Alcohol misuse: tackling the UK epidemic - London

Mental health
The mental health of adolescents
The mental health of adolescents is extremely important, not only in itself, but also because of the strong
links that it has with adolescent health risk behaviours, violence and delinquency. In many senses, mental
health is at the centre of adolescent health frameworks. Poor mental health can influence exercise
patterns, obesity and body image, substance abuse and sexual behaviour.
A recent Office for National Statistics (ONS) survey reported that one in 10 children and young people
suffer from a mental disorder. 122
However, many commentators suggest that, at any one time, up to one in
five children and young people experience some form of psychological problem. 123
Young Minds, a child
mental health charity, has calculated that in any secondary school of 1,000 pupils there are likely to be 50
pupils who are seriously depressed, 100 suffering serious distress, between 10 and 20 pupils with obsessive
compulsive disorder and between five and 10 girls with an eating disorder. 124
This chapter reviews the mental health of adolescents in the UK. It begins by outlining common
definitions of mental health and explaining some of the methods used to measure it. It then explores the
prevalence of mental health disorders among different groups of adolescents. Finally, current
interventions in the mental health of adolescents are outlined and assessed.
Defining and measuring mental health
As a recent review of mental health data 125
notes, inconsistency arises because there is no agreed definition
of what constitutes mental health. The clinical model tends to focus on ‘mental disorders’, or illnesses
usually associated with considerable distress and interference with an adolescent’s everyday life. 122
‘Mental disorders’ can include:
• emotional disorders such as phobias, anxiety and depression
• conduct disorders
• hyperkinetic disorders such as attention deficit disorder
• developmental disorders
• habit disorders
• eating disorders
• post-traumatic syndromes
• somatic disorders such as chronic fatigue syndrome
• psychotic disorders such as schizophrenia and drug-induced psychosis. 126
An alternative definition of mental health includes general happiness and overall satisfaction with life,
rather than just the absence of clinical disorders. Some commentators refer to this as ‘emotional
wellbeing’. 125
Measuring the mental health of adolescents is difficult. Medical records focus on narrow clinical
definitions and record only those people who use services. For this reason, most data sources rely on
questionnaires administered to the general population to gain information on adolescents’ mental health.
For example, the ONS uses a combination of clinical measures and the General Health Questionnaire
(GHQ12) for 13 to 24 year olds, or the Strengths and Difficulties Questionnaire (SDQ) for four to 15 year
olds. The self-administered GHQ12 asks about general levels of happiness, depressive feelings, anxiety and
sleep disturbance while the SDQ is filled out by parents and focuses on emotional and behavioural
problems.
British Medical Association Adolescent health 27