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November 27, 2015

Mental health problems of today's youth

Reuel S. Amdur

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The Royal Ottawa Hospital, in conjunction with the Ottawa-Carleton District Board of Education and the Children's Hospital of Eastern Ontario (CHEO), held a public educational program at Ottawa's Robert Borden High School on September 30. Children's mental health was the topic.

Timothy Logan, the Board’s head of psychology, spoke of some trends he was seeing. 

He identified an increase of depression and anxiety among students across the district, a trend also reported provincially.  He noted that children with learning disabilities, including attention deficit hyperactivity disorder (ADHD) may also suffer from anxiety and depression.  He also commented on the exponential increase in students whose functioning falls along the autism spectrum.

Dr. Smita Tatte, who serves as the clinical director of the Royal Ottawa Hospital’s youth program, addressed the situation with youth in a broader context.  She reported that somewhere between 15% and 25% of Canadians experience a mental health problem before the age of 19.  Of these, one in six is diagnosed, and of those diagnosed one of five is treated. 

More specifically, she said that 18% of adolescents have mental health problems, including substance abuse.  There is a strong tendency to avoid treatment because of stigma, but that stigma is diminishing.  Most adolescents do not experience mental illness, but development issues are not uncommon.  Young people may experience mental distress around relationships, family, or academic performance.  These problems are typically short-term.

While there is not always a clear separation of distress from mental illness, she listed some warning signs: persistence of the distress for six months, social withdrawal, loss of interest in things and of pleasure, trouble concentrating, eating more or less, sleeping too much or not enough, poor self-image, and deterioration of academic performance.  Agreeing with Dr. Logan, she expanded on the meaning of anxiety, indicating that it involves intense fear and dread. 

She put some numbers to certain conditions.  ADHD affects one in 20 children worldwide, psychosis one in 100.  One per cent of females from 15 to 24 have anorexia and/or bulimia.  While motor vehicle accidents are the leading cause of death between 15 and 19 years of age, suicide is number two. 

Turning to substance abuse, Tatte told the audience what they already knew—experimentation by young people is common.  She noted that smoking can lead to other drug use, and use of illegal substances is more frequent these days.  First use of marihuana takes place on average at age 14 and the first alcoholic drink at 12.

She identified changes in society and in the experience of the hospital that are occurring.  She sees increased use of social media as having a substantial impact on young people, substituting for actual human contacts.  Because youth are better informed and stigma decreased, there are more emergency room visits by young people, and more return visits.  The same is true of hospitalizations.  There is also an increase of substance abuse problems, including overdoses and drug-induced psychosis.

She also spoke of a couple other hospital trends.  There is a decrease in non-mental health hospital visits by children and youth, along with an increase in mental health visits.  There is also an increase in visits due to self-harm without any clear major psychiatric diagnosis, especially by girls.  Tatte says that self-harm is contagious and is a way of coping with distress.

Tatte tried to place today’s young people in the current social milieu.  They grow up in small families with a high rate of separation and divorce and parents who are busy and stressed.  The youngsters are involved in the world of social media and multi-tasking.  They tend to have a shortened attention span.  Especially because of the social media, they are apt to have but superficial communication with other people and few close relationships.  They turn more to peers than to parents.  (But is this new?)  The social media phenomenon brings with it the dangers of cyber bullying and sexting.  These messages never stop.  Even without mental illness, they can cause significant distress.

Yet, there are positives in the social media.  Young people are more willing to share feelings.  They become better informed and better connected.  But that is not enough.  Young people need a strong attachment to a nurturing adult.

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