Society of Bioethics and Medicine
Waging a War Against Adolescent Mental Health
Written by Jonathan Gao
Edited by Jacquelyn Tang
As soon as the medical team rushed through the doors, I blurted out what was wrong with my sons; my younger son had croup and my older son suffered head trauma. Almost immediately, they began assessing the severity of their issues. In a concerted fashion, they rattled off the names of numerous drug names, performed intubations, and delivered IV fluids to protect the lives of both.
Well … the story is somewhat true.
You see, my “sons” were actually training mannequins that wheezed and cried endlessly throughout the entirety of this pediatric simulation case.
While simulated, this experience was particularly impactful. Seeing how medical teams can put their heads together to treat patients whose physiologies are constantly developing and changing as they grow, was simply fascinating. Such observations have not only allowed me to understand the dynamic interactions between the physician and a child with their parents, but also to empathize with the countless children who come through the hospital doors, awaiting medical attention.
Adolescence, spanning ages 10 to 19, is often a very tumultuous time. It is a period in which one begins to concretize ideas about themselves and the world around them. Their identities, which dictate their ongoing adolescence and later adulthood, are pieced together like building blocks by everything – this includes the living conditions they grew up in, the friends they make, and the beliefs of groups that they hang out with.
While many kids will require stitches for their cuts, medication for bouts of nausea and stomach aches, or casts for their broken bones, leaving them excited to head home, there is a growing group of adolescents that present with invisible wounds, the kind that unhealthy social media use, emotional abuse, and social stigma will often trigger.
Take fictitious, fifteen-year old Tommy as an example…
If adolescents like Tommy cannot see a psychiatrist, whose waiting list may already be miles-long, Tommy will most likely visit the hospital emergency room, where the medical system is often ill-equipped to deal with ADHD and suicidal behavior.
Although the physician can prescribe Tommy some Adderall, pat him on the head, and send him on his way, antidepressant medications only temporarily treat the illness instead of the patient themself.
The American Academy of Pediatrics (AAP) reported that while mental health disorders affect 1 in 5 children, many of those affected have not received the appropriate services. In fact, a principal finding from a University of Michigan study stated that: “The national prevalence of children with a mental health disorder who did not receive needed treatment or counseling from a mental health professional was 49.4%, which ranged from 29.5% (Washington, DC) to 72.2% (North Carolina). “
While the AAP also declared that pediatricians must take on a larger role in addressing mental health issues, they also acknowledge that there is a tough pill to swallow: Pediatricians do not feel prepared to embark on such an arduous task.
A joint WHO-UNICEF effort, called the Helping Adolescents Thrive Initiative, is currently strengthening policies and programmes designed to improve adolescent mental health.
Furthermore, the WHO has also developed a new module in a clinical decision-making guide, the mhGAP Intervention Guide, for healthcare professionals to use in the face of mental, neurological, and substance use (MNS) disorders. The module provides doctors, nurses, and other health workers with protocols on how to recognize, assess, and manage a broad range of MNS disorders within adolescents in non-specialist health settings.
While the global health community has directed more effort into implementing interventions, the time is ticking for many adolescents – these organizational stopgaps haven’t done anything to push them up the long queue to see a specialist sooner.
The consequences of leaving mental disorders untreated are far too dire to ignore. While the simulations the the mannequins will prime healthcare professionals for assessing physical ailments, we also need to learn how to fight the good fight against mental health disorders in our nation’s primary care hospitals and clinics.