Mental health of young people: a global public-health challenge

Patel, Vikram; Flisher, Alan J.; Hetrick, Sarah; McGorry, Patrick D.

doi:10.1016/s0140-6736(07)60368-7

Cited by 2,536 publications

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“…Studies consistently find that the number of childhood risk factors or “adverse childhood experiences” predict adverse outcomes—including the likelihood of developing a mental disorder in adulthood 38, 39, 40, 41, 42, 43, 44. This association is well described in the Adverse Childhood Experiences study 3, 4, 5, 6.…”

Section: Methodsmentioning

confidence: 84%

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Risks for Mental Illness in Indigenous Australian Children: A Descriptive Study Demonstrating High Levels of Vulnerability

et al. 2017

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Policy Points: The developmental origins understanding of mental illness suggests the possibility of prevention, through addressing childhood adversities.More than 43% of Indigenous Australian children aged 6 to 10 years have 6 or more risk factors for mental illness in adulthood, and 23% are experiencing current psychological distress.Substantial risk is already present in infancy (eg, 67% exposed to 3 or more stressful family life events, and 42.5% are not living with both birth parents).An integrated service system response that can both offer high‐level therapeutic services and address associated multiple adversities, from conception to late adolescence, is urgently needed to address current psychological distress in Indigenous Australian children and to reduce the future burden of mental illness. ContextMental illness is a high source of disease burden across the globe. Mental illness is now understood as largely developmental, with its genesis at least in part in adverse childhood experiences. We sought to estimate the prevalence of childhood risks for poor mental health in Indigenous Australian children, noting that Indigenous Australians by virtue of their history of traumatic colonization and dispossession, child removal, and racism are potentially at greater risk.MethodsWe conducted a descriptive study of the modifiable risks and adversities associated with mental illness in Australian Indigenous children (infancy to 10 years), using data from the Longitudinal Study of Indigenous Children (LSIC), a cohort of 1,671 infants enrolled in 2008 and followed up annually. Risk factors of interest were identified from a comprehensive literature review of childhood determinants of adult mental illness by Fryers and Brugha (2013). The age‐category prevalence of individual risks and a multiple‐risk score were computed using data extracted from 6 waves of LSIC.FindingsThe analytic data comprised 8,378 person‐observations from the first 6 waves. Children in LSIC experience high rates of adversities. In utero, nearly 50% were exposed to smoking and 22% to alcohol. As infants, 42.5% were not living with both birth parents. Over two‐thirds of survey children were in households that had experienced, in the previous 12 months, 3 or more major life events; 22% to 26% lived in households with a drug or alcohol problem; and 18% were exposed to domestic violence (41% were ever‐exposed to age 10). At school, nearly 40% of children were bullied. Over 45% of children aged 6 to 10 years were exposed to 6 or more risks for mental illness. Few children (< 2%) were exposed to low parental warmth and, despite the high exposure to adversities, less than 5% of children report low self‐confidence. This suggests considerable resilience. More than 1 in 4 children had conduct problems in the clinical range and more than 1 in 5 were experiencing high psychological distress.ConclusionsIndigenous children in Australia face extreme levels of multiple disadvantage, exposing many to current psychological distress and high risk of developing me...

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Section: Methodsmentioning

confidence: 84%

“…Other studies put rates of psychological distress in Australian children higher, across a broad age range 21, 44, 45, 46…”

Section: Discussionmentioning

confidence: 97%

Risks for Mental Illness in Indigenous Australian Children: A Descriptive Study Demonstrating High Levels of Vulnerability

et al. 2017

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“…Gaming has enormous applied potential in mental health, where healthcare services have traditionally struggled to engage young people (Patel, Flisher, Hetrick, & McGorry, 2007). Research in this area is still in its infancy, but one promising line of enquiry involves Tetris game play.…”

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Selective Association Between Tetris Game Play and Visuospatial Working Memory: A Preliminary Investigation

Lau‐Zhu

Holmes

Butterfield

et al. 2017

Applied Cognitive Psychology

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SummaryRecent experimental and clinical research has suggested that Tetris game play can disrupt maladaptive forms of mental imagery because Tetris competes for limited cognitive resources within visuospatial working memory (WM) that contribute to imagery. Whether or not Tetris performance is selectively associated with visuospatial WM remains to be tested. In this study, young adults (N = 46) completed six standardized measures indexing verbal and non‐verbal reasoning, verbal and visuospatial short‐term memory, and verbal and visuospatial WM. They also played Tetris. Consistent with the hypothesis that visuospatial WM resources support Tetris game play, there was a significant moderate positive relationship between Tetris scores and visuospatial WM performance but no association with other cognitive ability measures. Findings suggest that Tetris game play involves both storage and processing resources within visuospatial WM. These preliminary results can inform interventions involving computer games to disrupt the development of maladaptive visual imagery, for example, intrusive memories of trauma. © 2017 The Authors. Applied Cognitive Psychology Published by John Wiley & Sons Ltd.

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confidence: 99%

“…Noteworthy, mean duration of antipsychotic visits was approximately 25 min and only approximately 30 % of them included psychotherapy [8], despite solid evidence on the efficacy of psychosocial interventions for several mental disorders, such as disruptive behavior disorders, for example in [15]. Children aged 2-5 years have also been Mental disorders are estimated to affect 10-20 % of children and adolescents around the world and are major causes of morbidity among youth [10]. Evidence from different countries suggests that the number of youths with reported diagnoses of mental disorders in the community has increased substantially during the past decades [1,17], although there is no evidence to indicate that the actual prevalence of disorders has increased [12].…”

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confidence: 99%

Identifying the gaps between science, policies, services, and the needs of youths affected by mental disorders

Polanczyk

2014

Eur Child Adolesc Psychiatry

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Second, there is a lack of solid empirical evidence for the treatment of a variety of conditions, and frequently the available evidence is not incorporated by the health systems [10]. The gap between interventions that are available in community settings and interventions that are evidence-based is even larger in low-resource settings [11]. Pharmacological interventions are commonly preferred because they are more easily delivered, with high fidelity if adherence is good. However, attributes of medications and patients' and families' preferences are usually not addressed by clinicians and have important implications on adherence [7]. On the other hand, psychotherapeutic approaches available in the health system usually lack consistency and are directed by the professional's theoretical affiliation, not by patient needs. Also, treatments are frequently delivered by professionals with limited training in inadequate formats. For example, nationally representative survey data from visits to office-based physicians in the US revealed that visits with a prescription of antipsychotic medications per 100 persons increased from 0.24 to 1.83 for children and 0.78-3.76 for adolescents between 1993-1998 and 2005-2009 [8]. Only 6 % of children and 12.7 % of adolescents' antipsychotic visits included a FDA clinical indication, and disruptive behavior disorders were the diagnosis for 63 and 33.7 % of visits for children and adolescents, respectively, despite the limited evidence for this indication and the urgent need of short-and long-term studies assessing its efficacy and safety, as addressed by the article from the Paediatric European Risperidone Studies Consortium in this issue [16]. Noteworthy, mean duration of antipsychotic visits was approximately 25 min and only approximately 30 % of them included psychotherapy [8], despite solid evidence on the efficacy of psychosocial interventions for several mental disorders, such as disruptive behavior disorders, for example in [15]. Children aged 2-5 years have also been Mental disorders are estimated to affect 10-20 % of children and adolescents around the world and are major causes of morbidity among youth [10]. Evidence from different countries suggests that the number of youths with reported diagnoses of mental disorders in the community has increased substantially during the past decades [1,17], although there is no evidence to indicate that the actual prevalence of disorders has increased [12]. Surprisingly, despite the fact that mental disorders have been increasingly recognized by professionals and the community, associated morbidity and mortality have remained stable [3].There are several possible explanations to explain why increasing rates of diagnoses do not translate into broad benefits to the health of the population. First, although rates of diagnoses have increased over time, the absolute number of youths affected by disorders who did not receive a diagnosis or treatment is still large. This is the case in the National Comorbidity Survey Adolescent Supplement (N...

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Mental health of young people: a global public-health challenge

Cited by 2,536 publications

References 107 publications

Risks for Mental Illness in Indigenous Australian Children: A Descriptive Study Demonstrating High Levels of Vulnerability

Risks for Mental Illness in Indigenous Australian Children: A Descriptive Study Demonstrating High Levels of Vulnerability

Selective Association Between Tetris Game Play and Visuospatial Working Memory: A Preliminary Investigation

Identifying the gaps between science, policies, services, and the needs of youths affected by mental disorders

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