Early intervention key for teen mental health

Poor sleep to lack of connection or difficulties in family life – different pathways contribute to teens’ poor mental health as they age, marking the importance of early intervention and targeted support.
 
This is according to new findings from the Black Dog Institute’s Future Proofing Study, which aims to prevent depression and anxiety in young people, revealing that while most navigate adolescence well, some are at higher risk for mental health problems.
 
Launched in 2019 as one of Australia’s largest longitudinal studies of adolescent mental health, 6388 students from 134 schools across the country enrolled in Year 8 for a five-year study period to be surveyed each year about their mental health and wellbeing.
 
The study found while 72% of students in Years 8–11 experience no depression, 12% report ‘persistent’ symptoms, 8% report ‘moderate increasing’ symptoms, and 7% decreasing symptoms that improve over time.
 
Similarly for anxiety, 67% report no symptoms, 18% persistent, 8% moderate increasing, and 7% decreasing.
 
The study’s co-lead, UNSW Professor Aliza Werner-Seidler, is concerned that ‘a significant proportion of young people follow trajectories where symptoms remain high or increase’ during the high school years.
 
‘Our research shows that while most young people navigate adolescence without significant mental health difficulties, a substantial number experience symptoms that worsen over time,’ she said.
 
‘This highlights the need for earlier intervention and more targeted support.
 
‘Adolescence is a critical period where mental health trajectories begin to take shape ... many of the influencing factors are identifiable and, in many cases, modifiable.
 
‘If we can identify young people earlier in that trajectory, there is a real opportunity to intervene before symptoms become more severe.’
 
Risk factors identified as contributing to higher pathways to anxiety and depression include being female or gender-diverse, having problems with peers, negative family interactions and exposure to adverse childhood experiences (ACEs).
 
While key protective factors to support young people to thrive include connections at school, healthy sleep habits, positive family relationships, reduced problematic screen use, and trauma-informed care for those exposed to ACEs.
 
The authors say their findings paint ‘one of the clearest pictures yet’ of how the most common mental health issues can progress during adolescence, and policymakers and community healthcare leaders have a strong support role to play before such issues become embedded.

GP and Chair of RACGP Specific Interests Child and Young Person’s Health, Dr Tim Jones, agrees.
 
‘[This study] speaks to the complexity of intersecting factors that affect the mental health and wellbeing of our youth,’ he told newsGP.
 
‘It speaks to the importance of early, proactive and supportive discussions with a trusted GP and robust social prescribing.
 
‘And it highlights the value of working on health fundamentals with our youth patients – including social connectedness, healthy relationships with screens, and better sleep routines.’
 
Building on existing evidence, healthy sleep habits are identified in the Future Proofing Study as playing an essential role in adolescents’ mental health and wellbeing.
 
But 38% of the surveyed students reported ‘persistent or increasing’ insomnia symptoms between Year 8–11, including 27% with symptoms increasing from Year 8, and 11% with ‘clinically significant’ insomnia. Those in the last category were four times more likely to experience high anxiety and six times more likely to experience high depression symptoms.
 
The authors say improving how sleep problems are identified and treated could make a significant difference to mental health outcomes.
 
Also highlighted is the impact of ACEs, with 57% of participants reporting at least one ACE by Year 8, linked with a higher risk of negative mental health outcomes by Year 10.
 
The authors say these findings reiterate the need for better family support and improved mental health screening and intervention for children and adolescents exposed to ACEs.
 
Dr Jones says GPs have a central place in this screening, pointing to an upcoming combined Specific Interests webinar for GPs on ACEs.
 
‘We know these are fundamental to long-term outcomes for adult wellbeing and that identifying them early is key,’ he said.
 
‘They predict everything from chance of completing school to long-term relationship security and movement out of poverty.’
 
With the Black Dog Institute’s research providing guidance for policymakers, educators and health services, the authors say investing in earlier support for young people provides an opportunity to ‘change the course’ of mental health outcomes.

And while Dr Jones agrees, he believes the solution lies at grassroots level.
 
‘The key needs this study highlights in our youth all need time and can’t be solved with a prescription,’ he said.
 
‘Hence that key message of time with a trusted GP being at the heart of good outcomes.’
 
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adolescence adolescent health adverse childhood experience anxiety depression mental health young people’s health