Mental health problems in youth
It is widely recognised throughout the Western world that heart disease and cancer are our biggest killers. However, in reality, an equally large burden on our society today really belongs to mental health problems because these are the problems that we live with long-term. They profoundly affect our ability to carry out our everyday duties, to go to work or school, our relationships with our friends, our families. In fact, all areas of our lives and those around us, can be acutely affected.
Myths and Misconceptions
There are a lot of myths and misconceptions that exist about mental illnesses and there are still many stigmas associated with these problems, yet mental health problems are common. Mental health problems now affect 1 in 5 Australian adults in any given year, in our teenagers the number is closer to 1 in 4. 18 is the median age of onset of all mental health problems - this means that half of all the mental health problems that will ever be, are already present in those teenage years.
Unfortunately, a lot of mental illness in youth goes undiagnosed for long periods of time. One of the main reasons for this is because it is difficult to recognise the difference between normal childhood behaviours and the signs of someone who is suffering from a mental illness. Many parents just start to see their children as being difficult or moody. Mood swings can be written off as a side effect of entering puberty or starting high school, but it can also indicate the onset of more serious mental health problems such as depression, anxiety, bipolar disorder or even schizophrenia.
There is so much happening in those adolescent years, that it can be hard to keep up with what is going on with our kids. There are dramatic changes in body shape and behaviours, confused thinking where their thoughts can speed up or even slow down, there is emerging sexuality, normal curiosity, the desire to become a grown-up, risk taking behaviours, experimenting with drugs and alcohol, dieting, peer pressure, to name a few. Parents can become so swamped with these changes and not realise that some of these changes can also be early indications of emerging mental health problems.
Many adults do not know how to talk with young people about their problems, in a non-judgemental way. In particular, how to ask those things that are really hard to ask, such as thoughts about suicide. For parents these conversations can be really difficult and quite confronting. Another thing that adults talking with youth are not very good at, is listening. We are so used to telling them what to do and how it is, that we don't listen enough to hear what they they have to say. Parents are notorious for telling teens to just get over it and on with it. So kids start to bottle it up out of shear frustration and they stop communicating and withdraw.
Another thing about teens and mental health, is that they think that they should be able to deal with their own problems and they don't often seek help for fear of being labelled as crazy. A lot of teens also think that there's nothing out there that can help them. So they fall through the cracks. Very few of them seek help for medical problems and even fewer for mental health problems.
First Aid for young minds - how adults can help
There are many things that we can do as adults to care for the mental health of our youth, and the first step is to better educate ourselves about the problems that effect them. Youth Mental Health First Aid training is a very good place to start. The Youth Mental Health First Aid courses were developed, so that adults can learn how to recognise when problems with young people arise and know how to respond to them appropriately. There are also parenting courses available and a great many support groups.
There are a lot of self-help strategies that have proven benefits, including relaxation therapy, yoga breathing exercises, anxiety management classes and mindfulness training, to name a few. There are enormous amounts of information and resources available on the internet, through your local library, community health and doctors surgeries. There is also a great deal of professional help available, if you know where to go.
The Australian Government recognised how serious a problem mental health was a few years ago and has sunk enormous amounts of money into making mental health services more available to the general Australian population. All Australians are now able to access up to 12 sessions a year with a psychologist, subsidised by Medicare. All that you need to do is to go and talk with your GP and request a referral.
Early intervention is the key to earlier recovery. Unfortunately, many people still do not know what to look for and what to do about it and many mental illnesses go unrecognised for long periods. Because often no-one picks up the signs and signals of these mental health problems in young people and the longer they go untreated, the more compounded the problems become. Depression leads to anxiety and visa versa, then substance abuse becomes a coping mechanism, and before you know it, there is a major problem of co-morbidity, where someone may have a number of mental health problems that will all need addressing.
Eating disorders are one of these compounded problems and they are on the rise. They can lead to very serious and sometimes deadly medical problems as well. One of the big myths about eating disorders is that they only effect young females. This is predominately so for Anorexia Nervosa and Bulimia Nervosa but it is also now being seen more in males. However, binge-eating disorder, which has the largest number of sufferers by far, does not discriminate and almost as many males as females suffer from it. It also affects people of all ages.
Psychosis and young people
If you were to look at a graph of mental health problems, you would see peaks at certain ages. One of the largest peaks is substance use between the ages of 16 and 18 - we are mainly talking about alcohol, although this is also the age where they are beginning to use drugs and in males this is also the age where you see a huge spike in suicides. In mid to late adolescence, substance abuse is their biggest problem.
There is definitely an association between drug use and mental health problems, particularly seen in cannabis use and schizophrenia. However many of the other common street drugs also cause psychosis in the short-term and serious problems with anxiety and depression in the long-term.
Psychosis is a general term used to describe a mental health problem in which a person has lost some contact with normal reality. There are severe changes and disturbances in thinking, emotion and behaviour. Psychosis can profoundly disrupt a person's day to day life. The most common psychotic illnesses are schizophrenia, bipolar disorder (which used to be known as manic depressive disorder), psychotic depression, schizo-affective disorder and drug-induced psychosis.
Without doubt, the psychotic illness that comes with the most serious and far ranging issues, is schizophrenia. Three quarters of sufferers of schizophrenia are aged between 16 and 25 when they have their first episode. It is not uncommon for young people with schizophrenia to go undiagnosed for a year or more, as this is one of those illness where many of the behaviours and emotional responses can be mistaken for normal childhood behaviours. It holds the highest risk of suicide of all mental health disorders and an alarming mortality rate - 10% of people who suffer from schizophrenia will die by suicide.
The first episode of psychosis can be an extremely horrifying experience, particularly for a young person. There are many, many symptoms that can be associated with psychosis, and these illnesses effect everyone differently. However most commonly they may involve extreme distortions in thinking, delusions, hallucinations, strange feelings, elevated or deflated moods and severe changes in behaviour patterns.
Routines disappear and the ability to care for oneself is often profoundly effected. Concentration is quite often acutely disabled, particularly if they are hearing voices or seeing things that don't exist. Under these circumstances it is best to be accepting of their reality, but do not claim that these things are real for you.
When trying to help someone who is suffering from psychosis, the best practice is to behave in a calm and positive manner. Make sure that you are in a safe position and never try to manhandle them or force your opinions on them. If there is a risk of harm, call 000.
Risk of harm
People who suffer from psychosis are at times at risk of harming themselves and on occasions others. However the biggest risk is of the sufferers themselves being harmed by others out of fear and a lack of understanding. There are so many myths that abound about the dangerous psychotic, that have been perpetuated by the media over the years, that the stigmas associated with psychotic illnesses are a real problem in our society. People who suffer from mental illnesses deserve our respect and our understanding.
Psychotic illnesses are able to be treated and many people make a complete recovery. It is best to first consult with your GP, who can then refer you on for appropriate treatment. In a crisis situation call the Mental Health Access Line - 1300 369 968, the local Mental Health Crisis Team, your nearest hospital, or emergency services 000.
In most areas now there are support groups for all the various types of psychotic illness and also parent and carer support groups. These are often very helpful to both sufferers and family members.
most important point to remember is that if you feel that a young
person may be suffering from a mental illness, talk with them
non-judgmentally, listen to them and offer to help them, because the
earlier they receive the help, the faster they will recover and better
the outcome will be.
About the author You can contact Nicqui at
Mental Health First Aid program
Betty Kitchener and Prof. Tony Jorm from the ORYGEN Research Centre, University of Melbourne, developed the world’s first Mental Health First Aid (MHFA) course in Australia in 2001. MHFA is now available in 15 countries and as of 2007, Youth MHFA was launched in Australia, Japan, New Zealand and America. 2007 also saw the introduction of Indigenous MHFA. In May 2008, the Adult MHFA E-Learning program was launched to enable those that are either disadvantaged by distance or circumstances to participate in learning about Mental Health First Aid.
Mental Health First Aid is a training program for members of the public over the age of 18 years, in how to support someone in a mental health crisis situation or who is developing a mental health disorder. Its’ role is to promote first aid - the initial help that is given before professional help is sought and to increase literacy about mental health problems.
The program increases knowledge, reduces stigma and, most importantly, increases supportive actions. It even helps the mental health of first-aiders. Mental Health First Aid training can assist in early intervention and in the on-going community support of people with mental illnesses. It is particularly useful for people employed in areas which involve increased contact with mental health issues and for parents and carers of people with mental illnesses.
The courses teach the signs, symptoms, causes and evidence-based treatments (both self-help and professional help), for the common mental health problems of depression, anxiety disorders, psychosis and substance use disorder. It also addresses the possible crisis situations arising from these mental health problems and steps to help.
The crisis situations include a person who is feeling suicidal: a person having a panic attack or acute stress reaction; a person who has had a recent traumatic experience; a person who is acutely psychotic and perceived to be threatening; and a person who has overdosed. In addition the Youth MHFA course also covers the more youth specific areas of eating disorders and non-suicidal self Injury (self-harm).
Although crises are dramatic consequence of mental health problems, it is better to intervene early before such crises develop. The MHFA program therefore emphasises the need for early intervention for mental disorders as they are developing. This is particularly important with adolescents, as most mental health problems start in the teenage years.
For further information on the Mental Health First Aid program go to
By Nicqui Yazdi