level 3, psychiatry nursing departement

1. Adolescent Mental Health
Rebecca L White, FPMHNP-BC, FNP-BC, NE
University of Rwanda
University of Illinois at Chicago
School of Nursing and Midwifery Midwifery

2. Objectives
• Recognize the mental health (MH) issues that are common for
the adolescent age group
• Identify risk factors for MH in the adolescent population
• Examine interventions and educational opportunities for MH
and resilience within the adolescent population

3. Epidemiology
• Mean prevalence data for mental disorders in ages 5–17 years was 6.7%
• Conduct Disorder 5.0%
• Attention-deficit/hyperactivity disorder: 5.5%
• Autism spectrum disorders : 16.1%
• Eating disorders : 4.4%,
• Depression: 6.2%
• Anxiety: 3.2%
• Erskine, Baxter, Patton, Moffitt, Patel, Whiteford & Scott, 2017
•

4. Epidemiology
• In a systematic review of 187 countries
• 124 had no data for any disorder.
– Many LMICs-poorly represented available prevalence data
– No region in sub-Saharan Africa had more than 2% coverage for any
disorder.
– Coverage increased between Global Burden of Disease Study 2010
and GBD 2013,
• differed greatly between disorders and few new countries provided data
• Erskine, Baxter, Patton, Moffitt, Patel, Whiteford & Scott, 2017

5. World Wide Statistics
• Globally-leading causes of death-adolescents are road injury,
HIV, suicide, lower respiratory infections and interpersonal
violence
• HIV-related deaths have more than tripled since 2000, making
it the number 2 cause of death among adolescents worldwide

6. Adolescent Statistics
• Depression, road injuries, iron deficiency anemia, HIV & suicide
– major causes of disability-adjusted life years lost in 10–19 y/o
• African Region-highest rates of disability-adjusted life years
among adolescents
• 35% of the global burden of disease has roots in adolescence
» WHO, 2019

7. Years Lost to Disability (YLD)
• The top five ranked causes of YLDs in 10-14 year old's
are:
–unipolar depressive disorders
–iron deficiency anemia
–asthma
–back and neck pain
–anxiety disorders

8. Risk for Sub- Saharan Africa
• Sub-Saharan Africa, infectious diseases with neuropsychiatric
sequelae such as malaria and HIV/AIDS are more prevalent
than elsewhere in the world
– Global Burden of Disease Study, 2015

9. Global Risk is High
• More than 1.2 million adolescents die every year
– nearly all preventable
– > 3000 adolescents die every day
– largely preventable causes
– 2/3 (2015) of these deaths were in LMIC
• Africa & South-East Asia
• Causes mental health disorders, substance use, or poor
nutrition
– No access to critical prevention & health care services

10. Male Adolescence
• Road injuries
– leading cause of adolescent death-10–19-year-olds
– 115 000 adolescent deaths annually
– Older adolescent- 15–19 years greatest burden
– Most are vulnerable road users
• pedestrians, cyclists and motorcyclists
• LMIC countries in Africa
– communicable diseases - HIV/AIDS, lower respiratory infections,
meningitis, and diarrhea diseases
– bigger causes of death among adolescents than road injuries

11. Female Adolescence
• Leading cause of death girls aged 10–14 years
– Lower respiratory infections (pneumonia)
• often a result of indoor air pollution-cooking with dirty fuels
– Pregnancy complications-top cause of death among 15–19-year-
old girls
– Hemorrhage
– Sepsis
– obstructed labor
– Complications-unsafe abortions

12. Self-Harm & Suicide
• Suicide & Accidental death from self-harm
– third cause of adolescent mortality (2015)resulting in an estimated
67, 000 deaths
• Self-harm largely occurs among older adolescent
– Globally- 2nd leading cause of death- older adolescent girls.
– 1st or 2nd adolescent death in Europe and South-East Asia for females
African statistics are limited
•

13. Adolescent health
• Vulnerable population in humanitarian and fragile settings
– Adolescent health needs intensify in humanitarian and fragile settings.
• Take on adult responsibilities-Caring for siblings or working
– May be compelled
• Drop out of school
• Marry early
• Engage in transactional sex to meet their basic survival needs
• Suffer malnutrition, unintentional injuries, pregnancies, diarrhea diseases, sexual
violence, sexually-transmitted diseases, & mental health issues.

14. Mental Health Care Challenges
• Challenges
– Stigma, isolation & discrimination
– Lack of access to health care and education facilities
– Violation of their fundamental human rights

15. Interventions
• Enhance social skills, problem-solving skills & increase self
confidence
– Health workers need to have the competencies to relate to young
people
• To detect mental health problems early
• To provide treatments which include counseling, cognitive-behavioral
therapy
• If needed psychotropic medications

16. Common Mental Health Issues
• Conduct disorders
• Anxiety
• Depression
• Eating disorders
• Risk taking behaviors
–Sexual behavior
–Substance abuse
–Violent behaviors

17. References
• Erskine, H. E., Baxter, A. J., Patton, G., Moffitt, T. E., Patel, V.,
Whiteford, H. A., & Scott, J. G. (2017). The global coverage of
prevalence data for mental disorders in children and
adolescents. Epidemiology and psychiatric sciences, 26(4), 395-402.
• Global Burden of Disease Study (2015) Global, regional, and
national age-sex specific all-cause and cause-specific mortality for
240 causes of death, 1990–2013: a systematic analysis for the
Global Burden of Disease Study 2013. Lancet, 385, 117–171.

18. References
Goodman A., Heiervang E., Fleitlich-Bilyk B., et al. (2012) Cross-national
differences in questionnaires do not necessarily reflect comparable differences
in disorder prevalence. Social Psychiatry and Psychiatric Epidemiology, 47,
1321–1331.
Owen, J. P., Baig, B., Abbo, C., & Baheretibeb, Y. (2016). Child and adolescent
mental health in sub-saharan africa: A perspective from clinicians and
researchers. BJPsych International, 13(2), 45-47.
doi:10.1192/S2056474000001136
WHO, 2012. Maternal, newborn, child and adolescent health. Retrieved
from https://www.who.int/maternal_child_adolescent/epidemiol
ogy/adolescence/en/