Intergenerational inequality, unregulated social media, wage theft, precarious employment and the climate crisis are fuelling a “dangerous” and “alarming” global rise in mental illness among young people, a consortium of health experts has warned.
There is an urgent need to address these factors and improve mental health services to reduce the rates of premature death, disability and loss of potential that have increased dramatically over the past two decades, according to research by The Lancet Psychiatry Commission into the mental health of young people.
The work, published on Wednesday, was led by the executive director of Australia’s Orygen Centre of Excellence in Youth Mental Health, psychiatrist Prof Patrick McGorry, who said: “This is the most serious public health problem we have”.
“If the rapid deterioration in health were to occur in another area of health care, such as diabetes or cancer, governments would take drastic measures,” he said.
The report found that mental health problems account for at least 45% of the total disease burden in people aged 10 to 24. Yet, only 2% of global health budgets are spent on mental health.
Even in the richest countries, less than half of needs are being met, the report said.
“There is an ambivalence that society often shows towards young people and their needs,” McGorry said.
“But we see a great fragmentation of society, which is mainly caused by the economic theory of neoliberalism, in which everything is a commodity,” he said.
This global emphasis on individualism and competition destroys social bonds, undermines public welfare and public services, and empowers harmful industries and corporations, he said.
“On the surface, it might seem that previous generations had it harder, given the Great Depression, world wars and nuclear threats,” McGorry said. “But in reality, there is far less certainty and hope for the future surrounding the current generation than ever before. The challenges facing today’s young people are unprecedented, they are devastating and they are worse than ever before.”
He said that in many countries, the median price of a home is several times the average annual salary. In addition, poorly regulated social media and digital platforms, which fuel political polarization, are making young people feel increasingly isolated, McGorry said.
“There are so many harmful things happening on the platforms that tech giants are responsible for, and they are completely a law unto themselves,” he said.
“It’s not the young people who are the problem, or who we need to restrict. We need to make it (the digital environment) a safe place to be in.”
A 23-year-old woman who advises Orygen on youth strategies, who only wanted to be identified as Li, said she first encountered pornography online when she was just 12 and that it had a lasting and devastating impact on her confidence and body image.
“There is so much adult content online and exposure to it is often completely unsolicited,” Li said.
“I felt like the internet was a place for me to escape or connect with other people from all over the world who were having similar experiences to me. But instead I was exposed to really unregulated, really bad stuff, and my parents’ generation doesn’t really understand it.”
The committee’s report, which was co-authored by psychiatrists, psychologists, researchers and young people, describes how young people are the biggest users of the internet, often ‘constantly’ online, and that this can be harmful and risky to mental health.
The article warns: “Mental health problems, for decades the leading health and social issue affecting the lives and futures of young people, have entered a dangerous phase.”
“(It) poses a major threat to the lives and futures of young people, and alarming evidence suggests its prevalence and impact are steadily increasing in many high-resource settings.”
An accompanying analysis by King’s College London found that much of the evidence underlying the commission’s report comes from high-income countries. This is problematic because 90% of children and adolescents live in low- and middle-income countries, countries that “have the highest burden of mental health problems”.
According to Carla Drysdale, spokeswoman for the World Health Organization (WHO), the unmet need for mental health care in low- and middle-income countries could be close to 100%.
“All countries, regardless of resource constraints, can take steps to improve mental health prevention and care for young people,” she said. Building a non-specialized workforce of school counselors, community workers and peers is critical, she said.
“WHO supports countries’ efforts to build community-based mental health services for young people by redesigning services and care pathways to make them accessible.”
Suicide is the leading cause of death among people aged 15 to 44 in Australia, 15 to 19 in New Zealand and 15 to 39 in India.
A child and adolescent psychiatrist who was not involved in the commission’s report, Dr Paul Denborough, described the article in The Lancet as “absolutely right, in the sense that a society with more inequality and marginalisation is very destructive”.
“The policies of the governments are really not beneficial for young people,” he said.
“Young people are aware of the unfairness of the intergenerational policy. They say: ‘You old people don’t give a damn about us’”.
Denborough is clinical director of headroom in Australia, a free or low-cost service for young people aged 12 to 25.
Denborough said it is important to acknowledge the many stressors young people face and address the underlying causes of that stress, rather than automatically labeling young people with a mental illness.
“The inequality, the lack of affordable housing, the insecure employment and the policies that underlie this are often the root cause,” he said.
“If society doesn’t look at what they’re doing with an intergenerational honesty lens and address the root causes, then you’re just covering up the problem.”