Mental Illness In Adolescents Research Articles

Study on the causes and coping strategies of adolescent mental illness

In recent years, especially since the epidemic, there has been an explosive increase in the incidence of adolescent mental disorders, which has aroused the attention of the whole society. From the perspectives of evolution, humanism, and psychodynamics, this paper analyzes the deep-rooted causes of the increasing incidence of psychological disorders in adolescents and explores various dilemmas adolescents face. From an evolutionary point of view, the current rate of social progress exceeds the rate of human evolution and the rate of cognitive improvement of young people, making it difficult for young people to adapt to complex social environments. In humanitarian terms, excessive academic pressure places a heavy burden on young people. From the perspective of psychodynamics, the conflict between standard, ego, and superego can cause mental illness in adolescents. In addition, this paper points out that adolescent mental illness marks the evolution of social awareness of mental health, and all parties in society need to build a supportive policy framework to foster widespread awareness of mental health.

National trends in adolescents’ mental health by income level in South Korea, pre– and post–COVID–19, 2006–2022

Despite the significant impact of the COVID–19 pandemic on various factors related to adolescent mental health problems such as stress, sadness, suicidal ideation, and suicide attempts, research on this topic has been insufficient to date. This study is based on the Korean Youth Risk Behavior Web–based Survey from 2006 to 2022. We analyzed the mental health problems of adolescents based on questionnaires with medical interviews, within five income groups and compared them with several risk factors. A total of 1,138,804 participants were included in this study, with a mean age (SD) of 15.01 (0.75) years. Of these, 587,256 were male (51.57%). In 2022, the recent period from the study, the weighted prevalence of stress in highest income group was 40.07% (95% CI, 38.67–41.48), sadness was 28.15% (26.82–29.48), suicidal ideation was 13.92% (12.87–14.97), and suicide attempts was 3.42% (2.90–3.93) while the weighted prevalence of stress in lowest income group was 62.77% (59.42–66.13), sadness was 46.83% (43.32–50.34), suicidal ideation was 31.70% (28.44–34.96), and suicide attempts was 10.45% (8.46–12.45). Lower income groups showed a higher proportion with several risk factors. Overall proportion had decreased until the onset of the pandemic. However, a significant increase has been found during the COVID–19 pandemic. Our study showed an association between household income level and the prevalence of mental illness in adolescents. Furthermore, the COVID–19 pandemic has exacerbated mental illness among adolescents from low household income level, underscoring the necessity for heightened public attention and measures targeted at this demographic.

Determinants of adolescents' depression, anxiety, and somatic symptoms in Northwest Ethiopia: A non-recursive structural equation modeling.

In low and middle-income countries, adolescent mental health is not only a major public health challenge but also a development concern. Depression and anxiety are the most common mental health disorders and somatic symptoms often co-exist with them. Adolescents with common mental health problems are associated with an increased risk of suicide, future unemployment, and poor quality of life. However, little is known about the mental health of adolescents in Ethiopia. Thus, this study aimed to assess the determinants of depression, anxiety, and somatic symptoms among adolescents in Northwest Ethiopia, in 2022. An institution-based cross-sectional study was conducted from June 8 to 24, 2022. Two-stage stratified random sampling was used to select 1407 adolescents in Northwest Ethiopia. Structured and standardized self-administered questionnaires were used to collect the data. Non-recursive structural equation modeling was employed to assess the direct, indirect, and total effects of predictors. Adjusted regression coefficients and corresponding 95% confidence intervals were used to interpret the strength of the association. The prevalence of depression, anxiety, and somatic symptoms were 28.21% (95% CI: 25.8, 31%), 25.05% (95%CI: 22.8, 27.5), and 25.24(95% CI: 23, 27.6%) respectively. Alcohol use had a significant positive effect on depression [β = 0.14, 95% CI: 0.073, 0.201], anxiety [β = 0.11, 95% CI: 0.041, 0.188], and somatic symptoms [β = 0.12, 95% CI: 0.062, 0.211]. Stress had a significant positive effect on depression [β = 0.76, 95% CI: 0.642, 0.900], anxiety [β = 1.10, 95% CI: 0.955, 1.264], and somatic symptoms [β = 086, 95% C: 0.700, 1.025]. Depression had a direct positive effect on anxiety [β = 0.74, 95% CI: 0.508, 1.010]. In this study, the prevalence of depression, anxiety, and somatic symptoms was moderate. Alcohol use and stress were significantly related to depression, anxiety, and somatic symptoms. The bidirectional relationship between anxiety and depression was significant. Therefore, public health interventions should focus on the bidirectional relationship between depression and anxiety, as well as on identified factors to reduce the burden of mental illness in adolescents.

A Cluster Randomized Controlled Trial on the Effectiveness of the Building Educators’ Skills in Adolescent Mental Health (BEAM) Program for Improving Secondary School Educators’ Confidence, Behavior, Knowledge, and Attitudes Toward Student Mental Health

Secondary school educators are well placed to recognize and respond to mental illness in adolescents; however, many report low confidence and skills in doing so. A confirmatory cluster randomized controlled trial involving 295 educators (Mean age: 40.10 years, SD: 10.47; 76.6% female, 2.7% Aboriginal or Torres Strait Islander) from 73 Australian secondary schools (22 in rural-regional locations) evaluated the effectiveness of a new professional development training program that aimed to improve secondary school educators’ confidence, behavior, knowledge, and attitudes toward student mental health. Relative to the control, training participants reported significantly greater levels of confidence in recognizing and responding to student mental health issues, perceived mental health knowledge and mental health awareness, and mental health literacy, at post-intervention (10-weeks post-baseline; d = 0.26–0.35) and at 3-month follow-up ( d = −0.21 to 0.41). Findings indicate that the Building Educators’ skills in Adolescent Mental health (BEAM) program improves important training outcomes for educators in the domain of student mental health.

Intervention of universities’ governance programs on students’ anxiety disorders

BackgroundAnxiety disorders are a type of mental illness in adolescents. It is found that the prevalence of anxiety in adolescents reaches 10-20%, with some adolescents experiencing conditions that extend into adulthood and even cause suicide or admission to psychiatric hospitals. The study from a psychological perspective analyzed and explored the intervention effects of universities’ internal governance programs on college students’ anxiety symptoms.Subjects and MethodsThe study divided 100 students with anxiety disorders in a college (has been consistent) into an experimental group and a control group, with 50 in each. The experimental group of students with anxiety disorders received an intervention treatment from the internal governance program of the university, and the control group were not formally treated. The study utilized the Screening Checklist for Anxious Emotional Disturbances (SCAED) (Verified abbreviations of technical terms) for the measurements. After 8 weeks, the total scores of two groups by SCAED were compared.ResultsThe study utilized SPSS 23.0 statistical software to analyze the data. The total SCAED score of the experimental group was (33.75±12.43) and that of the control group was (42.20±9.35), which was better than that of the control group, and there was a significant difference in the comparison between the groups (P<0.05).ConclusionsThe analysis from the psychological perspective shows that the internal governance program in colleges and universities can effectively alleviate the anxiety symptoms of adolescents, and it is worth to promote the application.

24.1 Early Identification of Severe Mental Illness in Adolescents

24.1 Early Identification of Severe Mental Illness in Adolescents

The curative effect of schools: A longitudinal study of the impact of school climate, school identification, and resilience on adolescent mental health.

Mental illness in adolescents is on the rise, thus it is vital to study factors that can improve youth mental health. The extant theory and research have identified both social (school climate; school identification) and individual (resilience) constructs as protectors of mental health. However, these protective factors remain in silo and require further integration. To address this issue, the present study proposed and investigated an integrative model in which social factors (i.e., school climate, school identification) nurture individual (i.e., resilience) protective factors, which in turn impact adolescent mental health. Using three-wave longitudinal data (2017-2019) from school students (Grades 7-8; N = 1,357), we found evidence supporting the integrated model examining five dimensions of mental health: anxiety, depression, happiness, life satisfaction, and positive affect. Greater Wave 1 school climate predicted greater identification 1 year later, which in turn predicted greater resilience. Furthermore, greater resilience predicted lower depression and anxiety, and greater happiness, life satisfaction, and positive affect 1 year later. These results support efforts to strengthen the school climate and reconceptualize resilience as an outcome of social processes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Longitudinal Study of Income Inequality and Mental Health Among Canadian Secondary School Students: Results From the Cannabis, Obesity, Mental Health, Physical Activity, Alcohol, Smoking, and Sedentary Behavior Study (2016–2019)

PurposeDepression and anxiety among adolescents are major public health concerns. Findings indicate that income inequality was associated with increased risk for depression and anxiety among adolescents; however, this has not been tested longitudinally. We aim to quantify the longitudinal association between income inequality and depression and anxiety among Canadian adolescents. MethodsWe used longitudinal data on 21,141 students from three waves (2016/17–2018/19) of the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary behavior (COMPASS) school-based study. Multilevel modeling was used to assess the association between census division (CD)-level income inequality and depressive and anxiety symptoms and odds for depression and anxiety over time. ResultsAcross CDs, the mean Gini coefficient was 0.37 (range: 0.30, 0.46). Attending schools in CDs with higher levels of income inequality was associated with higher depressive scores (ß = 0.08; 95% confidence interval [CI] = 0.02, 0.14) and an increased odds for depression (odds ratio = 1.55, 95% CI = 1.06, 2.28) over time. Income inequality was not significantly associated with anxiety symptoms or experiencing anxiety over time. Additional analyses showed that income inequality was associated with higher depressive scores among females (ß = 0.10; 95% CI = 0.01, 0.18) and males (ß = 0.08, 95% CI = 0.01, 0.15) and for anxiety scores among females (ß = 0.13, 95% CI = 0.04, 0.22), but not among males (ß = −0.01, 95% CI = −0.09, 0.06). DiscussionFindings from this study indicated that income inequality is associated with depression over time among adolescents. This study highlights key points of intervention for the prevention of mental illness in adolescents.

Analysis of the factors that influence caregiver burden in adolescents with dual diagnosis

IntroductionSerious mental illness in adolescence that not only has a significant impact on the patient but also on other contexts such as their family. Caregivers assume almost all of the care. This responsibility exposes caregivers to intense overload with negative consequences.ObjectivesTo evaluate and quantify the overload of the primary caregiver in children and adolescents with severe mental disorders.MethodsA prospective study was designed using structured interviews in caregivers of patients between 11 and 18 years of age with severe mental disorders and substance use who were evaluated in the psychiatric emergency service for 2 months. The Zarit Caregiver Burden Scale was used for quantitative assessment. Diagnosis, main caregiver, socio-health resources were recorded.ResultsOf a total of 35 patients with serious mental illness between 11 and 16 years of age, the following was observed: intense caregiver burden in 42.2% of cases, moderate in 21%. Being the main caregiver the mother. 27.5% had adequate use of socio-health resources, while 42.7% had not requested them. The greatest need detected was economic and rehabilitation.ConclusionsSerious mental disorder present since adolescence leads families to significant destabilization of the family nucleus and comorbidity of psychiatric disorders in caregivers. Good orientation and evaluation of individual cases are necessary to guide families about the resources available in the social and health network, thus avoiding a high overload of caregivers and improving the quality of life of families.Disclosure of InterestNone Declared

Clinical features of children with drug poisoning in a single emergency department in Goyang, Korea

Purpose: Pediatric drug poisoning is a frequent reason for emergency department (ED) visits. Considering the increasing number of mental illnesses in adolescents, it has become a serious public health problem. We aimed to investigate the drug poisoning in the ED.Methods: We retrospectively analyzed children aged 1-17 years with diagnostic codes related to drug poisoning who visited the ED from January 1, 2010 through October 7, 2022. Exclusion criteria were non-pharmaceutical poisoning, insufficient data, and poisoning via respiratory, dermal or ocular route. Baseline characteristics, clinical manifestations, and outcomes of drug poisoning were analyzed in the study population, according to intention of poisoning and drug category.Results: A total of 197 cases of 161 children were analyzed. Compared with non-intentional poisoning, intentional poisoning was associated a higher age, a longer time from ingestion to visit, and higher proportions of girls, antipyretics/analgesics or psychotropic drugs, symptoms related to the gastrointestinal, neurologic or cardiopulmonary systems (P = 0.034), psychiatric comorbidity, multiple drug ingestion, suicide attempt, decontamination (P = 0.017), the use of antidote, history of drug poisoning, and hospitalization (P = 0.004; all other Ps < 0.001). Acetaminophen, a representative of antipyretics/analgesics, was associated with a longer time from ingestion to visit and higher proportions of girls (P = 0.004), the presence of initial gastrointestinal symptoms, suicide attempt (P = 0.001), the use of antidote, and hospitalization (all other Ps < 0.001). Psychotropic drug was associated with higher proportions of psychiatric comorbidity (P < 0.001) and multiple drug ingestion (P = 0.012).Conclusion: This study will enable pediatricians or emergency physicians to obtain an overview of the management of drug poisoning in EDs.

Narrative Review on Psychosocial Challenges and Identity Issues Associated with Severe Mental Illness in Adolescents

The onset of severe mental illness (SMI) typically manifests during adolescence. Given that it is a particularly sensitive stage for adolescents from an identity development perspective, receiving a SMI diagnosis at this time may have long-term impacts on their identity, as well as presenting a number of psychosocial challenges. Most importantly, it is at this stage in life that adolescents are at a critical juncture in terms of making future plan and career paths, increasing social interaction, completing higher school education. This review will argue that, since SMI is more likely to occur during adolescence and this can have additional psychosocial challenges which may cause several issues on one’s identity, and this effect may be carried forward across lifespan. It seeks to establish the positive and negative impacts of severe mental illness on adolescents’ psychosocial development. It is essential to comprehensively understand this impact as this has implication for recovery and for health professionals selecting suitable treatment interventions.

SPORTS TRAINING TO DETECT THE HEART RATE AND BODY TEMPERATURE OF ADOLESCENTS

ABSTRACT Introduction: Due to the increase in the number of only children in China, mental illness in adolescents is on the rise, which affects the development of students’ physical and mental health. Objective: To study the effect of exercise training on the heart rate of adolescents. Methods: The students in the badminton and tai chi optional courses in the school's second grade were randomly selected for moderate-intensity badminton and tai chi training. Results: The mood score of the moderate-intensity tai chi test was between 44 and 51 points, and that of the moderate-intensity badminton experiment was between 42 and 49 points. The heart rate of the moderate-intensity tai chi test was 90 ~ 117 beats/min, and that of the moderate-intensity badminton test was 121 ~ 142 beats/min. Therefore, moderate-intensity badminton training has a significant influence on adolescents’ heart rate and mood. Conclusions: Moderate-intensity badminton exercise can improve adolescent's health and mood. It also has a positive effect on maintaining and stabilizing adolescents’ mental health. Level of evidence II; Therapeutic studies - investigation of treatment results.

Feasibility and Acceptability of Technology-supported Sexual Health Education Among Adolescents Receiving Inpatient Psychiatric Care

Mental illness in adolescence is associated with high-risk sexual behaviors including multiple sex partners, infrequent or inconsistent condom use, and nonuse of contraception. Inpatient psychiatric care represents a promising setting to provide sexual health education. This pilot study investigates the feasibility and acceptability of online sexual health education in this group by assessing usability and impact on short-term psychosocial outcomes. We administered online modules on healthy relationships, pregnancy prevention, condom use, and sexually transmitted infection (STI) prevention to youth. We evaluated outcomes using a single group, pre/post-intervention design. One quality improvement session assessed staff acceptability of the programming. Participants included 51 inpatients (mean age = 15.3; 61% female; 57% Hispanic or Latino; 55% heterosexual). Overall, the program was feasible to administer and highly acceptable to youth (84-89% liked the modules, 98-100% found them easy to use, 96-100% found them credible, 91-98% said information would lead to healthier dating relationships, and 78-87% would refer to a friend). Youth who completed modules demonstrated improvement in several outcomes: attitudes and norms towards violence (p < 0.001), intention to use a method of birth control other than condoms if having sex in the next 3 months (p < 0.001), condom knowledge (p < 0.001), condom use self-efficacy (p < 0.001), condom beliefs (p = 0.04), HIV/STI knowledge (p < 0.001), and perceived susceptibility to STI (p < 0.01). The quality improvement session revealed high acceptability by nursing staff on the unit. This intervention could be useful and efficacious in an inpatient setting and larger studies are warranted to understand its full impact.

Prevalence and predictors of relapse among adolescent patients with mental illness in Butembo city (Eastern Part of the Democratic Republic of Congo)

This study aimed to determine the prevalence and predictors of relapse in adolescents with mental illness. To carry this cross-sectional study, we recruited participants from the patients who attended healthcare services at five mental healthcare units located in the eastern Democratic Republic of Congo. We enrolled patients aged between 10 and 17 years old, with a history of being readmitted at least once to a mental facility. Nearly one in 10 patients with mental illness is an adolescent, and seven in 10 adolescents with mental illness are readmissions. The majority of participants were males, aged 17 years old; lived in rural settings, were illiterate, and were single mothers/fathers. The predictors of relapse are low educational level, being a female or a single mother/father, having the age of 17 years, low self-esteem, perceived poor social support, living in rural areas, and the highly expression emotions. Being treated for bipolar and substance use disorder increases the risk of relapse in adolescents. Our results highlight the burden of mental illness in adolescents.

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Mental health is essential for individual and public health. To improve mental health, promotion, prevention, and the treatment of disease are required. These three kinds of interventions are interrelated but independent from one another. Although separate efforts for mental health promotion and prevention are needed as well as the public need of mental health promotion and well-being, psychiatrists usually are not accustomed to mental health promotion and prevention. This review introduces an overview of the concept, subjects according to target populations, and various intervention strategies for mental health promotion and prevention of mental illnesses. SETINGS AND DESIGN: Quantitative evaluative research approach was discovered to be suitable for present study to check impact of structured teaching program on knowledge regarding mental health promotion and early identification of mental illness in adolescence among teachers in selected schools of Gujarat. One group pre-test and post-test Pre-Experimental Research Design was used. The population for the present study was 500 School teachers at selected district of Gujarat.

Considering ecological determinants of youth mental health in the era of COVID-19 and the Anthropocene: A call to action from young public health professionals.

In 2019, young Australians reported that two of their top concerns were ‘climate change and the environment’ and ‘mental health’. The events of 2020/2021, such as the ongoing climate emergency, the Australian bushfires, and the COVID‐19 pandemic, reflect the human‐induced environmental issues young people are most worried about and have also exacerbated the mental health issues which they already reported to be at a crisis point back in 2019. Given experiences of mental illness in adolescence are associated with poorer mental health across the lifespan, it is becoming increasingly important to address ecological determinants of youth mental health in the Anthropocene. However, despite the inclusion of ecological determinants of health in seminal health promotion frameworks, health promotion has been described as ‘ecologically blind’, emphasising social determinants of health at the expense of ecological determinants of health. A socio‐ecological model, which equally considers upstream social and ecological factors, should be applied to youth mental health issues. Using the Ottawa Charter for Health Promotion, we demonstrate how the ecological determinants of health may be incorporated into health promotion approaches targeting youth mental health. We also call for the health promotion sector to consider a number of actions to work towards achieving a transition to ecological determinants of health being at the forefront of health promotion activities. This commentary, written by young public health professionals, hopes to build on the momentum garnered by youth activists around the world and bring attention to the importance of ecological determinants of health for youth mental health promotion in the era of COVID‐19 and the Anthropocene.

Microbial Induced Autoimmune Inflammation as a Cause of Mental Illness in Adolescents: A Case Series

The incidence of mental health disorders in adolescents continues to rise. The cause of the increase in mental illness is multifactorial, including both environmental and biological causes. To investigate the latter, ten adolescents at a psychiatric residential treatment center in Colorado with the DSM-5 diagnosis of major depressive disorder (MDD), of whom seven were additionally diagnosed with generalized anxiety disorder (GAD), were chosen at random for further serologic study. Testing revealed exposureto group A Streptococcus(GAS) in 2 of 10 (20%); Borrelia Burgdorferi sensulato (Bbsl)in 2 of 10 (20%); and Bartonella speciesin 3 of 10 (30%). In addition, 9 of 10 (90%) subjects had abnormal Cunningham Panels, which measures levels of antineuronal antibodies that have been associated with psychiatric disturbances. Given the degree of psychological dysfunction in these adolescents requiring intensive residential treatment, this case series lends support to the hypothesis that exposure to infectious agents may play a role, perhaps by autoimmune mechanisms, in the significant and ongoing rise in the rate of neuropsychiatric illness in adolescents. This preliminary report adds to this premise and requires further investigation.

Considering Social Determinants of Health: A Case for the Just Treatment of Vulnerable Adolescent Mental Health Inpatients

The goal of this paper is to consider the case of a vulnerable adolescent inpatient who received the standard of care, and then to propose a harm reduction approach that reflects the patient's lived-reality and better fulfills the ethics of care. For certain vulner- able adolescent mental health inpatients, the idealized treatment they receive in hospital does not align with their lived-reality upon discharge. These adolescents experience unfavorable social determinants of health (SDH). They may live in families who experience poverty, trauma, unmanaged mental illness, and lack the capacity to navigate the healthcare system. The difference between the supports these adolescents receive as inpatients and those familiar to them before admission can negatively impact their ability to get and stay well upon return to their communities. As inpatients, interdisciplinary teams can provide medication management, therapy, emotional support, proper nutrition, education, recreation, and a daily routine that promotes sleep hy- giene, positive coping, and safety. These are the evidence-based ingredients that offer the best chance for recovery and management of mental illness in adolescents. If these cannot be sustained in the community, there exists an additional obligation for healthcare providers to act in the role of advocate, to ensure that the best interests of the patient are promoted through a harm reduction ap- proach. This approach entails providing treatment options and follow-up plans that reflect and respect the patients’ lived-realities even when in conflict with standard practices or hospital operating procedures. It is an approach rooted in beneficence, respect for autonomy and justice. The values of respect and compassion for the patient are promoted when healthcare providers broaden their concept of harm reduction to include bridging the gulf between idealized treatment and lived-reality outside of the hospital. Conclusion − A harm reduction approach that considers and responds to the effects of social determinants of health can better fulfill the ethics of care for vulnerable adolescent mental health inpatients.

Addressing the Stigma Surrounding Serious Mental Illness in Adolescents: a Brief Intervention.

Stigma in mental illness is a problem fueled by misrepresentation by the media and the assimilation of parent opinion, noted in those as young as six years old. Intervening in adolescence is critical given juxtaposition of increased judgement/fear of judgement and the onset of serious mental illness. This paper details the efforts of an intervention designed to specifically target the perception of dangerousness, social distancing, and use of stigmatizing language. A total of 124 high school freshman participated in the interactive presentation delivered over the course of a typical 40min class period. An identical survey with a 5-point Likert scale was administered before and after to measure level of agreement with stigmatizing statements. Most participants reported prior exposure through the media (86.6%) and through conversations with family/friends (67.7%). Post intervention, improvement was seen in the perception of dangerousness (MD = 0.45, t = 4.435, p = <0.001), the need for social distancing (measure 1: MD = 0.148, t = 1.785, p = 0.039; measure 2: MD = 0.142, t = 1.773, p = 0.04), and understanding of the experience of those with serious mental illness (MD = 0.377, t = 3.378, p = <0.001). No significant difference was seen in terms of stigmatizing language use (MD = 0.114, t = 1.192, p = 0.118). This study supports the delivery of anti-stigma education to adolescents that avoids the biogenetic and contact approaches, embraces the continuum model of mental health, normalizes psychotic experiences, addresses dangerousness with data, identifies prominent figures with mental illness, and uses personalized statistics to demonstrate why this topic is of importance.

Innovative approach to adolescent mental health in Japan: School-based education about mental health literacy.

Improving mental health literacy through school-based education may encourage mental health promotion, prevention and care and reduce stigma in adolescents. In Japan, instruction about mental illness has been formulated in a Course of Study that reflects governmental curriculum guidelines, which will be enforced from 2022 to promote an understanding of current issues of adolescent health. Educational resources available to schoolteachers have been developed. This article describes the development processes and contents of these resources. Our collaborating team, consisting of mental health professionals and schoolteachers, developed educational resources, based on feedback from high school students in general and young people who had experienced mental health problems. The new Course of Study covers: (1) mechanisms of mental illness, prevalence, age at onset, risk factors and treatability; (2) typical symptoms of mental health problems and illnesses; (3) self-help strategies for prevention of and recovery from mental illness; (4) enhancing help-seeking and helping behaviour and (5) decreasing stigma associated with people with mental health problems. The educational strategy is targeted at high school students (grades 10-12) and is conducted by teachers of health and physical education. The educational resources include short story animated films, filmed social contact and educators' manuals, which are freely available through the internet and open to all concerned including schoolteachers in Japan. Our efforts are expected to help implement mental health education of the public throughout Japan and other countries and promote the practice of early intervention and prevention of mental illnesses in adolescents.