Understanding Teenagers’ Mental Health

Teenage years are often tumultuous, marked by the push and pull of striving for independence while still craving the security of childhood. Hormonal changes, peer pressure, academic expectations, and the onset of serious decision-making can all take a toll on a teenager’s mental health.

The Intricate Link Between Mental Health and Live Casinos

Ever thought about live casinos in relation to mental health? It may sound strange, but there’s a connection. Playing games, like at live casinos, can be a thrilling experience that offers a break from daily stress. However, when not regulated properly, it can also lead to excessive stress and even addiction.

The Thrill and Pressure of Space XY Game

Take Space XY game, for example. This game, hosted in a live casino, is exciting and engaging. The adrenaline rush from trying to beat the odds can give players a sense of control and achievement. But when the stakes are high and the pressure mounts, it could trigger feelings of anxiety and stress, especially for teens who might not have fully developed coping mechanisms.

Common Mental Health Issues in Teenagers

Some common mental health issues in teenagers include depression, anxiety disorders, and eating disorders.

Depression

Depression is more than just feeling sad. It’s a persistent feeling of sadness, hopelessness, and a lack of interest or pleasure in activities.

Anxiety Disorders

Anxiety disorders involve more than just the typical nerves or worry. They can cause teenagers to become extremely fearful and worried, even when there’s no reason or in a disproportionate way to the situation.

Eating Disorders

Eating disorders involve extreme attitudes, emotions, and behaviors surrounding weight and food. They can have severe physical and psychological consequences.

Impacts of Mental Health Problems on Teenagers

Mental health issues in teenagers can significantly impact different aspects of their lives, such as their academic performance, social life, and physical health.

Academic Performance

Mental health issues can affect a teenager’s ability to concentrate, make it hard to keep up with schoolwork, or lead to frequent absences.

Social Life

Teenagers with mental health issues may struggle with relationships. They may isolate themselves from friends or family, or act out, causing friction with their peers.

Physical Health

Mental health problems can also lead to physical health issues, like sleep disorders, poor nutrition, or even self-harm.

How Can We Support Teenagers’ Mental Health

We all know that growing up can be a rough ride. Remember those teen years? Trying to fit in, grappling with body changes, school pressures – it can feel like walking a tightrope. If you’re a parent, a teacher, or simply an adult with a teen in your life, it’s important to understand how to support teenagers’ mental health. So, let’s jump in, shall we?

Keep The Conversation Going

Communication is the key, my friend. Having an open and honest chat about mental health can be a game-changer. It’s important to make these conversations a normal part of life, not a big scary ‘sit-down’ event. Talk about it while cooking dinner or on a drive. Let them know it’s okay not to feel okay, and remind them that you’re always there to lend an ear. And don’t forget to actively listen – sometimes, all they need is someone to just ‘get it’.

Encourage a Healthy Lifestyle

You’ve probably heard this a million times, but I’ll say it again: a healthy body can lead to a healthy mind. Encourage regular exercise – it could be anything from soccer practice to just dancing around in the living room. And remember, teens and junk food have a historic love affair. It’s okay to indulge sometimes, but try to promote a balanced diet. Sleep is another biggie. It can be a challenge to pry those electronic devices away from them at night, but a good night’s rest is super important for mental health.

Spot the Signs Early

Understanding the signs of mental health issues can make a huge difference. Watch out for any significant changes in their behavior, mood, sleep patterns, or eating habits. Remember, we’re not looking for the ‘drama queen’ behavior that can be typical in teens. We’re looking for consistent, long-term changes. And if you notice anything concerning, don’t wait – reach out to them.

Seek Professional Help

Sometimes, despite your best efforts, your teen might need extra help – and that’s perfectly okay. There’s a whole bunch of professionals out there like psychologists, therapists, or school counselors, who are trained to navigate these stormy waters. And in some cases, medication might be recommended by a psychiatrist. Remember, there’s no shame in seeking help.

Patience is Your Best Friend

Last, but certainly not least, be patient. Mental health recovery isn’t a sprint; it’s more like a marathon. There might be good days and bad days, and that’s okay. Just let them know you’re there for them, through the highs and the lows.

The Power of Understanding: A Conclusion

So, here’s the thing, guys. When it all boils down to it, it’s all about understanding – understanding what our teenagers are going through and how we can help them navigate through it. Teenage years can be rough, and mental health issues can make them even tougher. But guess what? We have the power to make a difference. We can start by learning about mental health, talking about it, and knocking down the stigmas. We can be there for our teens, letting them know it’s okay not to be okay, and help is available. The journey may be tough, but remember, understanding is the first step. And when we take that step, we open the door for our teenagers to grow into healthier, happier adults. Now, that’s pretty powerful, don’t you think?

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Harvard Medical School warns of a child mental health crisis in the U.S., calling it a national emergency.1 In the UK, more than 400,000 children are treated monthly for mental health problems, indicating an unprecedented crisis of well-being and well-being among children and adolescents.2 Meanwhile, UNICEF reports a decline in mental health in Europe and points out that suicide is now the second leading cause of death among Europeans

Strengthening young people’s stress tolerance

These days, adolescent mental health is a social problem. If mental health disorders are not treated in adolescence, they will stay with the person into adulthood. As a result, psychological and physical health will suffer and one will not be able to make full use of the opportunities provided by life. This is not only a tragedy for the individual – it has enormous implications for families, society, the health system and the economy.

Problems affecting the mental health of adolescents need to be addressed immediately to prevent a growing adult mental health crisis. A whole-of-society effort is needed to improve the stress tolerance of young people. There are many ways to accomplish this goal.

The Role of Parenting

Parents play a key role in the prevention of adolescent mental health problems. Numerous studies prove that proper parental involvement in a child’s life, including adolescence, has a positive impact on their well-being.

Parenting methods are a significant factor. In particular, parental warmth and kindness have been shown to have a positive effect on a child’s psychological well-being, while parental disapproval and hyper-parenting reduce self-esteem and increase psychological inflexibility.

Overprotective care is rarely considered detrimental to a child’s health, but overprotection prevents children from learning to cope with anxiety-inducing situations. Overprotection, even with the best of intentions, can have negative consequences.

Overprotective, critical and dismissive attitudes of parents affect a child’s self-esteem.

Mental health disorders are usually inherited. For family members and caregivers, this means having to deal with problems related to their own mental health. This is to set an example to follow. Don’t be afraid to talk to your children/adolescents about their mental health. However, try to avoid labels. Replace the word “depression” with “sadness,” the word “anxiety” with “fear.”

Early Identification of Problems

Early identification, accurate diagnosis, and effective treatment of mental health problems in adolescents is critical to preventing mental health problems as adults.

Parents should be able to recognize children’s mental health disorders early and know what steps to take when a problem is suspected. All adults involved in an adolescent’s life can help by having a dialogue with them, knowing what signs to look out for, and being a role model for mental health.

Teachers and youth workers also need to be on the alert and teach young people the art of self-care well in advance.

Adolescence is often a time of confusion and loss of direction. All the adults in a teenager’s life need to actively listen to him or her. Creating appropriate spaces for communication can help with this. It is important to ask open-ended questions and to allow adolescents to speak up at home, in appropriate social interaction situations and in the course of their studies.

In addition, parents and caregivers should actively support the treatment plan. Research has shown that a caregiver’s involvement in the treatment of a child’s mental health problems has a direct impact on successful outcomes.

The Role of Education in Protecting Mental Health

Schools play a vital role in fostering favorable mental health and are uniquely positioned to work with all children. In addition, schools have fewer barriers to intervention compared to what is offered by society or the health care system outside of educational settings.

A sense of belonging to the school community, also called “connectedness to school,” is considered an important indicator of mental health.6 It is about relationships with teachers, school staff, and peers, and reflects how accepted, recognized, and involved students feel in the community.

Research shows that good relationships in school, including attachment to teachers, connection to school, and a sense of community, have a direct impact on good mental health and life satisfaction.

Authorities and private school educators need to revise educational policies to reflect the growing need for mental health supports. There is strong evidence that school interventions can improve learning outcomes, increase stress tolerance and self-esteem, reduce anxiety and depression, and prevent aggressive and challenging behavior.

A study of the effectiveness of a universal mental health program in schools in six European countries found that the program increased social and emotional competence and improved prosocial behavior, and reduced behavioral problems of internalizing and externalizing students.

UNICEF identifies five main areas of mental health promotion and protection in education and learning.

These include:

• Creating a supportive learning environment for good mental health and well-being
• Guaranteeing the availability of early intervention, mental health care and support for mental health
• Improving the well-being of teachers Improving mental health and psychosocial support (MHPSS) for educators
• Ensuring effective collaboration between school, family, and community to create a safe and supportive learning environment

Value of Mental Health Awareness Campaigns

Adolescent mental health is an important public health issue. Campaigns that raise public awareness about mental health play a key role in helping parents, caregivers, educators, policymakers and adolescents gain relevant knowledge and understanding about supportive practices.

For example, in the U.K., the Time to Change and Young Minds campaigns have been inspirational in supporting mental health. And the National Health Service (NHS) in London recently launched a new mental health campaign for young people called London, You Good?

Promoting better self-care

A fundamental starting point for addressing adolescent mental health disorders is to empower teens to take better care of themselves. Of course, this is primarily a task for parents, but it should also be addressed in public education policy and public health ideas. In addition, the issue of teen mental health would cease to be an embarrassment if discussions about it were commonplace in all extracurricular activities.

Parents should ensure that time spent watching TV does not exceed time spent playing sports, exercising or taking walks. Family dinners are also important, even if they don’t happen every day: Children who regularly sit down to dinner with their family experience less anxiety, are less depressed, have a more extensive vocabulary, tend to eat healthier foods, and have higher self-esteem.
Improving Access to Mental Health Care

One of the most important factors for parents, caregivers, and the young men and women themselves is understanding that it’s time to seek professional help. Governments have an obligation to improve the availability of mental health care. In most developed societies, we are much more likely to seek help for physical complaints, but much less likely to seek help for mental health problems.

Providing treatment as early as possible will allow young people to recover quickly so they can take advantage of their education, build positive relationships, get jobs, and generally live more meaningful and productive lives.

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Medicaid will play an even more important role in providing insurance coverage for the elderly, blind, and disabled (ABD) with mental illness/substance use disorders after health care reform. Current estimates show that Medicaid will cover 24.3 percent of these individuals when reform is fully implemented in 2019. Medicaid participants with behavioral health disorders are expected to account for about 31.9 percent of the expected increase in total Medicaid spending. These costs are expected to increase by 49.7 percent, not counting the additional costs for many comorbidities that we know exist among Medicaid participants struggling with mental illness. Overall, the needs for appropriate care and health improvement are imperative for states to control their Medicaid budgets. We believe that the only way to achieve these goals is to implement a special behavioral health program.

Benefits of a special behavioral health program

Specialty behavioral health programs are defined as programs that contract directly with managed mental health organizations, separate from the rest of the health care package. These include mental health and substance use disorder specialists. Programs can range from simple administrative services only (ASO) contracts to shared savings and full per capita behavioral health payment models.

The benefits of specialty care programs have been studied since the inception of managed behavioral health care. Evidence shows that they have been successful in reducing costs and maintaining or improving access to care. They have been instrumental in addressing long-standing issues related to utilization, affordability, and the cost of mental health services.

Across the country, behavioral health specialty programs have provided a higher level of access and a higher level of specialty for Medicaid managed care than integrated mental health programs. Through contract language and performance incentives, specialized behavioral health care programs provide recovery-oriented services that are critical for people with serious mental illness and at-risk children. A SAMHSA-sponsored study of Medicaid managed mental health care found that state specialty care programs have a penetration rate of 11%, compared to the 5.6% penetration rate reported by HEDIS for HMO Medicaid nationally in Quality Compass 2000 (1999 data). Penetration of outpatient care was significantly higher in specialty care programs, with SAMHSA research programs averaging 10.9 percent compared to the NCQA average of 5.5 percent.

Some of the program elements that showed particular promise include:

• Specialized behavioral health care programs to address the special needs of populations, such as those with severe and persistent mental illness (SPMI) or those with dual diagnoses.
• Targeted care management and care coordination for people with complex care needs.
• Developing contract performance standards to ensure high quality care for individuals.
• Provider access standards to ensure that participants can receive timely care from providers and specialists.
• Transparency in program design and accountability of contractors and providers involved in the program.

Additional benefits of specialized mental health programs include:

• A single point of accountability with mental health supervision experience for Medicaid enrollees.
• Reduced costs, especially for inpatient services. Savings are greatest at the beginning of managed care programs in behavioral health.
• Access to a network of specialized mental health and behavioral health providers, including community-based providers, offers participants a wide choice of providers.
• Targeted Behavioral Health Performance Guarantees allow clients to manage their program and achieve their desired outcomes.
• Experienced behavioral health professionals provide utilization management in specialized programs and more effectively reduce costs while improving participant outcomes. Traditional Medicaid managed care organizations have not demonstrated the ability or interest in providing specialized services for individuals with serious mental illness unless significant money can be made by reducing benefits.
• Focusing on behavioral health conditions, especially those that accompany illness, can reduce costs across the board.
• Improved treatment coordination ensures that treatment is specialized and integrated into the PCP’s medical environment.
• The use of recovery strategies, person-centered planning, and evidence-based methods helps people with complex and serious needs who require a high level of knowledge to develop treatment plans.
• Demonstrated ability to help with reinvestment in the mental health care delivery system helps with the expansion of alternative services.
• Behavioral health expertise is woven into all client services: clinical services, reporting and data management, and consultation allows each client to analyze the data needed to make informed decisions.

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What is cognitive behavioral therapy?

Cognitive-behavioral therapy is about positively influencing feelings by changing behaviors and thoughts. It is recognized by the scientific community, and the costs are covered by state health insurance coffers. The terms “behavioral therapy” and “cognitive behavioral therapy” are commonly used synonymously.

Cognitive behavioral therapy is recommended as a first-line treatment for anxiety and obsessive-compulsive disorders. Cognitive behavioral therapy can also be used for depression, eating disorders, alcohol dependence and, under certain conditions, psychotic illnesses. In addition, cognitive-behavioral therapy can be used to relieve mental symptoms associated with traumatic brain injuries.

Therapeutic work is directed toward alleviating current symptoms and building coping skills and social competence. The development of mental illness over the course of a lifetime is only analyzed if improvement is not achieved with interventions that address the present problems.
An important goal of cognitive-behavioral therapy is to increase patients’ independence and ability to act.

An important goal of cognitive behavioral therapy is to increase patients’ autonomy and ability to act. It offers help for self-help. Patients and therapists must form a working alliance. In doing so, sympathy is helpful but not necessary for successful treatment. It is essential that patients speak openly about the thoughts, feelings, and behaviors that are problematic for them. With knowledge of important psychological mechanisms, therapists change these areas.

What are the other goals of cognitive behavioral therapy?

Another goal of cognitive behavioral therapy is to change thoughts and evaluations that are unhelpful in everyday life. This is accomplished by observing the thoughts, emotions, and behaviors that underlie mental illness. Interfering thoughts and behaviors that are detrimental to health are realistically categorized and, if possible, changed in ways that reduce the emotional burden.

Another goal is to treat the illness. In doing so, various factors are important:

• Increased knowledge of one’s own mental illness;
• coping strategies – e.g., specific behavioral techniques for regulating emotions;
• acceptance of certain unchanging aspects of the problems.

Important to know! The effectiveness of cognitive behavioral therapy has been proven in a variety of mental illnesses. This means that many patients are able to successfully alleviate the symptoms of their respective illness with therapy.

How does cognitive behavioral therapy work?

Behavioral therapy depends on individual needs and can be very different for different illnesses. A typical procedure is described here. Often, negative thoughts and beliefs are attempted through this therapy.

Behavior Analysis

At the beginning of therapy, the therapist and the patient describe the exact course of problematic situations. They also develop an explanation of mental illness together. The characteristics of the situation, body reactions, interpretations, behaviors and feelings are taken into account.

For example: the patient has a serious problem at work, and she thinks, “I have made a terrible mistake.” She feels guilt and shame. The patient reacts with this behavior: she leaves her place of work and goes home immediately. She torments herself with thoughts of “I am worthless” and goes to bed.

Feelings arise as a result of a mental evaluation of situations

This example shows that situation, thought, feeling, and behavior affect one another: feelings arise from the mental evaluation of situations. It was not the mistake at work itself that led to feelings of guilt and shame, but that the mistake was judged to be “terrible. It is also important for therapy that the patient clearly lacks the skills to correct the mistake or to express her position purposefully to her supervisor. In turn, detachment from the outside world exacerbates the problem.

Self-Monitoring

An important element of diagnosis and therapy is, among other things, self-observation. This means first noticing and then recalling one’s own behavior in daily life. Writing down the behavior, thoughts and feelings in daily life and then working through the depressing feelings and undesirable behavior in sessions helps.

Checking and changing automatic evaluations

If part of the problem is that the patient automatically evaluates himself and his environment according to certain unhelpful evaluations, therapy focuses on changing these evaluations. Often evaluations occur automatically. For example, when someone considers their successes insufficient compared to the successes of others. Together with the therapist, a check is made to see if this is realistic and reasonable.

Realistic evaluations and assumptions are then developed based on this. An example is the following acceptance: “It is inherent in people to make mistakes, and I can find a solution.” Often patients cannot immediately accept such alternative views; they need practical confirmation from everyday life. Strategies are developed for this during therapy. If the patient in the previous example makes another mistake at work, she herself will first question her spontaneous evaluations and talk about her problem, for instance with a colleague with whom she has a good relationship. Instead of going home and getting upset, she will approach her supervisor and work with her to find a solution. This may even result in a sense of pride and joy and allow her to continue working in a calm state of mind.

Behavioral or Situational Analysis

Situational analysis is the re-examination of emotionally depressing stressful situations from everyday life with the therapist as if under a magnifying glass. Immediately after the experience, patients have to write down some important points: what exactly happened, what they thought, and how they felt. In the therapy session, the therapist and the patient work together to sort out what is causing the particular thoughts and feelings. The thoughts associated with the stressful feelings are checked to see if they are real. In addition, new, helpful thoughts are developed.

Confrontation Techniques

Confrontation, also called exposure, is mostly used for anxiety disorders. In a nutshell, it is about accepting one’s misplaced fears and then learning to overcome them. The patient actively engages in situations that he or she previously avoided. This involves an objective assessment of the actual danger and emotional and physical reactions. In the next stage, it can be useful to specifically induce feelings of fear in order to further deepen the work with fear. To do this, patients are asked to put themselves in situations that cause anxiety. In this case, it is not a question of testing courage or overcoming fear, but of changing the physical and mental reactions to fear. In some cases, it may be sufficient to imagine an object or situation causing fear. During this, dramatizing assessments are tested. For example, does a rapid pulse really mean life-threatening?

On the one hand, therapy diverts attention away from “danger,” and on the other, a tolerance for anxiety symptoms, such as difficulty breathing, is trained. Patients learn that they are not helpless in times of fear, can influence it and thus cope with it. Gradually, they are able to experience more and more situations that they had previously avoided because they were afraid of them.

When is behavioral therapy used?

Behavioral therapy is a recommended form of treatment for most anxiety disorders, some addictive disorders, obsessive-compulsive disorders, psychotic disorders in non-psychotic phases, depression with other co-occurring psychiatric disorders and some personality disorders such as borderline personality disorder. Behavioral therapy is also recommended as a primary treatment for mental disorders caused by physical illness, disorders caused by brain or nerve damage, and eating disorders.

It is helpful if the patient is motivated to work on the problems. But even in difficult circumstances, such as lack of motivation, mental limitations, or lack of trust because of previous bad experiences, behavioral therapy can produce good results. The relationship between the therapist and the patient plays an important role. In behavior therapy, this relationship varies depending on the nature of the problems, from soulful and kindhearted to strict and demanding.

Where to get professional help?

If you are experiencing anxiety, discouragement, sadness or other anxious feelings and these feelings are affecting your daily life, talk to your family doctor, psychiatrist or appropriate qualified professional about it first. If the doctor sees the need for psychotherapy, he or she can advise on how to proceed. If necessary, your doctor can recommend a qualified psychotherapist or psychiatrist.

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The chances of survival for adolescents and young adults around the world vary widely. In 2020, 10- to 24-year-olds had the highest probability of dying in sub-Saharan Africa, Oceania (excluding Australia and New Zealand), North Africa, and South Asia (1). On average, a 10-year-old child is six times more likely to die before age 24 in sub-Saharan Africa than in North America and Europe.

Rights of adolescents

International legal instruments enshrine the rights of children (members of the under-18 age group) to survival, growth, and development. In 2013. The Committee on the Rights of the Child (CRC), which monitors the Convention on the Rights of the Child, published guidelines on the right of children and adolescents to enjoy the highest attainable standard of health, and in 2016 a general comment was published on the implementation of children’s rights in adolescence. It emphasizes the obligation of states to recognize the special health and developmental needs and rights of adolescents and young people.

WHO Activities

In May 2017. WHO published a major report, Global Accelerated Action for Adolescent Health (AA-HA!): a guide to support implementation in countries. This guide was prepared following extensive consultations with Member States, United Nations agencies, adolescents and young people, civil society representatives, and other partners. It is intended to assist national governments in identifying and planning the necessary actions to address the health needs of adolescents. This reference document is intended for policymakers and program managers at the national level in planning, implementing, monitoring and evaluating adolescent health programs. Sixty-eight countries have been trained to use the guide for national priority setting, program design, monitoring, and evaluation, and many countries are now using the methodology suggested in the guide to update national strategies and policies.

To improve adolescent health measurement worldwide, WHO, in collaboration with UNAIDS, UNESCO, UNFPA, UNICEF, UN Women, the World Bank Group and the World Food Programme (WFP), has established the Global Action for Measurement of Adolescent Health (GAMA) Advisory Group. It provides technical advice to WHO and its UN agency partners to identify a core set of adolescent health indicators for harmonizing efforts on adolescent health measurement and reporting.

Overall, WHO performs a variety of tasks in the area of adolescent health promotion, including:

• Developing evidence-based guidelines to support health services and other sectors;
• Developing recommendations for governments on adolescent health and adolescent-friendly health systems, including high-quality, age-appropriate health services for adolescents;
• Documenting progress in improving adolescent health and development;
• Raising awareness among the general public and other stakeholders about young people’s health issues;
• Advocating with governments and working with youth organizations and youth service providers to help create structures and build processes at the national level to institutionalize adolescent participation in dialogues related to relevant areas of public policy, funding, and program implementation.

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Unintentional injuries are the leading cause of death and disability among adolescents. In 2019, nearly 1,000,000 adolescents (10-19 years old) were killed in traffic crashes. Many of the fatalities were classified as “vulnerable road users,” i.e., pedestrians, bicyclists, or drivers of two-wheeled motor vehicles. In many countries, road safety laws need to be more comprehensive and enforcement needs to be strengthened. Instruction in safe driving techniques must also be provided for young drivers, and legal prohibitions on driving under the influence of alcohol and drugs must be strictly enforced for all age groups. The blood-alcohol limit for young drivers should be set at a lower level than for adults. It is recommended that novice drivers be issued driver’s licenses with a probationary period during which there is zero tolerance for driving under the influence of alcohol.

Drowning is also a leading cause of death among teens, with more than 30,000 teens estimated to have drowned in 2019, more than three-quarters of them boys. The most important measure to prevent this type of death is teaching children and teens to swim.

Violence

Interpersonal violence is the fourth leading cause of death for adolescents and young adults worldwide. The rate varies greatly by region. In low- and middle-income countries in the Region of the Americas, interpersonal violence is responsible for about one-third of all male adolescent deaths. According to the Global School Health Survey, 42% of adolescent boys and 37% of adolescent girls have experienced bullying. Sexual violence also affects a significant proportion of youth: one in eight youth report experiencing sexual violence.

In addition, adolescent violence increases the risk of injury, HIV and other sexually transmitted infections, mental health problems, poor academic performance and school attendance, premature pregnancy, reproductive health problems, and the risk of infectious and non-communicable diseases.

Effective approaches to violence prevention and response include parent education and supportive early childhood development, bullying prevention in schools, life and social skills development for children, and community-based approaches to limiting access to alcohol and firearms. Effective and attentive care and assistance for adolescent survivors of violence and ongoing support help overcome the physical and psychological effects.

Mental Health

Depression is one of the leading causes of illness and disability among adolescents, and suicide is the third leading cause of death in the 15 to 19 age group. Sixteen percent of the cumulative burden of illness and injury in adolescents and young adults aged 10 to 19 is attributable to mental health disorders. Half of all mental health disorders in adults begin to develop much earlier, before age 14, but are largely undetected and untreated at that age.

Adolescents’ well-being and mental health are affected by many factors. Violence, poverty, stigmatization, marginalization, living in a humanitarian disaster or instability can increase the risk of developing mental health disorders. The consequences of failing to address adolescent mental health disorders are felt in adulthood, causing damage to both physical and mental health and limiting adults’ ability to live fulfilling lives.

Developing social-emotional skills in children and adolescents and providing them with psychosocial support in schools and other contexts promotes their mental health. In addition, programs that strengthen the bonds between adolescents and their families and improve the quality of living conditions are important. When problems arise, they should be identified and addressed in a timely manner with the involvement of competent and attentive health professionals.

Alcohol and Drug Use

Alcohol use by adolescents is a serious concern in many countries. Alcohol leads to decreased self-control and increases the risk of dangerous behaviors, such as unsafe sex and dangerous driving. It is also a root cause of injuries (including those caused by traffic accidents), violence, and premature death. Alcohol use can also lead to health problems later in life and has a negative impact on life expectancy. Currently, more than a quarter of all 15-19 year olds worldwide – 155 million adolescents – drink alcohol. In 2016, the prevalence of occasional heavy alcohol use among adolescents ages 15-19 was 13.6%, and male adolescents were the most at risk.

Marijuana is the most commonly used psychoactive substance among young people, with about 4.7% of 15-16 year olds using marijuana at least once in 2018. Alcohol and drug use among children and adolescents causes neurocognitive changes that can lead to behavioral, emotional, social, and learning problems later in life.

Alcohol and drug use prevention is an important area of public health activity and can include strategies and interventions at both the population level and school, community, family, and individual levels of intervention. Establishing a minimum age for purchase and consumption of alcohol, banning child-oriented marketing and advertising of alcoholic beverages are among the key strategies to reduce adolescent alcohol use.

Tobacco use

The vast majority of people who currently use tobacco began doing so when they were teenagers. Measures such as banning the sale of tobacco products to minors (people under 18) and raising tobacco prices through higher taxes, banning tobacco advertising, and creating smoke-free environments are essential. Globally, at least 1 in 10 young people between the ages of 13 and 15 use tobacco, although the rate is significantly higher in some regions.

HIV/AIDS

In 2019, the number of adolescents (ages 10-19) living with HIV was estimated at 1.7 million, and approximately 90% of them lived in the WHO African Region (3). Despite a significant decrease in new HIV infections among adolescents from their 1994 peaks, approximately 10% of new HIV infections among adults still occur among adolescents, three-quarters of whom are girls (3). In addition, although the number of new infections appears to have declined in many of the most heavily affected countries, recent testing coverage has been low, suggesting that many adolescents and young people living with HIV are unaware of their HIV status (5).

Adolescents living with HIV have less access to antiretroviral therapy, lower adherence to treatment, more difficult to keep under observation and more difficult to achieve viral suppression. One of the key factors exacerbating this situation is the low level of adolescent-friendly services, including psychosocial interventions and support.

Adolescents and young adults need to be provided with information about HIV prevention and access to appropriate tools. This includes the ability to access HIV prevention interventions, including voluntary medical male circumcision services, condoms and pre-exposure prophylaxis, increased access to HIV testing and counseling, and the ability to establish closer contact with HIV treatment services for HIV-positive adolescents.

Other infectious diseases

The number of measles-caused deaths and disabilities among adolescents has decreased significantly due to increased childhood vaccination: in countries in the African region, for example, adolescent deaths decreased by 90% between 2000 and 2012.

Diarrhea and lower respiratory tract infections (e.g., pneumonia) are estimated to be among the 10 leading causes of death for adolescents aged 10-14 years. These two groups of diseases, along with meningitis, are among the top five causes of death for adolescents in low- and middle-income countries in Africa.

An infection such as the human papillomavirus usually occurs after the beginning of sexual activity and can lead not only to short-term consequences (genital warts) in adolescence, but also, more dangerously, to cervical cancer and other cancers that manifest decades later. The optimal age for HPV vaccination is early adolescence (ages 9-14), and it is estimated that if 90% of girls worldwide received the HPV vaccine, more than 40 million lives could be saved in the next hundred years. However, it is estimated that only 15% of girls worldwide received the vaccine in 2019.

Premature Pregnancy and Childbearing

In developing countries, approximately 12 million girls aged 15-19 years and at least 777,000 girls under the age of 15 have preterm births each year. Complications during pregnancy and childbirth are one of the leading causes of death among girls aged 15-19 worldwide.

According to the UN Population Division, the global teen birth rate in 2020 was 41 births per 1,000 adolescent girls, with country rates ranging from 1 to 200 births per 1,000 girls (5). This indicates a significant decline in the number of adolescent births since 1990. In parallel with this decline, the maternal mortality rate for girls aged 15 to 19 years has also declined.

One of the targets of the Sustainable Development Goal health-related goal (SDG 3) is to achieve global universal access to sexual and reproductive health services by 2030, including family planning services, information and education, and the integration of reproductive health into national policies and programmes.

Adolescents have a right to the comprehensive sexuality education they need, which is a formalized learning process of teaching and learning about the cognitive, emotional, physical and social aspects of sexuality. Improving access to contraceptive information and services can reduce premature pregnancies and births at too young an age among girls. Introducing and enforcing legislation that sets the minimum age for marriage at 18 can help.

If teenage girls become pregnant, quality prenatal care must be provided. If allowed under current law, adolescents who choose to terminate a pregnancy should have access to safe abortion services.

Nutrition and micronutrient deficiencies

In 2016, iron deficiency anemia was the second leading cause of lost years of life among adolescents due to death and disability. In addition, iron and folic acid supplements promote the health of adolescents who will eventually become parents. In areas where intestinal helminths such as ankylostomas are common, regular deworming is recommended to prevent micronutrient deficiencies (including iron).

Forming healthy eating habits in adolescents is the basis of good health in adulthood. Combating food advertising that is high in saturated fats, trans-fatty acids, free sugars and salt, and increasing access to healthier foods and creating opportunities for physical activity are important for all age groups, but especially for children and adolescents.

Malnutrition and obesity

Many boys and girls in developing countries enter adolescence chronically undernourished, making them more vulnerable to disease and the risk of premature death. In parallel, the number of overweight or obese adolescents in both low- and middle-income and high-income countries is increasing.

Globally, about 1 in 6 adolescents aged 10-19 years were overweight in 2016. The prevalence of overweight in different WHO regions ranges from less than 10% in the Southeast Asia Region to over 30% in the Region of the Americas.

Physical Activity

Physical activity has fundamental health benefits for adolescents, such as improving respiratory, cardiovascular, muscular and bone health, maintaining a healthy body weight, and enhancing psychosocial well-being. The WHO recommends that adolescents should average at least 60 minutes of moderate to vigorous physical activity daily during the week in the form of games, sports, and active modes of transportation (such as bicycling and walking) or physical education.

Globally, it is estimated that only one in five adolescents can meet these recommendations. A high prevalence of physical inactivity is found in all WHO regions, with higher rates among adolescent girls than boys.

In order to increase physical activity levels nationally, society at large and local communities must create safe and supportive environments and opportunities for all adolescents to engage in physical activity.

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