Academic journal article Perspectives in Public Health

Youth Mental Health: 'Dream It, Try It, Live It'

Academic journal article Perspectives in Public Health

Youth Mental Health: 'Dream It, Try It, Live It'

Article excerpt

Woody Caan reflects on a meeting of the Youth Health Movement hosted by the Royal Society for Public Health (RSPH), and the policy and commissioning context in which we need to promote the mental health of young people.

21st -Century Youth Mental Health

In 20th -century Britain, the research on adolescent health fragmented. Isolated researchers studied teenage pregnancy, substance use, sexually transmitted infections and road traffic accidents. The evidence base for improving youth health is very different in 2016, as the children of the Millennium Cohort Study reach their teens. What changed the situation, and how can we use 21st -century evidence to promote better mental health?

A meeting of the Royal Society for Public Health (RSPH) Youth Health Movement in July 2016 with the theme, 'What did you do at school today?' included discussion of mental health, peer learning environments, bullying and depression, social inclusion and flourishing. The meeting also addressed diet, exercise and health awareness, but this report focuses on public mental health.[1]

A turning point in youth mental health was a Foresight report in 2000 Health Care 2020 .[2] Its recommendations included establishing ways to maintain an overview of childhood development and wellbeing, and a higher priority for disease prevention in relation to mental health and brain development. They recommended a strategy to exploit the potential for health advancement through social policy innovation, contributing to the latter through the intelligent use of scientific and technological advances.

For young people, mental health promotion had to relate to their trajectories of development and their social and educational environment.[3] At the same time, the Chief Medical Officer for England developed some interest in the health of the teenage nation. He recognised that 'good health in the teenage years is inextricably linked to a young person's ability to fulfil their potential'.[4]

Champions for adolescent health included Dr Maggie Barker who held the innovative post of Head of Public Health at Great Ormond Street Hospital for Children. She changed professional perceptions with her appeal to stop the 'focus on single issue approaches'.[5] It was an eye-opener to work in the same disadvantaged young population on the problems of school age drinking[6] and depression.[7] Better family policies might improve youth mental health. However, huge inequalities in UK income, housing and education undermined 'family-friendly' policy.[8] Professor Sir Michael Marmot has subsequently demonstrated the social determinants of mental health, and their persistent impact.[9]

Promising professional initiatives included the Royal College of General Practitioners' Adolescent Primary Care Society or the schools programme of the British Association for Counselling & Psychotherapy.[10] As well as examples of better care for mental illness, initiatives arose to promote positive wellbeing and resilience in the face of adversity.[11] To listen to young people themselves has been a major development.[12]

Failures in Support

We know more about the need to intervene early in young people's problems, and more about interventions that work, but only a quarter of those who need support are reached. Even if they receive support, there is a 10-year average delay between their first symptoms and help.[13]

Suicides rose 14% for 10- to 19-year-olds, from 2012 (176 deaths) to 2014 (201 deaths).[14] Schools are reporting unprecedented demand for mental health care.[15] Young people not in education[16] or 'looked after' away from their families[17] have even less mental health care. The World Health Organization (WHO) survey of Health Behaviour in School-age Children finds UK teenagers among the least happy in the world,[18] especially girls aged 15. …

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