February 12, 2007

Treating and Preventing Adolescent Mental Health Disorders

Treating, Preventing Adolescent Mental Health Disorders - What we Know and What we Don't know.

Adolescents in the United States are more likely to suffer from a mental health disorder than ever before, but getting these teens diagnosed and cared for is a challenge that is not being met, suggests a book that is now available for free on the Internet. The book was reviewed in the Journal of the American Journal of Psychiatry in 2006 and more recently in the Journal of the American Medical Association - and has gotten excellent reviews in each. Now everyone can read the book online. While the book is a rather technical book (perhaps ideally suited for medical professionals, mental healthcare workers and university undergraduate and graduate students) - it may still be of value for people who want to understand the deeper issues around treating and preventing mental health disorders.

The book notes that one out of 10 adolescents in the U.S. struggles with a mental health problem severe enough to cause significant impairment, according to federal estimates. Yet those on the front lines of treatment and research encounter large gaps in knowledge about the problem.

In an attempt to improve understanding, more than 100 internationally respected experts in adolescent mental health were convened by the Annenberg Adolescent Mental Health Initiative to assess what is known - and not known - about this important public health issue. The result of that dialogue among physicians, psychologists and scholars is this book.

The book is titled Treating and Preventing Adolescent Mental Health Disorders: What We Know and What We Don't Know - A Research Agenda for Improving the Mental Health of Our Youth (Oxford University Press), in which 150 mental health specialists analyze recent research on teen mental health problems.

This team of reseaarchers and other experts found while one in five adolescents suffer from a mental health disorder, treating them is not a priority on the nation's public health agenda, and there is limited knowledge about how to best help them. The result: disorders are frequently undiagnosed or misdiagnosed, or teenagers receive treatment whose effectiveness has been mostly studied in adults.

"Teenagers are being neglected by our society, both medically and emotionally," said the book's lead author, Dwight L. Evans, MD, an expert on mood disorders and Psychiatry Department Chair at the University of Pennsylvania School of Medicine. "Without more research that targets this very malleable age group -- and without early detection and prevention services to get them the help they need -- this mental health crisis will only get worse."

* Between 20 and 30 percent of adolescents report symptoms of depression. While depression once was considered an "adult" affliction, the mean age of onset today is 15.

* An estimated 1.1 million teenagers, ages 12 to 17, needed substance abuse treatment in 2001. Of that number, only 100,000 actually received it.

* Almost 9 percent of high school students have attempted suicide in the past year.

Early diagnosis and treatment of mental health disorders increase the likelihood that the teenager can lead a productive adult life. And, the experts report, most prevalent adolescent disorders are treatable. But delivery of treatment is by no means assured. For example:

* Schools are the de facto mental health service delivery system for children and adolescents. But the level of services available is poor, and varies widely. Of 2,000 schools surveyed as part of this project, slightly more than half had full-time access to a mental health professional.

* Primary-care physicians - who can serve as a gateway to specialized treatment - often are inadequately trained to identify and diagnose mental health problems, according to another study conducted for the book. Many physicians expressed low confidence in their abilities to detect mental disorders among adolescents in their care.

These findings and recommendations also inform a new series of books written for parents.

The book, aimed at mental health practitioners and researchers, is a project of the Adolescent Mental Health Initiative of the Annenberg Foundation Trust at Sunnylands and the Annenberg Public Policy Center at the University of Pennsylvania. The publisher is Oxford University Press.

University of Pennsylvania President Amy Gutmann heralded the collaboration of scholars and scientists from Penn and around the nation. "By combining the knowledge and experience of many people in many disciplines, we have created a valuable tool that will benefit a large segment of our population, young people."

Many mental disorders begin during adolescence and carry over into adulthood, leading to significant long-term impairment. Although early intervention shows promising results, it often is not available.

"Adolescent mental health in the United States is, simply put, much poorer than it ought to be," conclude the two experts.

As a companion to Treating and Preventing Adolescent Mental Health Disorders, the Adolescent Mental Health Initiative and Oxford University Press has published four paperback titles aimed at parents. If Your Adolescent Has Depression or Bipolar Disorder and If Your Adolescent Has an Eating Disorder; If Your Adolescent Has Schizophrenia and If your Adolescent Has an Eating Disorder. The Adolescent Mental Health Initiative also maintains a mental health website for teens, www.copecaredeal.org

"The reports provide a hopeful assessment of our ability to treat the most prevalent adolescent disorders," writes Kathleen Hall Jamieson, director of the Annenberg Public Policy Center and program director of the Annenberg Foundation Trust at Sunnylands, in the conclusion of Treating and Preventing Adolescent Mental Health Disorders. "At the same time, enormous hurdles remain in our ability to deliver these treatments, and our knowledge base of effective treatments still has important gaps. These considerations suggest that we face formidable challenges if we wish to ensure the healthy development of our youth."

See the links below where the entire book is available for viewing:

Treating and Preventing Adolescent Mental Health Disorders (book)

Part II. Schizophrenia

Chapter 5. Defining Schizophrenia - Full Text

Chapter 6. Treatment of Schizophrenia - Full Text

Chapter 7. Prevention of Schizophrenia - Full Text

Chapter 8. Research Agenda for Schizophrenia - Full Text

Related Reading: Uncovering an Epidemic - Screening for Mental Illness in Teens


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