Multidimensional outcomes in youth mental health care

Multidimensional outcomes in youth mental health care: what matters and why?

Mood and psychotic syndromes (including anxiety, depression, bipolar disorder and psychosis) present one of the most serious public health challenges in the 21st century.

They affect fundamental aspects of human life – our ability to work, function and develop quality social relationships – and too often lead to the early loss of life.

About one in every three individuals is affected by such mental disorders over their lifetime, and studies continuously show they are a leading cause of years lost to disability.

Young people in particular are at risk, with over 75% of adult mental disorders emerging before the age of 25 years and over 45% of the total burden of disease for those aged 10–24 years being attributed to mental disorders.

Consequently, a key population health priority is to reduce the burden of these disorders so that their impact does not endure a lifetime. Much of the burden can be attributed to prevalence and early age of onset, which influence the chronicity and secondary risks (e.g. suicidal thoughts and behaviours, alcohol or other substance misuse) associated with these disorders.

Lifetime prevalence estimates indicate that up to one-third of young people meet diagnostic criteria for a mental disorder, while the 12-month prevalence among Australian young people aged 16–24 years was the largest across all age groups at about 26%.

Studies consistently report such high prevalence rates for mental disorders before the age of 25 years, irrespective of whether or not they adhere to strict diagnostic rules about symptom thresholds and impairment.

The prevalence of mental disorders during youth poses a risk for future health and wellbeing outcomes precisely due to the time at which they tend to emerge. Adolescence and young adulthood is a critical period of biological and social development.

Usually beginning with the onset of puberty, major physical and neurobiological changes occur, characterised by the development of key brain circuits responsible for higher order cognitive and emotional functions that, if suboptimal or disrupted, can have a significant impact on behaviours and the development of disorder.

This period is also characterised by significant social development as young people embark on the early phases of their careers via education and employment, and engage in more complex relationships with friends, family, and intimate and sexual partners.

During this time young people face increasing diversity in potential life trajectories as they move from relatively restricted and homogenous environments, such as school and home life, to environments characterised by greater independence and variability in new educational, employment and social environments.

For some, this transition may occur without major disruption; however for others, this change in context and roles can lead to maladaptive functioning or can manifest and amplify underlying problems.

Thus, the biological and social complexity of adolescence and young adulthood means that young people are susceptible to the onset of mental health problems that may have a long term impact on outcomes in adulthood.

To find out more, download our supplement ‘Multidimensional outcomes in youth mental health care: what matters and why?‘ from the peer-reviewed Medical Journal of Australia.