#Providenciales, April 3, 2019 – Turks and Caicos – The WHO defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity…”.  Mental health, specifically, is defined as not just the absence of a mental disorders but a state of well-being in which a person realizes their own abilities, is able to cope with life’s normal stresses, is able to work regularly and productively and is able to contribute to society.  Good mental health is therefore the foundation for an individual’s and a community’s effective functioning and well-being.  It is therefore critical to ensure the sound mental health of each individual beginning from childhood and throughout the lifespan.  Hence as a society it is our duty and obligation to nurture and maintain the mental health of everyone, especially our children and adolescents.  For the purpose of this article we will focus on adolescents.

Adolescence is defined as the developmental stage between ages 11 and 19/20 and is a time of great hormonal storms, decisions, pressures, identity formation, learning and personality formation.  While many adolescents have good mental health, multiple physical, emotional and social changes, along with various risk factors (see beneath) can all make adolescents vulnerable to mental health problems.  These factors can also determine the mental health of an individual into their adult life.  This stage of life is also the time to develop healthy physical, emotional and social habits to secure one’s mental health and some of these positive habits will be discussed later. 

Let’s review the statistics, according to the WHO:

• Of the world population 1 in every 6 persons is aged 10 to 19.
• 16% of the burden of disease & injury in the 10 to 19 age group is due to mental illness
• 50% of all mental health conditions start at age 14 but are largely undiagnosed or undetected, largely due to lack of knowledge, awareness and stigmatization.
• Globally depression is a leading cause of disability and illness among adolescents and the 9^th leading cause of overall illness in that age group, with anxiety being the 8^th leading cause.
• At its worse, depression can result in suicide and suicide is the 3^rd leading cause of death worldwide among 15-19 year olds.
• Failure to address mental conditions in adolescence unavoidably results in physical and mental challenges in adulthood and consequently limits the ability to lead fulfilling lives.
• Childhood behavioral disorders are the 6^th leading cause of disease burden among adolescents.  Such disorders affect academic performance and usually lead to delinquency.
• Eating disorders such as anorexia, bulimia, binge eating disorder and body dysmorphic disorder normally emerge in adolescence and often co-exist with depression, anxiety and/or substance abuse.
• Mental health issues account for self-harm in adolescents and in 2016, approximately 62,000 adolescents died globally from self-harm.
• In 2016, interpersonal crime was the 2^nd leading cause of death among older adolescent males.

Risk factors:

Some of the risk factors which predispose adolescents to mental illness include but are not limited to:

• Poverty and lack of opportunities, educational and otherwise.
• Physical, verbal, and emotional abuse, with special emphasis on sexual abuse.
• Parental neglect, abandonment, and incest.
• Violence and trauma at home and in the community.
• Harsh parenting and bullying.
• The stresses & struggle of identity formation as one fights for autonomy.
• Peer pressure to conform and experiment with different trends.
• Exploration of their sexual identity and sexual orientation.
• The extensive & inappropriate exposure to social media and technology.
• The disparity between their actual life and their perceptions/aspirations of the future.
• The quality of life at home and with their peers.
• Adolescents who belong to minority groups, are stigmatized or due to discrimination or exclusion.
• Chronic illness, developmental disorders, and disabilities.
• Teenage pregnancy and/or abortions, teenage parents, and those in early life marriages.
• Orphans.
• Exposure to alcohol and drug use at an early age.
• Genetic factors (hereditary traits of mental illness).
• Poor coping mechanisms and lack of social support systems.

Types of mental illness among adolescents:

While the array of mental health conditions is wide and varied, just a few common ones will be highlighted for the purpose of bringing greater awareness. 

• Emotional disorders e.g. depression, anxiety, along with excessive irritability, frustration or anger and mood swings.  These can also lead to clinical depression and bipolar disorder.
• Emotionally related physical symptoms e.g. stomach aches, headaches, nausea, acne.
• Behavioral disorders such as oppositional defiant disorder (ODD), conduct disorder, ADHD, and disruptive behavioral disorder.
• Eating disorders, such as anorexia nervosa, bulimia nervosa, binge eating disorder which are also linked to body dysmorphic disorder.
• Psychotic disorders such as schizophrenia in it’s different forms.
• Dissociative disorders such as dissociative identity disorder (also called multiple personality disorder) and depersonalization disorder.
• Suicide and self-harm.
• High risk behaviors e.g. drug use, promiscuity & unprotected sex, indulging in violent behaviors.

These conditions are chronic, long term conditions which can be controlled with medication, psychotherapy, and sound, consistent social support systems in the form of family, friends, mental health professionals, church and community.  Once clients comply with their medication regimes and counseling and there is good support then the possibility of patients living a relatively functional life is high.  Therefore, it is prudent to adopt the proactive approach in choosing prevention rather than cure when addressing mental illness, and being aware of the various risk factors empowers us to do so.

How do we nurture mental health in adolescents?

• Establishing healthy, regular sleep patterns as well as healthy daily routines for them.
• Providing a healthy diet and regular exercise for them
• Developing adaptive coping mechanisms; these should be taught/modeled by responsible caring adults.  Teens look towards the adults in their life for guidance hence we must set the tone for behaviors if we wish to see them emulated.
• Teaching them how to develop good decision making skills.  The decision making center of the brain does not fully develop until age 25, therefore it is crucial that we support our teens in their decision making.
• Developing healthy interpersonal relationships with everyone in their circle.
• Nurturing a healthy self-concept, with good self-esteem and self-worth.
• Teaching them to understand, appreciate, embrace and most importantly manage their emotions.
• Providing a happy, healthy home for them free of violence, abuse, aggression and anger.
• Remaining open and available for them to talk and share whatever they may need to.
• Spending quality time with them while you engage in healthy joint activities.
• Providing discipline in a way which they can understand and discuss and also setting boundaries for them to operate within.
• Remaining aware and interested in their life events, friendships, academic performance, and choices.
• Speaking positively into their lives and future and helping them plan for their future.
• Praising them for their efforts and accomplishments despite how seemingly small it may be; teens need to be encouraged especially by those they hold in high regard.
• Being a reliable, responsible, dependable model to them in every way.
• Giving them opportunities to develop autonomy and think for themselves so that they can differentiate as healthy individuals and not feel or remain overly dependent on others.
• Treating them with respect; speaking with them and not with negativity and condescension.
• Ensuring regular medical checkups and observing your teen for changes and challenges they may be experiencing.
• Placing realistic expectations on them and not making unreasonable demands.  Each teen is unique with their own competencies and capabilities and therefore they should not be compared to others.  Comparison brings unnecessary pressure, frustration, and discontent as teens often struggle to meet unrealistic and unfair expectations set by the adults in their lives.

Remember our adolescents are the next generation of tomorrows world, the leaders, the innovators, the decision makers and the parents of another generation.  It is therefore in the best interest of all society to nurture, maintain and preserve the mental health of this precious generation with the hope that they will be given the best chance for a bright and productive future and that they will do the same for those to come after them.

Therefore, we hope that this information has brought some level of insight and will serve as a motivating force in nurturing mental health in our adolescents.

References:

1. Adolescent Mental Health: WHO.int/news-room/fact-sheets/detail.

• How to Promote Good Mental Health: promisesbehavioralhealth.com/mental-health

Release: TCIG