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One in every seven 10- to 19-year-olds worldwide has a mental disorder, accounting for 13% of the global disease burden in this age group.
Among adolescents, depression, anxiety, and behavioral disorders are among the leading causes of illness and disability.
Suicide is the fourth leading cause of death among people aged 15 to 29.
Failure to address adolescent mental health conditions has long-term consequences, impairing both physical and mental health and limiting opportunities to live fulfilling lives as adults.
One in every six people is between the ages of 10 and 19. Adolescence is a distinct and formative period. Adolescents can become vulnerable to mental health problems as a result of physical, emotional, and social changes, such as poverty, abuse, or violence. Adolescent health and well-being are dependent on protecting them from adversity, promoting socio-emotional learning and psychological well-being, and ensuring access to mental health care.

Globally, it is estimated that 1 in 7 (14%) 10-19 year-olds suffer from mental health conditions(1), which go largely unnoticed and untreated.

Adolescents with mental health conditions are especially vulnerable to social exclusion, discrimination, stigma (which influences their willingness to seek help), educational difficulties, risk-taking behaviors, physical illness, and human rights violations.

Determinants of mental health
Adolescence is a critical time for developing social and emotional habits essential for mental health. Adopting healthy sleep patterns, exercising regularly, developing coping, problem-solving, and interpersonal skills, and learning to manage emotions are all examples. Protective and supportive home, school, and community environments are essential.
A variety of factors influence mental health. The more risk factors adolescents are exposed to, the worse their mental health may suffer. Exposure to adversity, peer pressure to conform, and identity exploration are all factors that can contribute to stress during adolescence. The disparity between adolescent’s lived reality, and their perceptions or aspirations for the future can be exacerbated by media influence and gender norms. The quality of their home life and relationships with peers are also important determinants. Violence (particularly sexual violence and bullying), harsh parenting, and severe socioeconomic problems are all known risks to one’s mental health.

Some adolescents are more likely to develop mental health problems due to their living circumstances, stigma, discrimination, exclusion, or a lack of access to quality support and services. Adolescents living in humanitarian and vulnerable settings; adolescents with chronic illness, autism spectrum disorder, an intellectual disability, or other neurological condition; pregnant adolescents, adolescent parents, or those in early or forced marriages; orphans; and adolescents from minority ethnic or sexual backgrounds or other discriminated groups are among those who qualify.

Emotional problems
Adolescents are prone to emotional problems. Anxiety disorders (which may include panic or excessive worry) are the most common in this age group and are more common in older adolescents than in younger adolescents. Anxiety disorders are estimated to affect 3.6% of 10-14-year-olds and 4.6% of 15-19-year-olds. Depression is estimated to affect 1.1% of adolescents aged 10-14 and 2.8% of those aged 15-19. Depression and anxiety share some symptoms, such as abrupt and unexpected mood changes.

Anxiety and depressive disorders can significantly impact school attendance and performance. Isolation and loneliness can be exacerbated by social withdrawal. Suicide can result from depression.

Behavioral issues
Younger adolescents are more likely than older adolescents to suffer from behavioral disorders. Attention deficit hyperactivity disorder (ADHD), characterized by difficulty paying attention, excessive activity, and acting without regard for consequences, affects 3.1% of children aged 10 to 14 and 2.4% of children aged 15 to 19. (1). Conduct disorder (characterized by symptoms of destructive or challenging behavior) affects 3.6% of 10-14-year-olds and 2.4% of 15-19-year-olds (1). Behavioral disorders can impact adolescents’ education, and conduct disorders can lead to criminal behavior.

Eating problems
Eating disorders, such as anorexia nervosa and bulimia nervosa, are most common in adolescence and early adulthood. Eating disorders are characterized by abnormal eating habits and a preoccupation with food, frequently accompanied by concerns about body weight and shape. Anorexia nervosa has a higher mortality rate than any other mental disorder, often due to medical complications or suicide.

Psychosis Conditions with psychotic symptoms most commonly appear in late adolescence or early adulthood. Hallucinations and delusions are common symptoms. These experiences can impair an adolescent’s ability to participate in daily life and education and frequently result in stigma or violations of human rights.

Suicide and self-harm are both options.
In older adolescents (15-19 years), suicide is the fourth leading cause of death (2). Suicide risk factors are multifaceted, and include the following:
Harmful alcohol use.
Childhood abuse.
Stigma against seeking help.
Barriers to care.
Access to means of suicide.
Digital media, like any other form of media, has the potential to strengthen or weaken suicide prevention efforts.

Risk-taking habits
Many health-risk behaviors, such as substance abuse or sexual risk-taking, begin during adolescence. Risk-taking behaviors can be an unhelpful coping strategy for adolescents, negatively impacting their mental and physical well-being.

In 2016, the prevalence of heavy episodic drinking among adolescents aged 15­-19 years was 13.6% worldwide, with males being the most vulnerable (3).

Tobacco and cannabis use also causes concern. Many adult smokers smoked their first cigarette before the age of 18. Cannabis is the most commonly used drug among teenagers, with approximately 4.7% of 15-16-year-olds using it at least once in 2018. (4).

Violence is a risky behavior that can increase the likelihood of low educational attainment, injury, criminal involvement, or death. In 2019, interpersonal violence was one of the leading causes of death among older adolescent boys (5).

Prevention and promotion
Mental health promotion and prevention interventions aim to improve an individual’s ability to regulate emotions, improve alternatives to risk-taking behaviors, build resilience for dealing with difficult situations and adversity, and promote supportive social environments and social networks.

These programs necessitate a multi-level approach with various delivery platforms, such as digital media, health or social care settings, schools, or the community, and various strategies to reach adolescents, particularly the most vulnerable.

Treatment and early detection
It is critical to address the needs of adolescents suffering from mental illnesses. Adolescent mental health depends on avoiding institutionalization and over-medicalization, prioritizing non-pharmacological approaches, and respecting children’s rights following the United Nations Convention on the Rights of the Child and other human rights instruments.

The WHO’s response
WHO is developing strategies, programs, and tools to help governments respond to the health needs of adolescents.

For example, the Helping Adolescents Thrive (HAT) Initiative is a joint WHO-UNICEF effort to strengthen policies and programs for adolescent mental health. More specifically, the Initiative’s efforts aim to promote mental health and prevent mental health conditions. They are also intended to help prevent self-harm and other risky behaviors, such as the harmful use of alcohol and drugs, which harm young people’s mental and physical health.

As part of the mhGAP Intervention Guide 2.0, WHO developed a child and adolescent mental and behavioral disorders module, this Guide offers evidence-based clinical protocols for assessing and managing various mental health conditions in non-specialized care settings.

Furthermore, WHO is developing and testing scalable psychological interventions to address adolescent emotional disorders and guidance on adolescent mental health services.

The WHO Regional Office for the Eastern Mediterranean has created a mental health training package for educators to improve their understanding of the importance of mental health in the school setting and to guide the implementation of strategies to promote, protect, and restore mental health among their students. It includes training manuals and materials to assist in increasing the number of schools that promote mental health.
Why is it important to recognize early stages of Depression in adolescents? What do these symptoms present as? Are there any tools that can be used in the office to help with evaluation( i.e. PHQ or HEADDS assessments)? Are there any national or local resources available for our patients?

Instructions: You will be providing supportive evidence with correct APA citations, and Your evidence should be scholarly articles, professional websites, research studies, and or books that provide supportive evidence in the last 5 years.

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