World Mental Health Day 2018: A Focus on Youth and Adolescents

On October 10^th, 1992, the World Health Organization (WHO) launched the first annual World Mental Health Day. Their goal was twofold: to promote mental health advocacy and educate the general public on issues related to mental health. Advocacy and education remained the focus for the first three years. The event featured a global telecast from Tallahassee, Florida, and interactive telephone participation with a broad international reach. WHO hosts received calls from Australia, Chile, England, Zambia, and Swaziland. Later they received their first post-event feedback from Peru, which highlighted the worldwide interest in the topic and affirmed their instincts for organizing the initiative in the first place: mental health was (and still is) an issue front and center in the minds of health professionals all over the world.

Yearly Themes

In 1994 the WHO changed the format and announced a theme for the day: “Improving the Quality of Mental Health Services Throughout the World.” Since then, they’ve chosen a different theme for each year. Topics addressed over the ensuing two-and-a-half decades include:

• Women and Mental Health (1996)
• Children and Mental Health (1997)
• The Effects of Trauma and Violence on Children and Adolescents (2002)
• Emotional and Behavioral Disorders of Children and Adolescents (2003)
• The Relationship Between Physical and Mental Health: Co-Occurring Disorders (2004)

Youth, Mental Health, and Change

This year, the theme for World Mental Health Day is “Young People and Mental Health in a Changing World.” Since we commit all our energy and resources every day of every year to helping adolescents struggling with mental health issues, we’re thrilled about this year’s topic. Here’s what the WHO says about their choice:

“Imagine growing up in our world today. Constantly battling the effects of human rights violations, wars and violence in the home, schools and businesses. Young people are spending most of their day on the internet – experiencing cyber crimes, cyber bullying, and playing violent video games. Suicide and substance abuse numbers have been steadily rising, LGBTQ youth are feeling alone and persecuted for being true to themselves and young adults are at the age when serious mental illnesses can occur and yet they are taught little to nothing about mental illness and wellbeing.”

Different Worlds, Similar Problems

This perspective is enlightening. In the United States, we’re relatively insulated from the direct effects of human rights violations related to war, the refugee crisis, and state-sponsored persecution of the LGBTQI community. Yet we relate to their struggles all the same, and empathize because our youth, in their own way, face similar challenges. Our LGBTQI youth are singled out for bullying and harassment on a regular basis. Like adolescents all over the world, our teens are at the age when symptoms of significant mental illness begin to appear, and like adolescents all over the world, our teens are taught very little about how to understand mental illness and take steps to ensure their own lifelong mental and emotional well-being.

2018: The Issues for Adolescent Mental Health

Data and evidence drive the choice for this year’s topic. In the U.S., recent reports on the increase in depression, anxiety, suicide, and self-harming behaviors in the adolescent population have parents, policy makers, and mental health professionals sounding the alarm. Adolescence is a tricky phase of life without confounding mental health issues. With them, reaching adulthood with a healthy set of coping skills and productive daily habits is all the more difficult. While we focus on the numbers here at home, the WHO presents worldwide data that contextualizes our unique issues and reinforces the idea that adolescents face a common set of challenges no matter where they grow up. The WHO cites the following facts to support their emphasis on youth and adolescence this year:

• People age 10-19 make up 1/6^th of the world population
• 16% of the worldwide financial cost of disease and injury for people age 10-19 is related to mental health conditions
• Close to 50% of all mental illness begins before age 14, but symptoms are often missed, misinterpreted, or go untreated for years
• Depression is a leading cause of illness and disability for adolescents worldwide
• Suicide is the third leading cause of death for people age 15-19
• Unaddressed mental illness has significant negative mental, emotional, and physical consequences that can last throughout adulthood
• Awareness, prevention, and education help adolescents navigate mental health issues and lead fulfilling, productive adult lives

Common Experiences

These numbers closely mirror what we see in the U.S. We’re concerned about depression, suicide, self-harming behaviors, the relationship of adolescent mental health and chronic health problems, and the disturbing fact that so many young people who need help don’t receive adequate treatment. The opioid crisis places a great deal of our attention on substance use disorders, but rising instances of alcohol and cannabis use worldwide have the attention of the global community. This underlines the commonality of the adolescent experience, and reminds us that no matter where we are, we’re all concerned with how we can help our teenagers meet their challenges and give them the skills they need as they grow and mature.

Priority: Building Resiliency

The primary practical goal of the WHO initiative this year is to offer parents, teachers, healthcare providers, communities, and policy-makers access to knowledge and tools that help adolescents build resilience. The global population of teens is in dire need of effective coping skills – i.e. resiliency – to navigate an increasingly complex world characterized by easy access and almost unavoidable exposure to a host of potentially damaging, adverse experiences. The WHO campaign means to achieve the goal of building resiliency in adolescents by prioritizing a wide range of promotion and prevention activities.

These include:

• Online Interventions
  • Group, self-directed, and one-on-one
• Family-focused Interventions
  • With attention to the needs of caregivers
• Community-based interventions
• Prevention programs that prioritize the most vulnerable adolescents, such as those in areas of humanitarian crisis, minority groups, and groups against which discrimination is common
• School-based interventions
  • Promotion of safe learning environments
  • Education and training about mental health issues
  • Life skills training
  • Staff training for early detection of adolescent mental illness and suicide risk
• Suicide prevention programs in schools, the community, and for families
• Sexual violence awareness and prevention programs in schools, the community, and families
• Alcohol and substance use awareness and prevention programs for schools, communities, and families
• Comprehensive sex-education programs
• Comprehensive violence prevention programs

Priority: Early Awareness

The WHO emphasizes that intervention, awareness, and preventions programs designed for adolescents should include a specific set of components that recognize and cater to their unique needs. They identify the following priorities for any program that includes youth or teens:

• Early detection followed by implementation of evidence-based treatment, especially in under-resourced communities
• Transdiagnostic treatment that targets co-occurring disorders
• Treatment provided by professionals trained in adolescent-specific issues and approaches
• Meeting teens where they are and considering their preferences when formulating a treatment plan
• Including family and caregivers in the treatment and recovery process
• Electronic mental health interventions. Particularly self-guided and virtual consultations for youth in areas where access to in-person care is difficult or impossible
• Reduction of stigma attached to mental illness through education and communication
• Reduction of psychotropic medication in cases where psychosocial interventions can be equally or more effective.  Cautious, responsible, professionally monitored use of medication for teens and youth with moderate-to-severe issues for whom psychosocial interventions are ineffective

Helping Teens in the Present – For the Future

World Mental Health Day 2018 speaks to community of parents, teens, and mental health professionals at Evolve Treatment Centers on multiple levels.

Firstly, we recognize the fortune of our position. When we read the words refugee and humanitarian crisis we immediately understand what it means. There are millions of people around the world without easy access to the bare necessities of life and survival. Much less high-quality treatment for mental health and substance use disorders. We understand that this situation by itself creates adverse, traumatic experiences for youth and adolescents. And we understand some already struggle with mental health disorders and prior trauma. Our professional minds see trauma piling upon trauma. Our family-oriented hearts quite literally break for families living in those conditions. While it’s true the teen population of the U.S. includes refugees and children who directly experience violence, poverty, and hunger, we know that our society protects the vast majority of our teens from the extreme circumstances experienced by children and families living in war-torn areas around the globe.

Secondly, we recognize we still have a lot of work to do to reduce the stigma attached to mental illness. We want more people seek therapy when they first recognize the symptoms, rather than years later. We need to teach our children that there’s no shame in seeking help for emotional or behavioral issues. Nor is there anything wrong with asking for help with alcohol or substance use problems.

A Cooperative Approach

Finally, we advocate for a comprehensive, systematic, nationwide effort. We can increase social and emotional learning during the early, middle, and high school years. We can teach effective stress tolerance and emotional regulation techniques to our children before they need them. That would be better than teaching them after they’re struggling with challenging symptoms. We can have systems in place to handle emotional and behavioral issues when they arise, rather than playing catch-up years later.

The youth and teens of today are the adults of tomorrow.

They’re our future teachers, psychiatrists, counselors, policymakers, and leaders. If they grow up unconstrained by the stigma still attached to mental illness, conversant in the language of support and openness, comfortable talking about their emotions and eager to help one another find productive ways to navigate the difficulties of adolescence, then we can have hope that in the future, our children and teens will ask for help with emotional issues as readily as they’ll ask for a glass of water when they’re thirsty or an aspirin when they have a headache.