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Mental Illness in Children and Adolescents: Early

Detection is the key

Introduction – self and topic

Alarming Statistics

Define Mental Illness/Good mental health

Why is this important

Children at risk and triggers

Types of Mental illness and Indicators

What can be done

An action Plan

Self Introduction

Introduction to Topic

Some General Statistics

• About 45% of adult Australians will experience a mental illness at some stage in their lives

• One in five Australians will experience a mental disorder in any 12-month period.

• Each year a further 20 000 Australians are found to have a mental illness. 

• In 2004-2005, mental illness was the leading cause of 'healthy life' lost due to disability.

• Many of those who experience mental health problems will experience more than one mental illness at the one time, such as depression and anxiety, which commonly occur together.

• Three million Australians will experience a major depressive illness during their lifetime.

• In 2004-2005, mental and behavioural problems were one of the most common reported long-term health conditions of socially and economically disadvantaged people.

• 21% of males and 22.1% of females with weekly household incomes of less than $580 experienced mental health problems, compared to 8.9% of males and 9.1% of females living in households with a weekly income of more than $1030.

• 5% of Australians experience anxiety so crippling that it affects every aspect of their lives.

• Almost one in 100 Australians will experience schizophrenia during their lifetime. 

• 3 in 100 Australians will experience a psychotic illness such as schizophrenia or bipolar disorder.

• Mental illness has the third highest burden of disease in Australia, followed closely by cancer and cardiovascular disease, second only to cardiovascular disease.

• Those with a mental disorder average three days out of role (i.e. not undertaking normal activity because of health problems) over a four week period. This compares with one day out of role for people with no physical or mental condition. 

Mental health problems were the fourth most common reason for seeing a GP in 2004-2005. Almost 1 in 9 GP encounters involve a mental health-related problem - mostly depression, anxiety and sleep disorders. 

From 2005-2006, 4.4% of all hospitalisations were for mental health-related principal diagnosis or specialised psychiatric diagnoses.

In 2004-2005, 11% of all persons self-reported a current long-term mental or behavioural problem. Half had mood disorders and nearly 50% had anxiety related problems.

YOUTH

AND MENTAL ILLNESS

STATISTICS

• The greatest number of people with a mental illness are within the 18-24 year age group.

• Many people with schizophrenia first experience symptoms in their mid to late teen years. 

• One third of people with a mental illness who are admitted to public hospitals are less than 30 years old.

• Depression is one of the most common health conditions in young people and increases during adolescence. 

Drug use can complicate diagnosis and exacerbate or trigger illness in vulnerable young people.

• In 2007, 26% of 16-24 year olds had experienced a mental disorder in the previous 12 months.

• Data published in 2008 revealed that during a 12-month period, 7% of Australian children and adolescents aged 0-17 were experiencing mental health problems.

In 2004-2005, one in 10 young Australians had a long-term mental health or behavioural problem. 

• In 2003, mental disorders were the leading contributor to the total burden of disease among young Australians, accounting for 49% of that total.

• There is a higher prevalence of child and adolescent mental health problems among those living in low-income, step/blended and sole-parent families. 

• 25% of males and 19.7% of females living in step/blended families, and 22.2% of males and 26.7% of females living in sole-parent families experienced mental health problems, compared to 11.3% of males and 10.7% of females living with their original parents. 

• Only one out of every four young persons with mental health problems had received professional health care. 

Even among young people with the most severe mental health problems, only 50% receive professional help. Parents reported that help was too expensive or they didn't know where to get it, and that they thought they could manage on their own. 

• Adolescents with mental health problems report a high rate of suicidal thoughts and other health-risk behaviour, including smoking, drinking and drug use. 

• 12% of 13-17 year olds reported having thought about suicide, while 4.2% had actually made a suicide attempt. Females had higher rates of suicide ideation than males.

Of critical importance-

• 90% of those who die by suicide suffer from diagnosable & treatable mental illness

What is a Mental Illness?

– behavioural/psychological pattern

– pain or impairment

– not otherwise explainable by physical condition

– not due to present unpleasant circumstance i.e. death

What about good mental health?

• Possession of skills necessary to cope with life and its challenges

• Ability to think clearly• Develop socially• Build fulfilling relationships• Learn new skills• Adapt to change• Cope with adversity

Causes

Nature v Nurture

Heredity (genetics): Mental illness tends to run in families, which means the likelihood to develop a mental disorder may be passed on from parents to their children.

Biology: Some mental disorders have been linked to special chemicals in the brain called neurotransmitters. Neurotransmitters help nerve cells in the brain communicate with each other. If these chemicals are out of balance or not working properly, messages may not make it through the brain correctly, leading to symptoms. In addition, defects in or injury to certain areas of the brain have also have been linked to some mental illnesses.

• Psychological trauma: Some mental illnesses may be triggered by psychological trauma, such as severe emotional, physical or sexual abuse; an important early loss, such as the loss of a parent; and neglect

Environmental stress: Stressful or traumatic events can trigger a mental illness in a person with a vulnerability to a mental disorder

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Emerging research indicates that intervening early can interrupt the negative course of some mental illness and may, in some cases, lessen long-term disability.

It is generally considered to be the case that mental illnesses can be attribute to both genetic and environmental factors. Certain risk factors lead to a higher change of the development of a mental illness and one of those issues can be family disturbance or trauma. It is for this reason that children in Foster Care are a high risk group of developing mental illnesses

Foster Children are a Risk Group

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Why Early Intervention?

• Vital for successful behavioral & educational outcomes.• If treatment & support occurs from the 1st early warning

signs, there is a better chance for success as adults. • Most mental health conditions worsen if not treated as the

brain’s development continues to be assaulted by negative influences.

• Behavioral interventions, therapy, medications and other interventions are proven to be effective treatment for many serious emotional & mental disorders

The Consequences…

A Study

• A study co-written by Jung Min Park and Joseph P. Ryan of University of Illinois followed 5,978 children in foster care for several years to determine how their placements were affected by their histories of mental illness.

• Children who receive inpatient psychiatric care have a substantially greater risk for parent-child separation.

• Children with inpatient psychiatric episodes were at rgeater risk for frequent placement disruptions and were less likely to reunite with their families of origin or be adopted.

• Inpatient mental health mental health episodes among children increased the likelihood of placement instability for them by 75%

The conclusion…

• “Early identification of service needs and related interventions for children with mental health needs was more cost-efficient (in terms of dollars and health) as it helped them achieve placement stability and permanence.”

Triggers

External environmental and psychological factors are also believed to be involved in the development of bipolar disorder. These external factors are called triggers. Triggers can set off new episodes of mania or depression or make existing symptoms worse.

• Abuse

• Stress

• Substance abuse

• Medication

• Seasonal changes

• Sleep deprivation

• Reminders

• Bad news

• Isolation

• Financial issues

• Aggression

Types of Mental Illnesses

Common mental health problems include problems such as anxiety, depression, phobias, obsessive compulsive and panic disorders

Severe and enduring mental health problems include those mental health problems such as psychotic disorders (including schizophrenia) and bipolar affective disorder (manic depression).

Personality disorder is defined as 'an enduring pattern of inner experience and behaviours that deviates markedly from the expectation of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time and leads to distress or impairment.

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Depression

• Definition: an illness when the feelings of sadness with great intensity persist and interfere with a person’s thoughts, feeling, and behavior.

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Anxiety Disorders

• Anxieties severe enough to interfere with the daily activities of childhood or adolescents.

• Terms you may hear:– Generalized Anxiety Disorder

– Phobias

– Social Phobia

– Panic Disorder

– Obsessive-Compulsive Disorder

– Post-Traumatic Stress Disorder

Indicators

• Restlessness or feeling keyed up or on edge

• Being easily fatigued • Difficulty concentrating or mind going

blank • Irritability • Muscle tension • Sleep disturbance

Schizophrenia• delusions • hallucinations • disorganized speech (e.g., frequent derailment or

incoherence) • grossly disorganized or catatonic behavior • negative symptoms, i.e., affective flattening, alogia

[1], or avolition[2]

[1] poverty of speech, is a general lack of additional, unprompted content seen in normal speech

[2] Avolition is a psychological state characterized by general lack of desire, drive, or motivation to pursue meaningful goals

Bipolar Disorder

A condition in which the patient has significant mood changes that last from weeks to months at a time. Patients will experience at least one manic episode where the mood is an elevated one; followed by a period of normalcy or balance for at least two months before an onset of a major depressive episode.

General Warning Signs• The following may indicate the need for further

professional assistance or evaluation:

• Decline in school performance

• Poor grades despite strong efforts

• Regular worry or anxiety

• Repeated refusal to go to school or take part in normal activities

• Hyperactivity or fidgeting

• Persistent nightmares

• Persistent disobedience or aggression

• Frequent temper tantrums

• Depression, sadness, or irritability 68

• Withdrawal from friends & activities

• hopelessness

• Lack of enthusiasm, energy, or motivation

• Anger and rage

• Overreaction to criticism

• Poor self-esteem or guilt

• Indecision, lack of concentration or forgetfulness

• Restlessness and agitation

• Changes in eating or sleeping patterns

• Substance abuse

• Problems with authority

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What Can We Do?

• Be aware- look and listen for changes in behavior

• Offer help & listen: encourage teens to talk about their feelings..

• Trust your instincts- if it seems serious, seek prompt advice/help.

• Seek Professional advice – go to your GP discuss and obtain a referral

Treatment Options

• Counseling

• Psychologists

• Psychiatrists

• Psychopharmacology

• Support network

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Paper & References

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