Mental Illness In Young People Research Articles

The prevalence of mental illness in young people in custody over time: a comparison of three surveys in New South Wales

Few studies have examined the prevalence of mental illness in young people over time within the same jurisdiction. In the current study, we compared data from three large surveys of youth in custody in New South Wales, conducted in 2003, 2009 and 2015. We examined rates of mental illness, self-harm and suicidal behaviours, substance use and childhood trauma and found little consistent change over time, though some fluctuations were observed regarding certain mental illnesses and substance use. We also descriptively compared findings with observed rates for the general population and found that young people in custody showed higher levels of all examined variables. In sum, these data suggest little improvement in the well-being of young people in custody in New South Wales over time. Better identification and treatment of these issues are vital if young people are to be prevented from becoming enmeshed in the criminal justice system.

Mental health interventions targeting children and young people: A mapping review of interventions, follow-up, and evidence gaps

Background: Young people with mental illness should be offered evidence-based treatments. In 2018, we developed a national evidence portal in Norway providing mental health professionals and others with living evidence summaries. This immense work has been an important contribution to mental health care in Norway but is also a rich data source for exploring the characteristics and evidence gaps of the existing research internationally. At the time of this study, eight overviews of systematic reviews (OoOs) had been published. These addressed treatments for attention deficit / hyperactivity disorder (ADHD), anxiety, depression, bipolar disorder, psychosis, obsessive compulsive disorder (OCD), self-harm and trauma/ post-traumatic stress disorder. The objective of this study was to do a secondary analysis of this evidence to describe the state-of-the art in this field, and to map: treatments evaluated for each patient group and the longest time of follow-uptreatment comparisons evaluated for more than one patient group Methods: We performed a mapping review of the eight OoOs. Data extraction was performed by one author and double-checked by another. All data was entered into Excel. Findings were visualized in descriptive tables and using Sunburst-diagrams. We used statistical thresholds to determine the size of effect and report the associated certainty. Results: We identified 200 treatment comparisons including a wide variety of interventions. Some mental illnesses are treated mostly with pharmacological or combination therapies and others solely with psychological or psychosocial treatments or with more diversity. The evidence supporting most treatments is of low to very low certainty. Ten percent of the comparisons included follow-up assessments beyond 12 months. Cognitive behavioural therapy, dialectic behavioural therapy, physical activity and mindfulness interventions were effective across populations. Conclusions: The evidence supporting treatment of mental illness in young people has important limitations. Future research efforts should address these evidence gaps.

Depression, anxiety, substance misuse and self-harm in children and young people with rare chronic liver disease

The burden of mental illness in young people with chronic liver disease is not known. In this population cohort study in England, we identified 358 individuals (aged ≤25 years) diagnosed with autoimmune hepatitis or liver disease related to cystic fibrosis and 1541 propensity-score-matched controls. By the first year of follow-up, the cumulative burden of psychiatric events in participants with liver disease was high compared with controls: anxiety disorder (6.87 per 100 individuals [95% CI 4.00-9.73] v. 2.22 [95% CI 1.37-3.07]), depression (5.10 [95% CI 2.83-7.37] v. 0.86 [95% CI 0.53-1.19]), substance misuse (10.61 [95% CI 9.50-11.73] v. 1.23 [95% CI 0.71-1.75]) and self-harm (3.09 [95% CI 1.12-5.05] v. 0.20 [95% CI 0.07-0.33]). Participants with liver disease had a 2-fold increase (OR = 1.94, 95% CI 1.45-2.58), a 2.5-fold increase (OR = 2.59, 95% CI 1.91-3.50) and 4.4-fold increase (OR = 4.44; 95% CI 3.46-5.71) in the risk of anxiety, depression and substance misuse, respectively. These findings highlight the need for effective intervention in psychiatric disorders in young people with rare liver disease.

The School of Hard Talks: A telehealth parent training group for caregivers of adolescents and young adults.

A large body of evidence demonstrates the importance of the family environment in the developmental trajectory of mental illness in young people. Caregiver communication skills training represents a potential model for influencing the outcomes of adolescents and young adults struggling with emerging mental health and behavioural difficulties. The aim of the current study is to describe the development of a telehealth group training intervention for caregivers of adolescents and young adults, and to report the results of a pilot feasibility-effectiveness study that took place in 2020-2021. The "School of Hard Talks" intervention consisted of 8h of training in communication skills consistent with motivational interviewing techniques. All pilot study participants were assigned to receive the intervention. Outcomes of interest were family conflict, caregiver stress, caregiver self-efficacy and expressed emotion (EE). Participants were assessed three times: prior to the intervention, after the intervention and 12 weeks later. A total of 62 participants enrolled in the study, of whom 49 completed the intervention. Large, significant improvements were observed over time in all four domains of interest. Qualitative feedback from parents was very positive and added context to quantitative observations. The School of Hard Talks was a feasible and effective intervention targeting both caregiver wellbeing as well as important mechanisms of risk for youth psychopathology, namely family conflict and EE. Further research involving a larger sample and a control condition are needed to confirm these findings.

A multifaceted approach in promoting positive mental health culture in Hong Kong secondary schools: The Mindshift educational networking programme.

Many young people with mental health problems refuse to seek help because of stigma and leave the problem untreated. Previous research suggests that contact interventions with education could improve the stigma of mental illness in young people, thereby encouraging help-seeking in distress. The current study examined the effectiveness of a multifaceted programme, the Mindshift educational networking programme (MENP), in promoting a positive mental health culture in Hong Kong secondary schools. The MENP provided activities at school, teacher and student levels to 14 Hong Kong secondary schools. School activities included visits, mental health talks and support for capstone projects. While teachers participated in workshops and regional seminars, students received ambassador training workshops, contact opportunities with people with psychosis and attachment programmes. The impact of MENP was evaluated by changes in students' knowledge, attitudes and behaviours toward people with psychosis and mental illness before and after the programme, as well as by teachers' feedback on the programme. This study analysed data from 55 students and 20 teachers. It was found that the MENP improved students' knowledge of mood symptoms (p= .03), acceptance of people with psychosis (p= .04) and intended behaviour toward people with mental illness (p= .02). The feedback of the teachers on the programme was positive. The results support the application of the multifaceted approach to promote a positive mental health culture in schools. The findings call on the government to implement the programme in schools in Hong Kong by providing financial support to relevant organizations.

Association between Fruit and Vegetable Consumption and Depression Symptoms in Young People and Adults Aged 15-45: A Systematic Review of Cohort Studies.

Higher consumption of fruit and vegetables has been associated with a lower risk of various chronic diseases including coronary heart disease, obesity, and certain cancers. Recently, fruit and vegetable intake has also been linked with mental health, including depression; however, this area is largely unexplored studies in young people and adults. This systematic review aimed to evaluate the association between fruit and vegetable intake and depressive symptoms in young people and adults aged 15–45. The review used a predefined protocol registered with International Prospective Register of Systematic Reviews (PROSPERO) database (ID no: CRD42018091642). The systematic review focused on peer-reviewed cohort studies published from 1 January 2000 to 31 August 2020 using searches of six electronic databases. The exposure was fruit and vegetable consumption analysed both separately and/or together, and the outcome was depression or depressive symptoms. Data from eligible studies were extracted according to predefined criteria and the studies were appraised using the Newcastle–Ottawa Scale (NOS) for cohort studies to evaluate for study quality and risk of bias. A total of 12 studies from seven countries were deemed eligible and included in the qualitative synthesis, one study was categorised as “very good” quality, nine studies were “good” quality, and two studies were “moderate” quality by the quality assessment based on the total score for the NOS. The majority of cohort studies support the evidence that fruit consumption is associated with decreased risk of developing depression. However, the inconsistent results were observed when the effects of vegetable consumption were analysed independently, and the effects of fruit and vegetables combined were analysed. Despite this, the evidence seems to be building that a possible association exists, and this may have implications for addressing the burden of mental illness in young people and adults aged 15–45 years. More well-designed prospective cohort studies are needed to provide more robust evidence on the relationship between fruit and vegetable intake and depression.

Practitioner Review: Effective management of functional difficulties associated with sensory symptoms in children and adolescents.

Sensory symptoms are defined as atypical behavioral responses to daily sensory stimuli that impact on the performance of everyday routines. Sensory symptoms have been observed in young people with and without developmental concerns. There is uncertainty, however, regarding the best way to identify and manage sensory symptoms. The aim of this paper is to provide a review of current best evidence regarding measurement of and interventions for sensory symptoms. A narrative review methodology is adopted to address the aims of this paper. First, sensory symptoms are defined, and then, an overview of the evidence for the relationship between sensory symptoms and childhood function is provided. Second, commonly used sensory assessment tools are summarized and evaluated. Finally, an overview and critique of the evidence for sensory and nonsensory-based interventions addressing sensory symptoms are given. The terminology used to describe sensory symptoms varies by discipline, and several conceptual taxonomies including sensory subtypes have been proposed. There is ample evidence to support the association of sensory symptoms with childhood function including social engagement, repetitive behaviors, anxiety, and participation in self-care routines. Measurement of sensory symptoms is dominated by proxy-report instruments, and few single instruments assess the entire domain of sensory symptomatology. The evidence for interventions for sensory symptoms is emerging but still limited by low quantity and methodological concerns. Effective management of sensory symptoms may mitigate the burden of neurodevelopmental disability and mental illness in young people. Identification of sensory symptoms should be conducted by a skilled practitioner utilizing multiple measurement methods. Intervention protocols for sensory symptoms should be informed by current best evidence which is strongest for Ayres Sensory Integration® , Qigong massage, the Alert Program® , and Social Stories. To make significant progress in this field, however, new intervention studies must address the question of 'what intervention works for whom?'.

Youth StepCare: a pilot study of an online screening and recommendations service for depression and anxiety among youth patients in general practice

BackgroundGeneral Practitioners (GPs) are ideally placed to identify and manage emerging mental illness in young people, however, many report low levels of confidence in doing so. A web-based universal screening service delivered via a mobile tablet, Youth StepCare, was developed to assist GPs in identifying depression and anxiety symptoms in youth patients. This service also provided evidence-based treatment recommendations and fortnightly monitoring of symptoms. The current study assessed the feasibility and acceptability of delivering the Youth StepCare service in Australian general practices.MethodsA 12-week uncontrolled trial was undertaken between August 2018 and January 2019 in two general practices in NSW, Australia. The service was offered to all youth patients aged 14 to 17 years who visited a participating GP during the screening period with their parent or guardian. Youth patients reported the presence of depressive and anxiety symptoms using the self-report Patient Health Questionnaire-9 and the Generalised Anxiety Disorder Questionnaire-7. New cases were defined as those who reported symptoms but were not currently seeking help from their GP, nor had sought help in the past. Feasibility and acceptability among GPs and practice staff were assessed using a battery of questionnaires.ResultsFive GPs and 6 practice staff took part. A total of 46 youth patients were approached, 28 consented, and 19 completed the screener (67.9%). Nine reported symptoms of anxiety or depression, two of which were new cases (22.2%). GPs and practice staff were satisfied with the service, reporting that there was a need for the service and that they would use it again.ConclusionsThe Youth StepCare service appears to be a useful tool for identifying youth with unidentified symptoms of mental illness that can be easily embedded into general practice. Further research would benefit from exploring the factors affecting initial GP uptake and a larger trial is required to determine the efficacy of the service on young people’s symptom reduction.

Exploring well-being: medical students and staff.

SummaryBackgroundMental illness in young people is a major public health challenge, with a higher prevalence amongst medical students. This study explores the perspectives of both students and staff in relation to the provision of well‐being support within one medical school in the United Kingdom.MethodsA total of 17 second‐year medical students and five members of academic and well‐being staff at Liverpool Medical School participated in one‐to‐one semi‐structured interviews. Staff and students were asked for their views on existing support services, exploring challenges and ideas for development. Interviews were recorded, transcribed and analysed thematically to identify common themes amongst both students and staff.ResultsStudents wanted to have more obvious support during their transition from sixth form to undergraduate studies. Perceived stigma surrounding mental health continues to prevent students seeking help over concerns this might have upon academic progress. Staff reported concerns that student expectations did not always match with what could realistically be provided by the medical school well‐being service.DiscussionThe provision of opportunities for students to ‘check‐in’ with staff, and the introduction of well‐being topics within the curriculum, were perceived by students and staff as being of potential benefit to the mental health of students. Such interventions may also help to build rapport and encourage students to engage with medical school support services. All well‐being support services are increasingly in demand amongst medical students, showing a need for them to expand and well‐being to be further incorporated into the course.

Adolescent Mental Health in an Australian Context and Future Interventions

This article presents an overview of the literature on mental health in the adolescent population in Australia and includes the prevalence and epidemiology of mental health issues and an analysis of a range of school-based interventions. The presence of mental illness in young people has become a major health problem globally, and increasing interest has been toward showing how Australian youths in the general population are specifically affected. It is becoming increasingly difficult to ignore the implications for mental illness in adolescents, and particularly in minority populations. Particularly troubling are reported suicide rates in this age group over the last decade. This article argues that the average age of onset for mental illness is falling, signifying that schools are fast becoming important environments for early identification and intervention programs. In recent years, a rapid increase in research has investigated the relationship between school connectedness and psychopathology. Empirical studies on school belonging and loneliness reveal considerable evidence that social connections play an essential role in the prevention of mental health issues and in the fostering of wellbeing. This article explores Australian studies on mental illness and its prevention and intervention in secondary schools. The article contributes to existing literature of mental illness in adolescents and has important practical implications for future intervention.

Mental health reform: increased resources but limited gains.

is the prime vehicle for monitoring the mental health system reform agenda outlined in the Australian Government’s National Mental Health Strategy. We consider here what the 2013 report tells us about the progress of that agenda.First, we know that mental health expenditure, after 18 years of mirroring growth in overall health spending, in the 2010–11 financial year accounted for an increased proportion of health spending within the health sector. The direct-care workforce employed in mental health services increased by 72% between 1992–93 and 2010–11.Second, the mix of services provided has improved. Inpatient care has moved from stand-alone psychiatric hospitals to psychiatric beds in general hospitals, while state and territory funding of ambulatory care services increased by 291% from 1992–93 to 2010–11. Between 2006–07 and 2010–11, the percentage of the population receiving Medicare-funded primary mental health care services rose from 3.1% to 6.9%, correlating to Medicare Benefits Schedule expenditure on mental health services increasing from $474 million to $852 million.Encouragingly, gains have also been made in other areas. Rates of use of licit and illicit drugs that contribute to mental illness in young people have decreased. For example, in 2010, 19% of 14–29-year-olds used cannabis, compared with 36% in 1998.

School-based interventions targeting stigma of mental illness: systematic review.

Aims and method To systematically review the published literature on the effectiveness of classroom-based interventions to tackle the stigma of mental illness in young people, and to identify any consistent elements within successful programmes.Results Seventeen studies were included in the analysis. A minority of studies reported a positive impact on stigma or knowledge outcomes at follow-up and there were considerable methodological shortcomings in the studies reviewed. These interventions varied substanitally in content and delivery. It was not possible to use this data to draw out what aspects make a successful intervention. There is currently no strong evidence to support previous conclusions that these types of intervention work for children and adolescents.Clinical implications When anti-stigma interventions for young people are rolled out in the future, it is important that the programme design and method of delivery have evidence to prove their effectiveness, and that the audience and setting are the most appropriate to target. There is a current lack of strong evidence to inform this.

A Community Outreach and Education Model for Early Identification of Mental Illness in Young People

Objective: The Portland [Maine] Identification and Early Referral (PIER) program was established in 2000 as a prevention system for identifying and treating adolescents and young adults at high risk of an initial psychotic episode. Community outreach and education to targeted groups was the primary method for identification. Methods: Community outreach and education is defined as any activity designed to inform key audiences about the importance of and methods for early detection and intervention of psychosis in adolescents and young adults. PIER program staff presented information on the early warning signs of psychosis and how to make a referral to target audiences within a young person’s social network. Results: Community outreach resulted in the referral of 780 youths who met demographic criteria, yielding 404 cases that were deemed sufficiently at risk to be eligible for formal assessment. After screening and assessment by PIER staff, 37% of community referrals were found to be at high risk for psychosis, and another 20% had untreated psychosis, yielding a correct-referral efficiency ratio of 57%. In addition, community educational presentations were significantly associated with referrals six months later. Conclusions: In its efforts to create a system of early identifiers for young people at the beginning stages of mental illness, the PIER program has developed a new model for community health education that has shown that it is possible to engage community members in the identification of adolescents and young adults who are experiencing the early symptoms of a psychotic disorder.

General practitioner experience and perception of Child and Adolescent Mental Health Services (CAMHS) care pathways: a multimethod research study

ObjectivesThis is a pilot study with the objective of investigating general practitioner (GP) perceptions and experiences in the referral of mentally ill and behaviourally disturbed children and adolescents.DesignQuantitative analyses on...

The effectiveness of simple psychological and exercise interventions for high prevalence mental health problems in young people: a factorial randomised controlled trial

BackgroundThe prevalence of mental illness in young people is the highest of any age group, with the onset of depression, anxiety and substance use peaking between 18 and 24 years. Effective treatments that target sub-threshold or mild to moderate levels of disorder in young people are required to reduce the risk of persistence and recurrence. The aims of this study are to evaluate whether treatments that are less intensive than cognitive-behaviour therapy, such as problem solving therapy and exercise treatments, are acceptable and effective in managing depression and anxiety symptoms in young people and to identify possible attributes in those who are likely to respond to these treatments.Methods/designThis is a factorial randomised controlled trial conducted at a large, metropolitan youth mental health service. Participants are young help-seekers aged 15-25 years with sub-threshold or mild to moderate levels of depression and anxiety (with or without comorbid substance use). The interventions comprise 4 treatment combinations delivered by psychologists over 6 sessions on a weekly basis: a psychological intervention (problem solving therapy versus supportive counselling) and an exercise intervention (behavioural exercise versus psychoeducation). Structured assessments occur at baseline, mid-point, end-point (6 weeks) and at a 6- and 12-month follow-up. The primary outcomes are depression and anxiety symptoms as measured by the Beck Depression and Anxiety Inventories. Secondary outcomes include remission (defined as no longer meeting the diagnostic criteria for a disorder if threshold level was reached at baseline, or no longer scoring in the clinical range on scale scores if sub-threshold at baseline), substance use, and functioning.DiscussionThe effectiveness of less complex psychological and exercise interventions in young help-seekers with sub-threshold or mild to moderate presentations of high prevalence disorders is yet to be explored. This study has been designed to examine the effectiveness of these interventions delivered alone, or in combination, in a youth-specific service. If effective, the interventions have the potential to prevent the progression of early symptoms and distress to later and potentially more serious stages of mental disorder and reduce the likelihood of ongoing problems associated with the risk of persistence and recurrence.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12608000550303

Troubled youth: an island of misery in an ocean of happiness, or the tip of an iceberg of suffering?

To critically examine the orthodox view that young people's health and wellbeing are continuing to improve in line with historic trends. Transdisciplinary synthesis is used to analyse and integrate a wide range of evidence on young people's health and wellbeing. Synthesis seeks coherence in the overall conceptual picture rather than precision in the empirical detail. The orthodox view rests mainly on declining mortality among teenagers and young adults, and findings that most say they are healthy, happy and satisfied with life. With health improving for most, the focus of attention is on social inequalities in health. However, mortality rates understate the growing importance of non-fatal, chronic health problems, especially mental illness; self-reported health and happiness are flawed indicators of overall well being. Evidence suggests that rates of mental illness in young people have increased over time, and are higher than in older age groups. Explanatory factors include quite fundamental features of modern societies, which go beyond inequality and disadvantage; trends in these factors predict a deterioration in health and wellbeing. Contrary to the dominant view that young people have never been healthier, their health and wellbeing may have declined over several generations. Which perspective is right has important implications for understanding and addressing youth mental health problems, implications that go well beyond medical interventions.

Effect of Pathological Use of the Internet on Adolescent Mental Health

To examine the effect of pathological use of the Internet on the mental health, including anxiety and depression, of adolescents in China. It is hypothesized that pathological use of the Internet is detrimental to adolescents’ mental health. A prospective study with a randomly generated cohort from the population. High schools in Guangzhou, China. Adolescents aged between 13 and 18 years. Pathological use of the Internet was assessed using the Pathological Use of the Internet Test. Depression and anxiety were assessed by the Zung Depression and Anxiety Scales. After adjusting for potential confounding factors, the relative risk of depression for those who used the Internet pathologically was about 21⁄2 times (incidence rate ratio,2.5;95%confidence interval,1.3-4.3) that of those who did not exhibit the targeted pathological internet use behaviors. No significant relationship between pathological use of the Internet and anxiety at follow-up was observed. Results suggested that young people who are initially free of mental health problems but use the Internet pathologically could develop depression as a consequence. These results have direct implications for the prevention of mental illness in young people, particularly in developing countries.

Panel: Government Must Work Harder to Prevent Mental Illness in Young People

evidence creates new challenges. Calabrese noted that many physicians are not familiar with PML and how to identify it and that those who do choose to use these drugs must learn how to monitor their patients for signs of PML. According to the NINDS, such symptoms may include clumsiness and progressive weakness, as well as changes in vision, speech, and, sometimes, personality. In addition, Smith noted that PML can be particularly difficult to diagnose in patients with multiple sclerosis or some other neurological diseases because physicians may attribute the symptoms to a worsening of the patient’s existing illness. The potential risk of PML also profoundly changes the risk-benefit analysis for these drugs, Calabrese said. But it can be difficult for severely ill patients to objectively weigh the risks of a treatment that they hope will help them, noted Smith, who dissented with the FDA panel’s decision to allow marketing of natalizumab for Crohn disease. She explained that even though these disorders may be devastating to the individuals affected by them, it is important to question whether the benefit that a patient might derive from the drug is worth the risk of PML, which results in death for the majority of patients, often within months. It is not yet clear which patients may be at greater risk of developing PML when taking these drugs, although Calabrese and colleagues suspect patients with systemic lupus erythematosus may be particularly vulnerable. Treatment primarily involves immuneboosting therapies. In patients with HIV, such treatment consists of highly active antiretroviral therapies; however, only about 50% survive. The prognosis for patients without HIV is even worse: 80% die within 6 months, while survivors may have severe neurological problems.

Reducing The Stigma of Mental Illness Among Adolescents and Young Adults: The Effects of Treatment Information

The stigma of mental illness is pervasive in adolescents and interferes with treatment and overall life quality for those with disorders. A strategy for reducing stigma is to create awareness of counterstereotypes that can undermine the perceived homogeneity of the stigmatized group and promote help seeking for those with the illness. This study tested the strategy by presenting counterstereotypical information about the effectiveness of treatment for major depression in a national survey of youth ages 14 to 22 (N = 1,258), some of whom had experienced symptoms of depression (N = 284). The information was presented either before or after evaluating an untreated person with major depression. Despite the stigma of the mental illness stereotype, respondents reported lower levels of unfavorable stereotype expectations and reduced stigma for an individual with major depression who had been successfully treated compared with one who was not treated. The effect was robust across differences in beliefs about treatment efficacy and experiences with symptoms of depression; it was even stronger when the counterstereotypical information was presented after respondents evaluated an untreated person. The results indicate that messages focusing on persons who have been successfully treated are part of a promising strategy for reducing the stigma of mental illness in young people.

Familial, psychiatric, and socioeconomic risk factors for suicide in young people: nested case-control study

Objective: To estimate the risk of suicide in young people related to family and individual psychiatric and socioeconomic factors.Design: Population based nested case-control study.Setting: Data from longitudinal Danish registers.Cases and...