Generational inequality, unregulated social media, wage theft, precarious employment and the climate crisis are driving a “dangerous” and “alarming” global surge in mental illness among young people, a coalition of health experts has warned.
A study by the Lancet Psychiatry Commission into young people's mental health says there is an urgent need to address these driving factors and improve mental health treatment to halt rates of premature death, disability and lost potential that have skyrocketed over the past two decades.
The study, published on Wednesday, was led by psychiatrist Professor Patrick McGauley, executive director of the Origen Centre of Excellence in Youth Mental Health in Australia, who said “this is the most serious public health problem we have.”
“If we were seeing a rapid decline in health outcomes in other areas of health, such as diabetes and cancer, the government would take dramatic action,” he said.
The report finds that mental disorders account for at least 45 per cent of the total disease burden among people aged 10-24, yet only 2 per cent of global health budgets are allocated to mental health care.
Even in the wealthiest countries, less than half of the need is being met, according to the report.
“There is an ambivalence that society often shows towards young people and their needs,” McGauley said.
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“But we are witnessing a huge division in society, which has actually been caused by the neoliberal economic theory that everything is a commodity,” he said.
A global emphasis on individualism and competition has destroyed social bonds, undermined public welfare and services, and strengthened harmful industries and businesses, he said.
“On the surface, it may seem like previous generations had it harder – the Great Depression, world wars, nuclear threats,” McGauley says, “but in reality, the current generation feels less secure and hopeful about the future than they've ever known. The challenges facing today's generation of young people are unprecedented, devastating and worse than anything we've seen before.”
McGauley said the median house price in many countries is several times the average annual salary, and that poorly regulated social media and digital platforms that exacerbate political polarization are making young people feel increasingly isolated.
“There's so much harmful stuff happening on the platforms that the tech giants are responsible for, and they're completely following their own rules,” he said.
“It's not young people that are the problem and we shouldn't restrict them. We should make it a safe place.”
A 23-year-old woman who advises Origen on its youth strategy, who gave her name only as Lee, said she was first exposed to pornography online when she was 12, which had a lasting and devastating impact on her self-esteem and body image.
“There's a lot of adult content online and many times people don't want to be exposed to it at all,” Lee said.
“I thought the internet was an escape for me, or a place to connect with people all over the world who had similar experiences to me. But in reality, I was exposed to really bad stuff that was really unregulated. My parents' generation doesn't really understand that.”
The commission's paper, co-authored by psychiatrists, psychologists, researchers and young people, states that young people are the most frequent users of the internet and are often “constantly” online, which can cause harm and pose risks to their mental health.
“Mental illness, a major health and social issue affecting the lives and futures of young people for decades, has entered a dangerous phase,” the paper warns.
“(It) represents a major threat to the lives and futures of young people, with worrying evidence suggesting its prevalence and impact is steadily increasing in many resource-rich environments.”
An accompanying analysis led by King's College London acknowledges that much of the evidence on which the commission's report is based comes from high-income countries, which is problematic because 90% of children and adolescents live in low- and middle-income countries “where the burden of mental illness is highest”.
Carla Drysdale, a spokeswoman for the World Health Organization (WHO), said the level of unmet need for mental health services in low- and middle-income countries can be close to 100 percent.
“All countries, regardless of resource constraints, can take steps to improve youth mental health prevention and care,” she said. Building a non-specialist workforce that includes school counselors, community activists and peers is key, she said.
“WHO is supporting countries in their efforts to build community-based mental health care for adolescents and is redesigning services and care pathways to make them more accessible to adolescents.”
Suicide is the leading cause of death among 15-44 year olds in Australia, 15-19 year olds in New Zealand and 15-39 year olds in India.
Dr Paul Denborough, a child and adolescent psychiatrist who was not involved in the commission's report, said the Lancet paper was “right on its face in that societies with increasing inequality and exclusion are deeply destructive”.
“Government policies are not actually in favour of young people,” he said.
“Young people are noticing generational inequities in policy. They're saying, 'You old people don't care about us.'”
Denborough is clinical director for Headspace Australia, a free or low-cost service aimed at young people aged 12 to 25.
Ms Denborough said it was important to recognise the different stressors young people face and address the root causes of their distress, rather than automatically labelling them as mentally ill.
“Inequality, a lack of affordable housing, precarious employment and the policies that cause them are often the root causes,” he said.
“Unless society looks at their behavior through the lens of intergenerational equity and addresses the causes, it is simply band-aiding the problem.”
In Australia, the Crisis Support Service Lifeline number is 13 11 14. In the UK and Ireland you can contact Samaritans toll free on 116 123 or email [email protected] or [email protected]. In the US you can call or text the National Suicide Prevention Lifeline on 988, chat at 988lifeline.org or text HOME to 741741 to connect with a crisis counsellor. Other international helplines can be found at befrienders.org.
