Citation

Azzopardi P, Hijazi Z, Wulan N, Requejo J, Lai J, Carvajal-Velez L, Patton G. J. Adolesc. Health 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Elsevier Publishing)

DOI

10.1016/j.jadohealth.2021.03.021

PMID

36229395

Abstract

The majority of mental health problems commonly emerge in adolescence, coinciding with a pivotal point in individual development that lays the foundations for future and intergenerational health. As a result, poor mental health in adolescence can impact on educational attainment, social relationships, societal productivity, and quality of life in the short and long term, and potentially across generations. Yet, policy and practice responses to address poor adolescent mental health have been inadequate almost everywhere. Even in high income countries where there have been substantial investments in early clinical intervention, there has been little shift in the population prevalence of adolescent mental disorders. There is a growing need to rethink mental health problems in this developmental window, both in strengthening treatment responses, and also investing in mental health promotion and prevention. Programmatic and policy actions must include efforts to measure the burden of adolescent mental health problems and their determinants so as to ensure that actions are responsive to varying and often complex needs. Furthermore, there is a need to both monitor the impact of any investments to ensure accountability, and to build the evidence base for effective actions.

World Health Organization's (WHO) widely accepted definition affirms that good mental health is more than the absence of disease. To be mentally healthy is to have "the capacity for thought, emotion and behaviour that enables individuals to realise their own potential, cope with normal stresses, to study or work productively, and to contribute to society". There are challenges however in translating this holistic definition into country policies and programing. If mental health is the embodiment of a life well lived, what does a scalable approach (across age, gender, and culture) include? Clinical guidelines (such as WHO's mental health Gap Action Programme [mhGAP]) focus on identifying and managing mental disorders through primary healthcare services. This approach helps to address disease, but risks neglecting opportunities across sectors and within communities for broader mental health promotion and prevention that are perhaps most critical during adolescence, a time characterized by rapid change in interpersonal relationships, identity, health behaviors, and service access. Importantly, how do we operationalize a framework that recognizes that adolescent mental health is situated in a broader environment that includes family, peers, and community, all of which should be taken into account when working toward enhancing the psychosocial well-being of adolescents? And what are the opportunities for sectors outside of health, particularly education and social welfare? We propose a pragmatic conceptualization that enables a public health response, framing adolescent mental health around broader opportunities for intervention...

Language: en