by A consortium of health experts warned that generational inequality, unregulated social media, wage theft, precarious work and the climate crisis are leading to a “dangerous” and “alarming” global rise in mental ill health among young people.
These driving factors must be addressed urgently. Treatment of mental illness must be improved to reverse the sharp rise in premature death, disability and loss of potential over the past two decades, according to a study by The Lancet’s Psychiatry Commission on the mental health of young people.
The work, published on Wednesday, was led by the executive director of Australia’s Orygen Centre of Excellence in Youth Mental Health, psychiatrist Prof Patrick McGorry, who said: “This is the most serious public health problem we have.”
“If health were to deteriorate so rapidly in another health area, such as diabetes or cancer, governments would take drastic measures,” he said.
While mental illness accounts for at least 45 percent of the total disease burden among the 10- to 24-year-old age group, only two percent of global health budgets go to mental health care, the report says.
Even in the wealthiest countries, less than half of the needs are met, the report says.
“Society often shows ambivalence towards young people and their needs,” said McGorry.
“But we are experiencing a strong fragmentation of society, which is actually caused by the economic theory of neoliberalism, according to which we operate and in which everything is a commodity,” he said.
This global emphasis on individualism and competition is destroying social bonds, undermining public welfare and public services, and giving power to harmful industries and corporations, he said.
“On the surface, it may seem that previous generations had it harder because of the Great Depression, world wars and nuclear threats,” McGorry said. “But in reality, there is much less security and hope for the future for today’s generation than ever before. The challenges facing today’s generation of young people are unprecedented, they are devastating and worse than ever before.”
He said in many countries the average house price is several times the average annual salary. In addition, poorly regulated social media and digital platforms that drive political polarisation are leaving young people feeling increasingly isolated, McGorry said.
“So many harmful things happen on the platforms that the tech giants are responsible for, and they completely follow their own laws,” he said.
“It is not the young people who are the problem or who we should restrict. We should [the digital environment] a safe place.”
A 23-year-old who advises Orygen on youth strategies and asked to be identified only by the nickname Li, said she was first exposed to online pornography when she was just 12 years old and that it had a lasting and devastating impact on her self-esteem and body image.
“There is so much adult content on the Internet and the use of this content is often completely unsolicited,” Li said.
“I felt like the internet was a place where I could escape or connect with other people from all over the world who had similar experiences to me. But instead I was exposed to really unregulated, really bad things, and my parents’ generation doesn’t really understand that.”
The Commission’s paper, co-authored by psychiatrists, psychologists, researchers and young people, describes young people as the most frequent users of the Internet and as often being “constantly” online, which can be potentially harmful and put mental health at risk.
The newspaper warns: “Mental illness, which has been the biggest health and social problem affecting the lives and futures of young people for decades, has entered a dangerous phase.”
“[It] poses a major threat to the lives and futures of young people, and there is worrying evidence that its prevalence and impacts are steadily increasing in many resource-intensive settings.”
An accompanying analysis led by King’s College London acknowledges that much of the evidence underlying the commission’s report comes from high-income countries. This is problematic because 90 percent of children and young people live in low- and middle-income countries, which “have the highest burden of mental ill health.”
In low- and middle-income countries, the unmet need for mental health care could be close to 100 percent, said World Health Organization (WHO) spokeswoman Carla Drysdale.
“All countries, regardless of limited resources, can take steps to improve mental health prevention and care for young people,” she said. Building a non-specialist workforce that includes school counselors, social workers and peers is critical, she said.
“WHO supports countries’ efforts to build community-based mental health care for young people by transforming services and treatment pathways to make them accessible.”
Suicide is the leading cause of death among 15- to 44-year-olds in Australia, 15- to 19-year-olds in New Zealand and 15- to 39-year-olds in India.
Dr Paul Denborough, a child and adolescent psychiatrist who was not involved in the commission’s report, described the Lancet article as “making the point that a society in which there is more inequality and exclusion is very destructive”.
“Government policies really do not favor young people,” he said.
“Young people are aware of the intergenerational injustice in politics – they say: ‘You older people don’t give a damn about us.'”
Denborough is clinical director of Headspace in Australia, a free or low-cost service for young people aged 12 to 25.
Denborough says it is important to recognise the multiple stressors young people face and address the root causes of this stress, rather than automatically labelling young people as having a mental illness.
“Inequality, lack of affordable housing, job insecurity and the policies behind it are often the root cause,” he said.
“If society does not consider its actions in terms of intergenerational justice and address the causes, then it will only be putting a Band-Aid on the problem.”
