This document discusses mental health and substance abuse among adolescents. It defines health, mental health, and substance abuse. Common mental health problems among adolescents include depression, schizophrenia, suicide, and substance abuse. Stress, anxiety, depression, peer pressure, and lack of family support can contribute to mental health issues. The role of health workers is to identify problems early, provide counseling, and refer cases that require more specialized treatment. Prevention of substance abuse involves education on risks and building life skills while treatment involves addressing the underlying causes through counseling and engaging social support systems.

1. Mental health in adolescents and
substance abuse
BNS 3 SEM 2
2016

2. Learning objectives
By the end of the session, students will be able to:
1. Define health and mental health
2. Discuss common mental health problems among
adolescents
3. Identify factors which may lead to mental health problems
among adolescents
4. Discuss ways in which adolescents can prevent themselves
from development of mental health problems.
5. Discuss the role of a health worker in dealing with
adolescents with mental health problems

3. Definitions
What is health?
Health is a state of complete physical, mental and
social well-being of an individual and not merely
the absence of disease or infirmity.
Mental health involves the well-being of a person’s
emotions, thoughts, the way they perceive
situations and the way they respond or behave in
various situations i.e. social behaviour.

4. Common mental health problems in
adolescents
 Depression
 Schizophrenia
 Suicide
 Deliberate self-harm
 Alcohol and drug abuse (substance abuse)
 Sexual problems

5. Problems cont’d
 Conduct disorders
 Eating disorders
 Psychiatric disorders presenting with physical
complaints
 Hysterical conversation disorders
 Somatoform pain disorders
 Malingering

6. What contributes to mental health
problems in adolescents
Stress
• Conflicts
• Lack of emotional support
• Role models – bad role models
• Parenting issues
• Substance abuse
2. Anxiety

7. Problems cont’d
3. Depression
4. Suicidal behavior
5. Delinquent behavior e.g. running away from
home, stealing, prostitution, fighting,
bullying
6. psychosomatic symptoms
7. hysterical – conversion symptoms
8. Substance abuse (alcohol and drugs).

8. What should the H/W do?
• Use good communication skills.
• Should provide counseling to parents.
• Counsel the adolescent helping him/her explore the problems
• If depressed severely, should refer.
• Every health worker should be able to recognize adolescents
with mental health problems, give them basic counseling and
should refer those in need of help to a trained counselor.

9. How can adolescents prevent
themselves from these problems
• Sharing problems with parents and friends
• Exercising and sports
• Self appraisal - Continuous self-assessment emphasizing on
the strengths than weaknesses
• Serving others e.g. youth clubs, boys scout, girl guide.
• Seeking counselling, guidance and information from
- Health worker, Religious leaders, NGOs, etc.

10. Role of a H/W
• Understanding & accepting
• Identifying the problem early & facilitating to
seek treatment
• Supporting & caring to ensure compliance
• Assisting them to have sustainable livelihoods
• Assisting them to continue with school while
on treatment

11. SUBSTANCE ABUSE
What is substance abuse?

12. Definition of terms
• Substance
This is a product taken in the body & affects the
way we feel, think, taste, hear, walk, or
behave.
It can be medical such as morphine, industrial
such as glue.
It may be legal alcohol & cigarettes or illegal e.g
heroin & cannabis

13. Terms cont’d
• Drug
This is any natural or synthetic substance which
when taken by the living organism modifies its
function.
• Abuse
Pathological pattern of use that causes impairment
in social, physical or occupational function.
• Misuse
Non medical or inappropriate use of a drug

14. Terms cont’d
• Tolerance
State in which markedly increased amounts of
the substance are required to achieve the
desired effect.
• Dependence
Compulsion to take a drug on a regular basis in
order to experience its mental effect or to
avoid the discomfort resulting from the its
absence.

15. Terms cont’d
• Intoxication
Temporary state caused by the use of the
psychoactive substance. It is characterized by
clinically significant behavior & psychological
changes that result from the effect of
substances or the central nervous system.
• Overdose
Poisoning with the substance when a person
ingests more than he can tolerate.

16. What are some of the drugs the
adolescents use?
• Kuber
• Alcohol
• Shisha
• Cocaine
• Marijuana/khat, mairungi, banji
• Fuel
• Tobacco, datura stramonium,
• Opium, Viagra, cow dung

17. Why do adolescents use drugs?
• Peer influence
• Overcome stress
• Gain confidence
• Keep awake/alert
• Pass time/ kill boredom
• Become strong
• Keep their bodies warm
• Feel happy / high
• Increase libiddo
• For adventure
• Kill hunger
• Gain sleep
• Forget problems
• Reduce body fat

18. Effects of substance abuse
Emotional disorders may occur eg;
Anxiety
Depression
Dizzeness
Feeling dissatisfaction& restlessness
Drowsiness
Irritability / suicidal thoughts
Apathy – lack of interest

19. Psychosomatic disorders
Abdominal pain
Muscle cramps
Headaches
Insomnia
Fatigue
Poor digestion
Loss of weight
Loss of appetite etc

20. Psychiatric disorders
Delusion (persistent false beliefs)
Paranoia (superstitions)
Hallucination(hearing voices that aren’t there)
Psychosis (loss of contact with reality)
Delirium (confusion)
Disorientation

21. Conduct disorders
Aggression
Intoxication
Early sexual involvement
Rape/ defilement
Criminal tendencies like theft
Absenteeism etc

22. Trends in substance use
• Experimental use
• Functional use
• Dysfunctional use
• Harmful use
• Dependent use

23. How can we prevent substance
abuse in adolescents?

24. Prevention & treatment
• Provide information
• Build skills like peer resistance
• Teach abstinence, restraint & responsibility
• Teach about dangers of drug abuse
• Provide counseling
• Deal with client problems
• Provide recreation activities
• Work with families
• Reduce supply

25. Stages of change
In helping an adolescent to change his behavior
toward substance use one may go through
several stages.
These are vital & should be appreciated by every
health care worker in the process of helping
an adolescent achieve his / her desired
change.
Theses stages are as follows;

26. Stages Cont’d
Pre-contemplation stage
Here one has not yet considered giving up
substance use, hence try the following;
-build a relationship
- sensitize the youth further about the
consequences
-work with family & community
note: Do not push the person.

27. Stages of change cont’d
Contemplation stage
Here the user thinks about doing some thing to
change but has not reduced its level.
- Discuss the advantages & disadvantages of
using and of quitting.
- Make observations & provide information
- Note: avoid arguing & being judgmental

28. Stages of change cont’d
Action stage
At this point the substance user attempts to quit
or reduce substance use.
-be active & help the person learn skills &
develop strategies that are substance free.
What are some of these strategies?

29. Stages of change cont’d
Relapse stage
In trying to quit many users go through series of
temptations to resume substance use
- Prepare the use for this stage in advance
- Identify high risk situations for relapse
- Copying with emotions & stress
- Attachment & relationships
- Make plans to deal with the problem
- Continue offering information about dangers of
substance use

30. Stages of change cont’d
Maintenance stage
Here the person wants to practice the desired new
behavior.
Person wants to maintain new pattern e.g
controlled drinking
- Help person develop a health life style e.g moving
into new neighborhood
- Maintain selected level of use
- Monitor the person