Answer

Mental Health Crises Faced by Young People Compared to Previous Generations

Introduction/Background

The purpose of this paper is to conduct a review of current literature using a systematic approach to seek an explanation as to why young people face major mental health crisis compared to other generations. The Organization for Economic Co-operation and Development [OECD] (2018) state that half of cases of mental illnesses begin by the age of 14 years and three-quarter of cases begin by the mid-20s. Similarly, Colizzi, Lasalvia and Ruggeri (2020) is in agreement with OECD’s findings that half of mental disorders begin by 14 years. Mental disorders result in negative effects on an individual’s development, health, education and employment (OECD, 2018). Mental health disorders represent the highest of proportion of burden of disease among young people (OECD, 2018). Young people are more vulnerable compared to the other generations to develop mental disorders.

PICO: An explanation of why young people (P) with socioeconomic challenges (I), compared with the previous generations (C) face major mental health crises (O).

Aim: The aim of this review of literature is to establish evidence-based explanation and conceptualization as to why young people face major mental health crises compared to other populations.

Method

            This is a literature review to establish why young people face major mental health crises compared to other generations. Search terms that were used include ‘mental health issues in young AND other generations’; ‘causes of mental health issues in young people AND other generations, and ‘generational differences in mental health issues.’ Databases that were explored include PubMed, EBSCOhost, Google Scholar, and Cochrane Library. Inclusion criteria included relevance to the subject matter; articles published not later than 2016; peer-reviewed evidence-based articles; CASP score 9-10/10; articles published in the English language, and full-length articles. Exclusion criteria involved articles that did not meet any of the above inclusion criteria. Refer to Figure 1 and Table 1 below.

Results

Figure 1: Search Strategy and Results

Table 1: Article Analysis

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Summary of Findings

            Young people are more vulnerable to develop mental disorders as opposed to older people. One of the explanations is that young people face multiple risk factors (Jörns-Presentati et al., 2021). These include affiliation with delinquent peers resulting in involvement in risky sexual behavior (Isakson et al., 2021), COVID-19 (Browning et al., 2021), and high social media activity and cyber bullying (Keles et al., 2019). Other explanations include increased mental and psychological vulnerability during the COVID-19 period (Browning et al., 2021) and placement in foster care setting (Turney & Wildeman, 2016). The prevalence of mental disorders seems to decrease from the twenties to thirties/forties (Gustavson et al., 2018).

Discussion

            Adolescent populations are more vulnerable than other generations to developing mental disorders. Early childhood years is associated with increased sensitivity and vulnerability to development of mental disorders (Colizzi et al., 2020). Adolescent population significantly contribute to the higher burden of substance use and mental disorders worldwide (Jörns-Presentati et al., 2021). Half of all cases of mental health disorder begin by 14 years. Mental disorders among people age between 0 to 25 age span account for 45% of the burden of disease globally (Colizzi et al., 2020). In sub-Saharan African, mental health issues in the adolescent population are contributed by a combination of a high prevalence of HIV and AIDS and impoverished living conditions in addition to risk factors for mental disorders experienced in high-income countries such as adverse childhood experiences and paternal psychopathology (Jörns-Presentati et al., 2021). In the adolescent population, it was established that affiliation with their delinquent peers and externalizing symptoms are strongly associated with involvement of adolescents in risky sexual behavior. Involvement in risky sexual behavior, on the other hand, increases the risk of HIV infection (Isakson et al., 2021).  Children who are foster care setting are in poor physical and mental health relative to children not in foster, children in economically disadvantaged families, and children across specific family types. Children placed in foster care undergo a number of disadvantages including conditions that lead to their foster care placement including maltreatment, parental drug and alcohol abuse, poverty, epigenetics, and neighborhood disadvantages. It is by no surprise that children under foster care experience more anxiety, depression, attention-deficit/hyperactivity disorder and conduct/behavior problems (Turney & Wildeman, 2016).  Other risk factors contributing to mental disorders among adolescents in sub-Saharan Africa include exposure to violence and trauma, orphanhood, poverty, socioeconomic disadvantages, and being out of school (Jörns-Presentati et al., 2021).

Any form of abuse increases vulnerability to mental disorders in young people. Female adolescents also stand risk of sexual abuse, gender-based violence, gender discrimination, and suffering from internalizing mental health disorders. These risk factors may explain high prevalence of anxiety, depression, behavioral and emotional difficulties, suicidal behavior, and posttraumatic stress disorder among adolescents (10 to 19 years) in sub-Saharan Africa (Jörns-Presentati et al., 2021). Vulnerability and sensitivity to development of mental disorder during the childhood years have long-lasting effects on emotional, social, academic, and behavioral achievements in adulthood (Colizzi et al., 2020). Mental disorders such as mood disorders and anxiety present to people 25 years and older and it is the main cause of disability-adjusted life years, contributing to 45% of the global burden of disease, with the associated substance use including illicit drugs and alcohol being the major risk factor for disability-adjusted life-years (Colizzi et al., 2020).

            Social media use contributes to mental health issues among young people; particularly, among adolescents. Time spent in social media, social media activity, addiction, and investment on social media is directly correlated with psychological distress, anxiety, and depression (Keles et al., 2019). Anxiety and depression have adverse consequences on adolescent development including impaired social relationships, school dropout, lower educational attainment, and increased risk of mental health problems, suicide and substance. As opposed to other age groups, adolescents tend to use the social media to compared themselves with the abilities and opinion of others. Adolescents also have limited capacity for self-regulation; thus, they are more vulnerable to develop mental disorders compared to younger adults, children, and older people (Keles et al., 2019). Reliance on digital technology as exacerbated feelings of depression and anxiety among young people. This is a major concern since young people are the leading consumers of digital technology and typically spend more than two hours per day online. Digital platforms increase vulnerability of young people by exposing them to cyber-bullying and body image concerns (OECD, 2018).

            Young people increase the risk suicide. The rate of suicide among people 15 and 19 years and 20 and 24 have increased to highest point in 2017 since 2000. The rate of suicides at ages 15 to 19 years in 2017 was 11.8 per 11.8 per 100,000 (5.4 per 100,000 in females and 17.9 per 100,000 in males.

The rate of suicide at ages 20 to 24 years in 2017 was 17 per 100,000 (6.2 per 100,000 in females and 27.1 per 100,000) (Miron et al., 2019).

COVID-19 has contributed to rising cases of mental disorders among young people. Depression and anxiety experienced by adolescents associated with social media contributes to incidence of suicide observed in this age group (Keles et al., 2019). Loades et al. (2020) state that social isolation and loneliness during the COVID-19 period is associated with increased risk of anxiety and depression among children and adolescents. In which case, duration of loneliness is more strongly correlated with mental health symptoms more than the intensity of loneliness (Loades et al., 2020). COVID-19 has more negative impact in terms of mental health wellbeing among people aged 18 to 24 years. University students aged 18 to 24 years across the globe were experiencing increasing levels of depressive moods, anxiety, psychosomatic problems, lack of self-esteem, substance abuse, and suicidality even before the COVID-19 pandemic. The pandemic only appears to have worsened existing mental health disorders or increased vulnerability to develop mental health issues (Browning et al., 2021). According to Giuntella et al. (2021), physical activity disruption during the pandemic is the leading factor for development of depression during the pandemic. However, restoration of physical activity does not seem to have meaningful improvement of mental well-being. The pandemic has increased incidences of mental health disorders more among young adults compared to older adults (Giuntella et al., 2021). There has been dramatic rise of depression across all age groups during the pandemic period (Giuntella et al., 2021).

Prevalence of mental disorders decrease with age. According to Gustavson et al. (2018), the prevalence of mental health disorders seems to decrease from the age of twenties to the thirties or forties. In a 12-month prevalence study, it was established that the prevalence of mental disorders in people in their twenties was 19.8% for men and 32.4% in women. These mental disorders include anxiety disorders, major depressive disorder, and alcohol use disorder (Gustavson et al. 2018). An explanation for the observed decreased in the prevalence of mental health disorders in the thirties/forties compared to twenties include decrease in cases of alcohol use disorder and specific phobias and major depressive disorder (Gustavson et al. 2018).

Conclusion

            Young people are more vulnerable than older people to be influenced by their peers. Affiliation with delinquent peers for leads to involvement of risky sexual behaviors and HIV infection. Peers can increase the likelihood of development of mental disorders; especially, through activities such as cyberbullying, body shaming, substance abuse, and the struggle to fit in. Other explanations for increased prevalence of mental disorders among young people include predisposition to multiple risk factors, increased mental and psychological vulnerability during the COVID-19 period and placement in foster care setting. It is also important to note that the prevalence of mental disorders seems to decrease from the twenties to thirties/forties.