and adolescents have been suffering from mental disorders in Bangladesh. According to the World Health Organisation (WHO), globally, about half of all mental health conditions start by 14 years of age. But most cases remain undetected and untreated. Depression is one of the leading causes of illness and disability among adolescents.

Emotional Disorders: Emotional disorders commonly emerge during adolescence. In addition to depression or anxiety, adolescents with emotional disorders can also experience excessive irritability, frustration, or anger. Symptoms can overlap across more than one emotional disorder with rapid and unexpected changes in mood and emotional outbursts. Younger adolescents may additionally develop emotion-related physical symptoms such as stomach ache, headache, or nausea. Emotional disorders can be profoundly disabling to an adolescent's functioning, affecting schoolwork and attendance. Withdrawal or avoidance of family, peers or the community can exacerbate isolation and loneliness. At its worse, depression can lead to suicide.

Childhood Behavioural Disorders: Adolescence can be a time where rules, limits and boundaries are tested. However, childhood behavioural disorders represent repeated, severe and non-age-appropriate behaviours such as hyper-activity and inattention (such as attention deficit hyperactivity disorder) or destructive or challenging behaviours (for example, conduct disorder). Childhood behavioural disorders can affect adolescents' education, and are sometimes associated with contact with judicial systems. 

Psychosis: Disorders that include symptoms of psychosis most commonly emerge in late adolescence or early adulthood. Symptoms of psychosis can include hallucinations (such as hearing or seeing things which are not there) or delusions (including fixed, non-accurate beliefs). Experiences of psychosis can severely impair an adolescent's ability to participate in daily life and education. 

Suicide and Self-harm: Suicide is the third leading cause of death in older adolescents (15-19 years). Suicide attempts can be impulsive or associated with a feeling of hopelessness or loneliness.

Risk-taking Behaviours: Many risk-taking behaviours for health, such as substance use or sexual-risk taking, start during adolescence. During this time, there are limitations in adolescents' ability to plan and manage their emotions. Risk-taking behaviours can be both an unhelpful strategy to cope with poor mental health, and can negatively contribute to and severely impact an adolescent's mental and physical well-being. For example, violence is a risk-taking behaviour which can increase the likelihood of low educational attainment, injury, involvement with crime, or death.

The consequences of not addressing adolescent mental health conditions extend to adulthood, impairing both physical and mental health and limiting opportunities to lead fulfilling lives as adults. Such mental health issues need to be addressed on an urgent basis. This is also the reason why youngsters need to be busy in sports, cultural and social activities and not be in an unhealthy competition to do phenomenally well in academic exams which can exert mental pressure on them. 

Treatment: It is crucial to avoid institutionalisation and over-medication, prioritise non-pharmacological approaches, and respect the rights of children in line with the United Nations Convention on the Rights of the Child and other human rights instruments.

Promotion of mental health and well-being helps adolescents in building resilience so that they can cope well in difficult situations or adversities.  Promotion programmes for all adolescents and prevention programmes for adolescents at risk of mental health conditions require a multi-level approach with varied delivery platforms, such as digital media, health or social care settings, schools, or community.

Dr. S M Yasir Arafat is an Assistant Professor, Department of Psychiatry, CARe Medical College, Dhaka, Bangladesh



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