Youth mental health declining worldwide — top medical journal

A top medical journal and a specialized “commission” in psychiatry had sounded the alarm that the worldwide incidence of declining mental health among young people has reached a “dangerous phase”.

Such observations by The Lancet Psychiatry Commission on Youth Mental Health dovetailed with results from a 2021 nationwide survey in the Philippines—on overall adolescent health and youth development— that found “alarming” mental health conditions by Filipino youth.

A September 2024 article in the journal The Lancet - Psychiatry, by a team of 54 psychiatrists from multiple countries, wrote that there has been a steady decline in the mental health of emerging adults since the turn of the new millennium.

The surge of young people’s mental health issues, the authors wrote, even rose during the COVID-19 pandemic and, whether previously or after the pandemic, through five “megatrends:” rising intergenerational inequality among families, the rise of the smartphone and unregulated social media use, wage theft, insecure employment conditions, and climate change.

“This alarming trend [declining youth mental health] signals a warning that global megatrends and changes in many societies around the world in the past two decades have harmed the mental health of young people and increased mental ill health among them,” the journal’s youth mental health commission said.

Such global observation also gets reflected in the Philippines: results from the 2021 Young Adult Fertility Survey (YAFS) by the University of the Philippines Population Institute, released in October 2022, show that nearly one in five Filipino youth aged between 15 and 24 years old have entertained thoughts of ending their lives.”

Lancet Psychiatry’s youth mental health commission found that mental illnesses by young people peak at the onset of 15 years old, while the peak of 63-to-75 in the onset of these illnesses occurs at 25 years old. That observation “represents the epidemiological inverse of physical diseases,” the commission writes.

The Lancet commission thinks emerging adulthood emerges as a crucial phase in a person’s “developmental momentum” since this phase “involves dramatic and visible changes” in people’s biological maturity “that are mirrored by less outwardly visible changes in brain structure and function, psychological development, and social and vocational spheres.

“Mental ill health emerging during youth,” the Commission said, “typically disrupts development and maturation, undermining the attainment of key milestones including identity relation formation, educational and vocational attainment, financial independence, and culturally-appropriate personal autonomy.”

Unless checked, youth mental health concerns “is the primary threat to the health, well-being and productivity of young people who are in transition from childhood to mature adulthood,” the 54 co-authors of the Lancet article wrote (led by Dr. Srividya Iyer of McGill University in Canada and Dr. Eóin Killackey of the Orygen institute in Australia).

This is not to mention that the COVID-19 pandemic exacerbated the situation, with pandemic-induced mental ill health by young people “occurring across resource and income levels”.

“Young people as a cohort have had a marked increase in distress and disproportionately poorer mental health outcomes since the COVID-19 pandemic, especially those living with social and economic disadvantage.”

Not surprisingly, such pandemic-related outcomes were seen in the Philippines. The UPPI’s 2021 YAFS study, conducted in the middle of the pandemic and which yielded 10,949 randomly-selected 15-to-24 year olds, finds that young people often feeling depressive symptoms substantially increased from 2013 to 2021.

Those surveyed by YAFS 2021 often experienced loneliness, sadness, and being disliked by others.

Young Filipinos experiencing “suicidal attempts” also more than doubled between the 2013 and 2021 rounds of the YAFS (from three percent to seven percent). Female young people (11 percent) had higher incidences of suicide ideation compared to males (four percent).

In absolute numeric estimates, UPPI said some 1.5 million Filipino youth experienced trying to end their lives in 2021 (compared to over-574,000 in 2013).

Today’s Filipino youth “have poorer mental well-being than in the last few decades,” UPPI observed. “The reasons for this are many and complex, but as it is, multiple challenges, including severe understaffing, the cost of consultation and treatment, and the stigmatization of mental health problems confront mental healthcare in the country.”

The Lancet Psychiatry Commission on Youth Mental Health’s article was based on a 2019 consultation it conducted with various medical and non-medical researchers from high-and-low-income countries. The commission also cited multi-country studies worldwide, (packaged as systematic reviews and meta-analyses, on youth mental health.

The commission nevertheless thinks that the prevention and promotion of youth mental health care “can be highly cost-effective”.

The Lancet group also recommendations a combination of approaches to address the world’s youth mental health situation: strong economic arguments for government investments on youth mental health, “emotionally-engaging storytelling” coming from young people; real-world and localized solutions; having “champions” (including politicians) to promote youth mental health solutions; media support; and targeted information campaigns.

As a response, the Philippines had enacted Republic Act 11036, or the National Mental Health Act, on June 20, 2018. As to youth mental health, chapter 5 of RA 11036 mandated “education (and) promotion of mental health in educational institutions and in the workplace”. Schools and universities were mandated by the law to set up mental health programs.

A 2024-2028 Philippine Council for Mental Health Strategic Framework, launched in October 2023, will operationalize the mandates of RA 11036 after a first strategic plan was rolled out during the period 2018 to 2022.

“As long as so many emerging adults die prematurely, are consigned to a life of welfare dependency, are denied sufficient respect and nurture, and languish in precarity, society itself will become more precarious,” the Lancet Psychiatry Commission on youth mental health wrote.

“The youth mental health crisis is more than a warning sign, and now might be our last chance to act.”

Jeremaiah Opiniano teaches journalism and research methods courses at the University of Santo Tomas (UST) in Manila.