Opinion: compared to adults, mental health is the single biggest health issue young people face

As a researcher and a practicing clinical psychologist, it’s been wonderful to see the increased focus on mental health in the national media. So many different voices and experiences are shaping the narrative – from celebrities like Mariah Carey talking about living with bipolar disorder to Prince Harry talking about the psychological effects of grief. Nationally, individuals from the world of sports have also made important contributions, including Dublin GAA footballer Nicole Owens and Galway hurler Conor Whelan talking about coping with mental health difficulties, either one’s own or those of a family member.

As these conversations happen, public understanding of mental health and mental disorders is expanding. Previously, conversations about mental health focused particularly on depression and suicide. Now, other mental health difficulties, including bipolar disorder, OCD, social phobia, borderline personality disorder, and schizophrenia are starting to be included for discussion.

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An RTÉ Sport discussion as part of The Big Picture about sport and mental health with the GAA's Community and Health manager Colin Regan, Westmeath footballer Laura Lee Walsh, former Offaly footballer Niall McNamee and chaired by Evanne Ni Chulinn 

What is perhaps still not being discussed enough though is that a majority of these disorders begin in young adulthood. There is good evidence now to show that 75 percent of serious mental health difficulties start between the ages of 15 and 25. Furthermore, by comparison with older adults, for whom mental health is only one among several causes of disability (along with cardiovascular disease, neurological disorders, and cancer), mental health represents THE single biggest health issue young people face.

Despite this, young people and their families face enormous problems with accessing appropriate services, not just in Ireland but in other developed countries also. Some of these problems are to do with the developmental stage of the young person. On the one hand, the young man or woman is meant to be on a trajectory towards moving out of home, relying less on parents and more on their peer group. On the other hand, he or she is ill-equipped in terms of life experience to seek help or advocate for themselves. Difficulties with correctly recognising symptoms, and continuing high levels of stigma, compound this problem.

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From RTÉ 2fm's Nicky Byrne Show with Jenny Greene as part of The Big Picture, comedian Joanne McNally talks about her experience with mental health issues 

However, other problems with accessing services are structural. Mental health services, like most health services, are designated as either child and adolescent services (up to aged 18 years) or adult (from 18 years onwards), creating an enormous sense of discontinuity. It positions young people aged 15 to 25 at the "edges" of both services, rather than as their target group. Many families are appalled by their experience of this gap – there is nothing worse than having a son or daughter in crisis, seeking help, and finding yourself in a waiting room full or 40 and 50 year olds.

Other criticisms include an insufficient range of services, the only qualified professional you can be guaranteed to see is a medical professional and, even at that, services are often delivered by junior doctors who change positions every six months. Not a major problem if you’re having your appendix out over a couple of days, but a serious barrier if the mental health care you need is likely to take several months.

It positions young people aged 15 to 25 at the "edges" of both services, rather than as their target group

Last December, the National Youth Mental Health Task Force commissioned by the Irish government outlined 10 key recommendations designed to tackle the gaps in service provision. These included tackling these issues of accessibility and alignment of youth mental services. It also recommended strengthening the provision of youth mental health services in schools and third level institutions where young people are, rather than just in traditional mental health services, and strengthening community supports more broadly. It also identified the need to improve our knowledge about youth mental health and build a critical mass of researchers in this area, which has been lacking until now.

Paralleling this recommendation, the Irish Health Research Board recently committed €1.5 million to fund a consortium of Irish and International researchers to carry out a series of studies tackling key questions about causes, treatments, and the delivery of services in youth mental health. Led by researchers from NUI Galway, UCD and RCSI and partnered by the HSE and JIGSAW, the YOULEAD research will last for five years, and will provide PhD level training to a group of future clinical and academic research leaders in youth mental health.

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From RTÉ Radio One's Ryan Tubridy Show, Blindboy Boatclub discusses mental health issues 

The five key areas being tackled by the YOULEAD programme are: (1) adversity and outcomes – identifying preventable causes of youth mental health difficulties (led by Profs Mary Cannon and David Cotter, RCSI); (2) understanding barriers to treatment – identifying strategies to support parental help-seeking (led by Prof Eilis Hennessy and Dr Caroline Heary, UCD/NUI Galway); (3) improving participation – establishing a framework for youth participation in mental health service development and delivery (led by Dr Padraig MacNeela, NUI Galway); (4) community interventions - evaluating the effectiveness of current community based interventions (led by Prof Barbara Dooley and Dr Aileen O’Reilly, UCD/Jigsaw and (5) online social interventions – evaluate the health benefits of providing online social supports (led by Prof Gary Donohoe, NUI Galway).

The questions being tackled do not have simple answers and translating any new knowledge into policy and practice will be challenging. But establishing this research network and training future leaders in youth mental health research represents one of the key steps needed in getting serious about tackling the largest health issue facing our young people. The YOULEAD program will commence in September 2018 and is currently accepting applications from prospective clinical fellows and PhD scholars.


The views expressed here are those of the author and do not represent or reflect the views of RTÉ