This page contains a summary that describes and explains the mental health of children and youth. This version is a first draft prepared by members of a Canadian Community of Practice in the Spring of 2010. Please comment on these document using the "thread" tool at the bottom of this page or edit the text using the "easy edit" tool found at the just above this text.
The Mental Health of Young People: Nature, Prevalence & Implications
The mental health of children and youth can be conceptualized as a tapestry of inter-related threads that can be loosely grouped into four overlapping categories; positive mental health (e.g emotional health, mindfulness, critical thinking, attachments), problems caused by life experiences (e.g. bereavement, stress, divorce), interactions with other health or social problems (e.g. bullying, addictions, discrimination based on race or sexual orientation) and mental illness (e.g. depression, anxiety, suicide). Fundamentally, mental health is about the individual successfully adapting to her/his environment, by making changes in him/herself, by changes being made in their environment or in modifying the interactions between people and their environments.. Mental health does not mean absence of mental distress as distress can often be normal or expected and is often a signal that adaptation is needed. Mental health is dependent upon a healthy brain, a healthy body and a healthy environment. Mental health problems can be understood as difficulties in adaptation, either due to individual traits, undeveloped strengths or weaknesses that make it difficult for the individual to adapt, factors in the environment that make adaptation difficult, significant life experiences or incidents or a combination or interactions of the above. A mental disorder can be understood as a failure of adaptation, either due to factors within the individual (for example: genetics), factors unique to the environment (for example severe and ongoing trauma) or a combination thereof.
Social, economic and cultural factors will interact with the social norms of the local community, the practices of families and schools and the individual emotional, genetic, developmental and intellectual characteristics of students to influence mental health. Mental health is interwoven with several other health and social issues affecting young people. Psychological health and well-being is also an independent feature of the child and is comprised of several aspects of the mind. The mental health of children can be more vulnerable during transitions into primary school, between primary and secondary school, into a new neighbourhood, between secondary school and post-secondary studies or work. Such stress, or stress caused by other life events, may cause the onset of a previously latent or manageable mental illness. One of the major complicating factors in preventing or managing mental health problems or illnesses is that social stigma discourages people from seeking medical help or other forms of support.
Mental disorders in young people contribute the most significant proportion to the burden of illness in this group. About 70% of mental disorders onset during childhood and adolescence. About one in five young people will experience a mental disorder requiring professional help. Many more young people will demonstrate significant mental health problems that may require interventions. In Canada it is estimated that one in six young people who require care do not receive it in a timely manner. Although suicide rates among young people have been decreasing over the last decade, suicide still remains a leading cause of death in this age group.
Prevalence of Positive Mental Health, Problems and Illnesses World Wide
(To be added)
Prevalence in Selected Countries
Full statistical portraits are not available from all countries, so we have selected a few examples below representing high-income countries:
Canada
The prevalence of mental health problems and illnesses among children and youth in Canada can be described as follows. Over 70% of mental illnesses begin their onset during childhood and adolescence. The international survey, Health Behaviors in School Age Children, indicates that Canadian young people are less able to access social support from their parents or peers relative to other countries. According to Encarta, Canada’s suicide rate has historically been similar to or slightly higher than that of the United States. More than 3,500 suicides are recorded in Canada each year, at a rate of about 11 per 100,000. An accurate comparison of suicide rates among countries is difficult because of the unreliability of official suicide statistics and varying methods of certifying how deaths occurred. A 2002 federal Report on Mental Illnesses in Canada reported that 4.1 to 4.6% of people each year will report major depression, 0.3% will report schizophrenia, 12.2% will report anxiety disorders, about 1% of women will report eating disorders and 12.2 per 100,000 will commit suicide (24% of which are among youth aged 15-24. The Canadian Community Health Survey has been used to track general mental health prevalence since 2003. According to the statistics available on the Statistics Canada web site from this survey, perceived mental health among 12-19 year old youth has remained stable each year since 2003. ("Very good or excellent" improved slightly from 76.1% to 78.7%; fair or poor from 3.4% to 3.3%; satisfied or very satisfied with life 94.1% to 94.4%; perceived quite a lot of stress from 18.4% to 16.3%) The answers from this age group did indicate that mood disorders had increased from 2.7% to 3.4% of the population. An analysis of the 2002 CCHS data done by the Canadian Population Health Initiative reports that positive mental health is correlated with self-reported physical health. The CPHI report also noted geographical differences (Newfoundland reported highest levels of PMH). Males reported higher coping skills and emotional well-being, while females reported higher social connectedness and spirituality. Income and education were not consistently linked to high PMH. For example, those with higher education reported higher coping skills but less life enjoyment, social connectedness, spirituality and emotional well-being. Social connectedness and community belonging were the strongest correlates of high PMH.
Scotland
Singapore
Australia
Several well-recognized theories have been developed to explain the problem of child/youth mental health as well as approaches, programs and other interventions that can promote positive mental health, prevent mental health problems or alleviate/reduce the impact of mental illnesses. These include:
- emotional intelligence theory, which has evolved into a "social-emotional" approach to mental health promotion and learning
- attachment theory that has evolved into a variety of programs that seek to strengthen the connection between the young person and their family, peers, trusted adults in the school or other institutions or their community
- resilience theory, which is leading to new understanding of why some youth bounce back from and overcome severe challenges and how response mechanisms can be built into contexts, institutions and programs to support recovery or endurance
- stages of change/trans-theoretical theory that explains how behaviours are contemplated, adopted and changed
- self-determination theory
- cognitive-behavioural theory which is used to guide various therapies and health services
- health-belief model which describes how beliefs about customs/norms and our own capacity to act will influence our behaviour
- social learning theory, which explains how we use cues and observations from our relationships and social environments as a guide for our own actions