3 Sector Report “Children, Adolescents and Young People up to 24 years in educational and other relevant settings
3.1 Introduction
The importance of working with children, adolescents and young people
In recent years, mental health issues of children, adolescents and young people – particularly the prevention of mental health problems and the promotion of positive mental health – have been receiving considerable attention throughout European Union Member States. The European Commission published a report On the State of Young People’s Health in the European Union in March 2000. Aimed at policy mak-ers, analysts and researchers in the EU Member States, it outlines the particular health risks among young people in the EU and their health and well being and in-cludes a section on mental health.
Between 1997 and 2001, Mental Health Europe, a non governmental organisation based in Brussels and committed to the promotion of positive mental health and the prevention of mental distress, carried out two Action Projects financed by the Euro-pean Commission in the framework of the EU Community Action Plan for Health Promotion, Information, Education and Training. Between 1997-1999 and between 2000-2001, two reports on “Mental Health Promotion for Children up to 6 Years” and
“Mental Health Promotion of Adolescents and Young People” were completed.
Re-ports of the content and outcome of these projects are published in Directory format and are available upon request2.
The present project “Mental Health Promotion and Prevention Strategies for Coping with Anxiety, Depression and Stress-related Disorders in Europe” (November 2001-July 2003) focuses on promoting positive mental health and more particularly on the prevention of anxiety and depression.
When discussing the mental health status about children, adolescents and young people, it is important to take into consideration the fact that they do not by any means form a homogeneous group. They can be divided into the following sub-groups: young children (1-6 years), children (7-12 years), pre-adolescents and ado-lescents (13-18 years), and young adults (18-24 years). All these different age groups deserve particular and distinctive attention, one of the main reasons being that childhood and adolescence are crucial stages in life. The incidence of many dis-orders, such as for instance depression, is known to increase from childhood to ado-lescence, and to continue to rise into adulthood3. Mental health promotion of these age groups is therefore essential since the influences in the early stages of the life cycle will have an impact on the rates of disorder in later stages of the child and young person’s life. Depression is one of the most prevalent psychiatric disorders, which affects 340 million people world-wide and occurs across the life span.
Depressive symptoms, particularly in adolescents and young people are seen by adults as being part of the mood swings that can occur with changes in the develop-mental stages of the life cycle. However, if these signs do not go away, and the problems are left untreated, they can have long-lasting effects in all aspects of the young people in their adult years. Since the pace of a young person’s life is fast, it is important to prevent problems and intervene before it is too late and before problems become overwhelming and unmanageable.
Depression commencing in adolescence, is a highly recurrent condition causing se-vere psychosocial impairment, and is a major public health problem. Depression in
2 Directories are available at Mental Health Europe, 7, boulevard Clovis, B-1000 Brussels.
3 Hackauf, Horst and Winzen, Gerda: On the State of Young People’s Health in the European Union.
(1999) Munich: German Youth Institute, p.27.
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childhood and adolescence is associated with subsequent adjustment problems, underachievement in education and suicidal behaviour4. In addition, depression in children and adolescents has also been associated with conduct or oppositional dis-order, aggression, antisocial behaviour, anxiety, and substance abuse {Rohde, Lewinsohn, et al. 1991 269 /id}.
According to the epidemiological data available, the lifetime prevalence of major de-pression is about 4% in the age group 12-17 and 9% at age 185. Although some studies have found depression to be twice as high in females as in males, it has been shown from a developmental perspective that among children, male depressives are twice as prevalent as females, the reverse of the sex ratio in adolescence. The latest findings suggest an increase in the prevalence of adolescent depression6. Moreover, population surveys show that one third of people that have met criteria for major de-pression in their lifetimes report that the first attack occurred before the age of 21 (Andrews, G. 2001) Child adversities have also been linked with the presence of de-pression later in life. For example, a recent case-control study in Boston indicated that women who had suffered from any abuse in their childhood or adolescence were 3.4 times more likely to suffer from major depression in adulthood7. Other childhood hardships have also been linked to a later risk for depression during adulthood, such as separation from a parent or family turmoil {Kessler, Davis, et al. 1997 393 /id}8. Children of depressed mothers are at considerably increased risk for depression (Downey et al., 1990)9 and children and adolescents who suffer from depression are at greater risk for recurrence of depression than are adults.
4 Hackauf, Horst and Winzen, Gerda: On the State of Young People’s Health in the European Union.
(1999) Munich: German Youth Institute, p.27.
5 Hackauf, Horst and Winzen, Gerda: On the State of Young People’s Health in the European Union (1999) Munich: German Youth Institute, p. 27.
6 Hackauf, Horst and Winzen, Gerda: On the State of Young People’s Health in the European Union.
(1999) Munich: German Youth Institute, p. 27.
7 Wise, Zierler, et al. 2001 246/id
8 Kessler, 1997
9 Downey & Coyne, 1990