Half of all mental illness begins by the age of 14

Mental illness can strike anyone at any time in their life. In fact, more than 350 million people across the world – of all ages and from all communities – suffer from depression. But half of all mental illness begins by the age of 14, according to the World Health Organization (WHO). And it is that shocking statistic which is the focus of this year’s World Mental Health Day.

The good news is we are learning to better understand and deal with mental health issues. Here are some key developments.

Early intervention

While half of all mental illness begins by the age of 14, most cases go undetected and untreated.

Teenagers and young adults have many changes to deal with, including changing schools, leaving home and starting university or a new job. This can lead to stress and apprehension. In some cases, if not recognized and managed, these feelings can lead to mental illness.

In some countries, the formative years of a child’s life have been dominated by conflict and upheaval, leaving these young people particularly vulnerable to mental distress and illness.

In terms of the burden of disease among adolescents, depression is the third leading cause, while suicide is the second leading cause of death among 15-29 year olds. Harmful use of alcohol, drugs and eating disorders are also cause for concern.

Despite this troubling picture, the WHO says there is a growing recognition of the importance of helping young people build mental resilience at an early age. Parents and teachers can help young people build life skills that help them cope with everyday challenges at home and school. More schools are launching initiatives such as mindfulness and meditation, and some provide psycho-social support.

This does however require investment from governments. And that investment needs to work in tandem with programmes to raise awareness, helping peers, parents and teachers know how to support their friends, children and students.

The role of genetics

Research has shown that 30-40% of the risk for both depression and anxiety is genetic and 60-70% is due to environmental factors, according to the National Institute for Health Research.

Now, the NIHR and King’s College London are calling for 40,000 people diagnosed with depression or anxiety to join what they say will be the largest ever database of volunteers.

The researchers plan to explore the genetic factors behind the two most common mental health conditions – anxiety and depression.

“It’s a really exciting time to become involved in mental health research, particularly genetic research which has made incredible strides in recent years – we have so far identified 46 genetic links for depression and anxiety,” explains Dr Gerome Breen of King’s College London.

“By recruiting 40,000 volunteers willing to be re-contacted for research, the study will take us further than ever before. It will allow researchers to solve the big unanswered questions, address how genes and environment act together and help develop new treatment options.”

Technology and the brain

Conventional wisdom suggests that spending too much time online is in some ways detrimental to the human brain and mental health.

And there is a growing body of scientific work pointing to the dangers of a digital lifestyle. For example, neuroscientist Adam Gazzaley has written a book The Distracted Mind: Ancient Brains in a High-Tech World which explores how internet-connected devices degrade our attention, and have implications for mental health and stress levels in the workplace.

However, many scientists also believe that technology can be harnessed to address mental health issues, and there has been a proliferation of apps aimed at wellbeing.

For example, the Happify app promises to reduce stress and anxiety by providing happiness games and activities. The basic principle is that you can change and modify the brain by training it as if it were a muscle – a theory called neuroplasticity. By adopting new thinking habits, its users can overcome negative thought patterns and learn to cope with everyday stresses.

The app already has 3.5 million users, and claims to help people with schizophrenia, clinical depression and chronic illnesses.

There is also growing scientific evidence that points to the success of online therapy.

In the UK, the National Institute for Health and Care Excellence which provides national guidance on improving healthcare, has approved the use of online cognitive behavioural therapy (CBT).

CBT is one of the well-established talking therapies, but now scientists recognize that it is sometimes easier for people to open up to a machine rather than a human being. CBT is also notoriously expensive and time-consuming, so technology may also allow for treatment to become more widely available.

A policy priority

World leaders have recognized the importance of mental health and well-being by including it in the Sustainable Development Agenda, which was adopted at the UN’s General Assembly in September 2015.

As part of Goal 3, world leaders have committed to the “prevention and treatment of noncommunicable diseases, including behavioural, developmental and neurological disorders, which constitute a major challenge for sustainable development”.

The then Director-General of the WHO, Dr Margaret Chan, explained the significance of the decision, saying it will help the world achieve greater fairness.

“The inclusion of noncommunicable diseases under the health goal is an historic turning point. Finally these diseases are getting the attention they deserve,” she says.

Specific goals include reducing premature mortality from noncommunicable diseases by one third by 2030 and strengthening the prevention and treatment of substance abuse including narcotic drug and alcohol use.

It is through this type of ongoing commitment, as well as the growing awareness of mental health issues, that progress can be made.