Global Adolescent Mental Health Crisis: Key Facts and WHO’s Response

Key Facts

• Globally, one in seven adolescents aged 10-19 experiences a mental disorder, accounting for 13% of the global disease burden in this age group.
• Depression, anxiety, and behavioral disorders are leading causes of illness and disability among adolescents.
• Suicide ranks as the fourth leading cause of death among 15-29 year-olds.
• Addressing adolescent mental health is crucial for preventing long-term consequences that impair both physical and mental health, as well as opportunities for fulfilling adult lives.

Introduction

One in six people are between the ages of 10 and 19. Adolescence is a unique and formative period marked by physical, emotional, and social changes. These changes, coupled with factors such as poverty, abuse, or violence, can make adolescents susceptible to mental health issues. Protecting adolescents from adversity, promoting socio-emotional learning and psychological well-being, and ensuring access to mental health care are essential for their overall health and well-being during adolescence and into adulthood.

Globally, it is estimated that 1 in 7 (14%) 10–19-year-olds experience mental health conditions, yet these issues largely go unrecognized and untreated.

Adolescents with mental health conditions are particularly vulnerable to social exclusion, discrimination, stigma (which affects their willingness to seek help), educational difficulties, risk-taking behaviors, physical ill-health, and human rights violations.

Mental Health Determinants

Adolescence is a critical period for developing social and emotional habits important for mental well-being. These include adopting healthy sleep patterns, regular exercise, developing coping, problem-solving, and interpersonal skills, and learning to manage emotions. Protective and supportive environments in the family, school, and wider community are vital.

Multiple factors influence mental health. The more risk factors adolescents face, the greater the potential impact on their mental health. Stress during adolescence can stem from exposure to adversity, peer pressure, and identity exploration. Media influence and gender norms can further widen the gap between an adolescent’s reality and their aspirations. Other important determinants include the quality of home life and peer relationships. Violence (especially sexual violence and bullying), harsh parenting, and severe socioeconomic problems are recognized risks to mental health.

Some adolescents are at greater risk of mental health conditions due to their living conditions, stigma, discrimination or exclusion, or lack of access to quality support and services. This includes adolescents in humanitarian and fragile settings, those with chronic illness, autism spectrum disorder, intellectual disabilities, or other neurological conditions, pregnant adolescents, adolescent parents, those in early or forced marriages, orphans, and adolescents from minority ethnic or sexual backgrounds or other discriminated groups.

Emotional Disorders

Emotional disorders are common among adolescents. Anxiety disorders, which may involve panic or excessive worry, are the most prevalent in this age group and are more common among older adolescents. Approximately 3.6% of 10–14 year-olds and 4.6% of 15–19 year-olds experience an anxiety disorder. Depression affects about 1.1% of adolescents aged 10–14 years, and 2.8% of those aged 15–19 years. Both disorders can significantly impact school attendance and performance, with social withdrawal potentially leading to isolation and loneliness. Depression can also lead to suicide.

Behavioral Disorders

Behavioral disorders are more common in younger adolescents than older ones. Attention deficit hyperactivity disorder (ADHD), characterized by difficulty paying attention, excessive activity, and impulsivity, affects 3.1% of 10–14 year-olds and 2.4% of 15–19 year-olds. Conduct disorder, involving destructive or challenging behavior, occurs in 3.6% of 10–14 year-olds and 2.4% of 15–19 year-olds. These disorders can affect education and may lead to criminal behavior.

Eating Disorders

Eating disorders, such as anorexia nervosa and bulimia nervosa, often emerge during adolescence and young adulthood. These disorders involve abnormal eating behaviors and preoccupation with food, often accompanied by concerns about body weight and shape. Anorexia nervosa has a high mortality rate due to medical complications or suicide.

Psychosis

Psychotic conditions typically emerge in late adolescence or early adulthood and can include symptoms like hallucinations or delusions. These symptoms can impair an adolescent’s ability to participate in daily life and education and often lead to stigma or human rights violations.

Suicide and Self-Harm

Suicide is the fourth leading cause of death among older adolescents (15–19 years). Risk factors include harmful alcohol use, childhood abuse, stigma against help-seeking, barriers to accessing care, and access to means of suicide. Digital media can play a significant role in either enhancing or weakening suicide prevention efforts.

Risk-Taking Behaviors

Many risk-taking behaviors, such as substance use or sexual risk-taking, start during adolescence. These behaviors can be coping mechanisms for emotional difficulties and can severely impact an adolescent’s mental and physical well-being.

Globally, 13.6% of adolescents aged 15–19 years engaged in heavy episodic drinking in 2016, with males being most at risk. Tobacco and cannabis use are also concerns, with many adult smokers having their first cigarette before age 18. Cannabis is the most widely used drug among young people, with about 4.7% of 15–16 year-olds using it at least once in 2018.

Perpetrating violence is another risk-taking behavior that can lead to low educational attainment, injury, involvement in crime, or death. Interpersonal violence was among the leading causes of death for older adolescent boys in 2019.

Promotion and Prevention

Mental health promotion and prevention interventions aim to enhance emotional regulation, provide alternatives to risk-taking behaviors, build resilience to manage difficult situations and promote supportive social environments and networks.

These programs require a multi-level approach with varied delivery platforms, such as digital media, health or social care settings, schools, and communities, and diverse strategies to reach adolescents, especially the most vulnerable.

Early Detection and Treatment

Addressing the needs of adolescents with mental health conditions is crucial. Strategies should avoid institutionalization and over-medicalization, prioritize non-pharmacological approaches, and respect the rights of children in line with the United Nations Convention on the Rights of the Child and other human rights instruments.

WHO Response

WHO develops strategies, programs, and tools to help governments respond to the health needs of adolescents. The Helping Adolescents Thrive (HAT) Initiative, a joint WHO-UNICEF effort, aims to strengthen policies and programs for adolescent mental health, promoting mental health, preventing mental health conditions, and addressing self-harm and other risk behaviors.

WHO has also created a module on Child and Adolescent Mental and Behavioral Disorders as part of the mhGAP Intervention Guide 2.0, providing evidence-based clinical protocols for assessing and managing various mental health conditions in non-specialized care settings.

Furthermore, WHO is developing and testing scalable psychological interventions to address emotional disorders in adolescents and providing guidance on mental health services for this age group.

WHO’s Regional Office for the Eastern Mediterranean has developed a mental health training package for educators to improve their understanding of the importance of mental health in schools and guide the implementation of strategies to promote, protect, and restore mental health among students. This includes training manuals and materials to help scale up the number of schools promoting mental health.

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