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Better understanding of youth mental health
Editorial
Health an afterthought in a single-issue election
PA Images John Stillwell/PA Wire/PA Images
“We need a general election and we need one now, because we have at this moment a one-off chance to get this done while the European Union agrees its negotiating position and before the detailed talks begin.” Last week, UK Prime Minister Theresa May set out her case for a general election. One would be forgiven for thinking, reading the transcript of her speech, that May was readying the nation for a second referendum on the political issue of a generation, Britain leaving the European Union (EU). May’s government was formed from the ashes of postreferendum chaos, and was immediately tasked with making sense of a seismic shock threatening to envelop every level of government in a single-issue maelstrom. Progress towards exiting the EU has been made, but at the same time there has been stagnation and regression in areas which, in any other era, would themselves be viewed as a national emergency. UK health care and social provision find themselves at a crossroads with no clear path, and under the care
of a government too busy to provide a map. While the prospect of waiting until a post-Brexit general election in 2020 was unpalatable, the suggestion that it may now be 2022 until non-Brexit issues can dominate national debate is positively inedible. Furthermore, the UK now finds itself in a position where all health policy for the next 5 years will be determined during just 6 weeks of campaigning on a single-issue. Debate surrounding this election is likely to be so completely dominated by Brexit, itself too complex an issue to distil into a 50-day campaign, that health policies will struggle to reach the national consciousness. Presuming there is no earth-shaking polling swing in store (something of a gamble given the past 12 months), this vote seems almost a free pass for May’s government on all non-Brexit issues. It must be hoped that the current travails of the NHS and social care provision capture the British public’s attention in the run-up to June 8, because this is an issue that can wait no longer. n The Lancet
Getty Images funky-data #: 500810806
Better understanding of youth mental health
For the Youth Mental Health Report, see https:// blackdoginstitute.org.au/docs/ default-source/research/evidenceand-policy-section/2017-youthmental-health-report_missionaustralia-and-black-dog-institute. pdf?sfvrsn=6 For the WHO comprehensive mental health action plan, 2013–20 plan, see http://www. who.int/mental_health/action_ plan_2013/en For more on adolescent health and wellbeing see The Lancet Commissions 2016; 387: 2423–2478
1670
Mental health issues are the leading cause of disability in adolescents aged 15–19 years in all the world’s regions, contributing 45% of their overall burden of disease. Early intervention to prevent mental health disorders is crucial to suicide prevention and to improve lifelong wellbeing. On April 18, the charity Mission Australia, in association with the Black Dog Institute, a research institute based in New South Wales, published the 5th Youth Mental Health Report. From a survey of 21 000 Australian adolescents emerges a grim picture of mental health, with 22·8% of young Australians meeting the criteria for probable serious mental illness (PSMI), as assessed by the Kessler 6 measure of non-specific psychological distress. Alarmingly, the rate has increased by about 4% since 2012. Adolescent girls were almost twice as likely than boys to meet the criteria for PSMI, consistent with data reported in other countries. Importantly, a significantly higher proportion of Aboriginal and Torres Strait Islander responders in the Australian survey met the criteria for PSMI (31·6%), and respondents reported higher rates of concern about issues relating to substance use than nonAboriginal and Torres Strait Islanders.
Early intervention, the report states, is key and must be personalised, taking into account factors such as gender and community. Successful intervention might include support for family and friends, technology complementing or providing an alternative to face-to-face care, or evidence-based prevention and intervention in schools. The community is also important, especially in Australia’s Indigenous populations, who deserve special recognition. According to the Australian Institute of Health and Welfare, Indigenous children under 14 are nearly eight times more likely to die by suicide than their nonIndigenous peers. In the WHO 2013–20 plan for comprehensive mental health action, which 194 member states agreed to, it was noted that, “The early stages of life present a particularly important opportunity to promote mental health and prevent mental disorders…Children and adolescents with mental disorders should be provided with early intervention”. Unlike many other countries, Australia has a wealth of information concerning young people’s mental health. If this new report is any indication, stronger action must be taken to reach the targets for 2020. n The Lancet www.thelancet.com Vol 389 April 29, 2017
Health an afterthought in a single-issue election
PA Images John Stillwell/PA Wire/PA Images
“We need a general election and we need one now, because we have at this moment a one-off chance to get this done while the European Union agrees its negotiating position and before the detailed talks begin.” Last week, UK Prime Minister Theresa May set out her case for a general election. One would be forgiven for thinking, reading the transcript of her speech, that May was readying the nation for a second referendum on the political issue of a generation, Britain leaving the European Union (EU). May’s government was formed from the ashes of postreferendum chaos, and was immediately tasked with making sense of a seismic shock threatening to envelop every level of government in a single-issue maelstrom. Progress towards exiting the EU has been made, but at the same time there has been stagnation and regression in areas which, in any other era, would themselves be viewed as a national emergency. UK health care and social provision find themselves at a crossroads with no clear path, and under the care
of a government too busy to provide a map. While the prospect of waiting until a post-Brexit general election in 2020 was unpalatable, the suggestion that it may now be 2022 until non-Brexit issues can dominate national debate is positively inedible. Furthermore, the UK now finds itself in a position where all health policy for the next 5 years will be determined during just 6 weeks of campaigning on a single-issue. Debate surrounding this election is likely to be so completely dominated by Brexit, itself too complex an issue to distil into a 50-day campaign, that health policies will struggle to reach the national consciousness. Presuming there is no earth-shaking polling swing in store (something of a gamble given the past 12 months), this vote seems almost a free pass for May’s government on all non-Brexit issues. It must be hoped that the current travails of the NHS and social care provision capture the British public’s attention in the run-up to June 8, because this is an issue that can wait no longer. n The Lancet
Getty Images funky-data #: 500810806
Better understanding of youth mental health
For the Youth Mental Health Report, see https:// blackdoginstitute.org.au/docs/ default-source/research/evidenceand-policy-section/2017-youthmental-health-report_missionaustralia-and-black-dog-institute. pdf?sfvrsn=6 For the WHO comprehensive mental health action plan, 2013–20 plan, see http://www. who.int/mental_health/action_ plan_2013/en For more on adolescent health and wellbeing see The Lancet Commissions 2016; 387: 2423–2478
1670
Mental health issues are the leading cause of disability in adolescents aged 15–19 years in all the world’s regions, contributing 45% of their overall burden of disease. Early intervention to prevent mental health disorders is crucial to suicide prevention and to improve lifelong wellbeing. On April 18, the charity Mission Australia, in association with the Black Dog Institute, a research institute based in New South Wales, published the 5th Youth Mental Health Report. From a survey of 21 000 Australian adolescents emerges a grim picture of mental health, with 22·8% of young Australians meeting the criteria for probable serious mental illness (PSMI), as assessed by the Kessler 6 measure of non-specific psychological distress. Alarmingly, the rate has increased by about 4% since 2012. Adolescent girls were almost twice as likely than boys to meet the criteria for PSMI, consistent with data reported in other countries. Importantly, a significantly higher proportion of Aboriginal and Torres Strait Islander responders in the Australian survey met the criteria for PSMI (31·6%), and respondents reported higher rates of concern about issues relating to substance use than nonAboriginal and Torres Strait Islanders.
Early intervention, the report states, is key and must be personalised, taking into account factors such as gender and community. Successful intervention might include support for family and friends, technology complementing or providing an alternative to face-to-face care, or evidence-based prevention and intervention in schools. The community is also important, especially in Australia’s Indigenous populations, who deserve special recognition. According to the Australian Institute of Health and Welfare, Indigenous children under 14 are nearly eight times more likely to die by suicide than their nonIndigenous peers. In the WHO 2013–20 plan for comprehensive mental health action, which 194 member states agreed to, it was noted that, “The early stages of life present a particularly important opportunity to promote mental health and prevent mental disorders…Children and adolescents with mental disorders should be provided with early intervention”. Unlike many other countries, Australia has a wealth of information concerning young people’s mental health. If this new report is any indication, stronger action must be taken to reach the targets for 2020. n The Lancet www.thelancet.com Vol 389 April 29, 2017