Adolescent health

March 2011

FocusAdolescent health

Is this normal?

Assessing mental health in young people

Volume 40, No.3, March 2011 Pages 94-97

Patrick D McGorry

Sherilyn Goldstone

Background

Mental ill-health is a key health issue facing young Australians today. While the physical health of young people has improved in recent decades, their mental health appears to have worsened. Mental health and substance use disorders now account for over 50% of the burden of disease in the 15–25 years age group, and 75% of mental health disorders that will affect people across the lifespan will have emerged for the first time by the age of 25 years.

Objective/s

This article provides the general practitioner with key factors in assessing the young person with a mental illness: when to worry and what the early stages of mental illness look like; and provides guidance and tips for effective treatment.

Discussion

Mental ill-health in young people is all too often accepted as a ‘normal’ feature of adolescence. However, the short and long term consequences of mental illness include impaired social functioning, poor educational achievement, substance abuse, self harm, suicide and violence. Distinguishing between what represents transitory and normative changes in behaviour and disturbances that may represent the early signs of the onset of a potentially serious mental illness is difficult, particularly in young people, where emotional disturbance and distress is such a common experience. The primary goal of initial assessment is not to make a definitive diagnosis but rather to assess risk and the need for clinical care. The GP has an important role to play in longitudinal assessment and ongoing review, and facilitating access to treatment and mobilising support networks.

The onset of adolescence heralds a period of tumultuous change for young people; changes that will affect every domain of their lives. The physical changes that come with puberty are accompanied by rapid changes in the young person’s cognitive, emotional and social development as they move through adolescence toward independent adulthood. This transition presents unique developmental challenges; young people in this age group are in the process of defining their individuality: establishing their own social networks, beginning intimate relationships, completing their education and moving into employment.1 It is hardly surprising that mental ill-health, even when brief and relatively mild, can disrupt this developmental trajectory and limit a young person’s potential. If more severe and persistent mental illness occurs, the spectre of premature death or long term disability and social exclusion is very real.

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Correspondence afp@racgp.org.au

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