Mental Health for Adolescents: A Call to Action Vikram Patel, Harvard Medical School, Public Health Foundation of India, Sangath, India

Rethinking mental health in adolescents Two epidemiological observations Two neuroscientific observations

“passionate, irascible and apt to be carried away by their impulses” Aristotle

What does this mean? Teenagers are biologically and evolutionary ‘primed’ to behave the way they do

So what? While the developmental characteristics of adolescents offer major advantages on the one hand, they also present unique vulnerabilities on the other. The social worlds that teenagers live are key to understanding “risk” behaviors and poor mental health.

Key examples of social determinants Child neglect Parental deprivation, mental illness and family disruption Earlier age of puberty (yes, hormones do matter!) Violent experiences Use of unhealthy products such as alcohol and ‘energy drinks’ Rigid social norms about gender and life choices inconsistent with expectations

The consequences Mental and substance use disorders, and injuries (self-inflicted, intentional and accidental) are leading causes of death and disability in all countries and both genders across the youth age spectrum in all countries (irrespective of their human development index)

Impact beyond health Poor educational attainment Impaired economic inclusion Antisocial and criminal behaviours Alienation and radicalization

What can we do about this? Society Promote progressive attitudes towards youth sexuality, gender empowerment, and diversity of employment Interventions to limit the adverse impacts of marketing of harmful products Community Life skills and social capital in schools Access to mental health care Reduced access to lethal methods Reduced youth violence and gender discrimination Home Parenting practices

Joining up for adolescent well-being From population to individual Inter-disciplinary, integrating neuroscience with social, clinical and public health sciences Coordinated inter-sectoral/multiple platforms for delivery Youth engagement at all levels

https://www.youtube.com/watch?v=1Bq4Zo-iHXM 

Key messages The adolescent brain is a work in progress Cumulative factors operating from conception onwards influence the health outcomes and behaviours in adolescence A package of interventions, delivered across the life course from conception to marriage, can potentially transform the capabilities of young people to enjoy good mental and physical health

Vikram Patel @SangathGoa #GlobalYouth2017