Patrick D McGorry
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.
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.
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
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
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