SINGAPORE — Youths today are more mentally unhealthy than their parents or grandparents, but not because they are weaker or softer, said mental health experts at a conference here on Wednesday (Oct 4).

Rather, this is due to rising uncertainties in the world that youths have grown up in, said the experts, one of whom warned that the rapid rise of mental health illnesses among young people should be seen as the most urgent public health threat of the day.  

Speaking at the Singapore Mental Health Conference, the experts suggested that early intervention and tailoring mental health services to youths are vital to tackling the issue.

Professor Patrick McGorry of the University of Melbourne said that to help youths adequately manage the “maelstrom of adolescence and emerging adulthood”, mental health services have to “build a bridge between childhood and adulthood”.

And when planning mental health services, “their needs should be taken into account right from the inception”, said Ms Janhavi Vaingankar, the deputy director of research at Singapore’s Institute of Mental Health (IMH).

These include creating more “pleasing” and casual spaces, such as using beanbags instead of chairs and allowing youths to choose whom they want to share their information with.

Associate Professor Swapna Verma, the chairman of IMH’s medical board, emphasised that the best way to help youths with their mental health is to listen to them. 

YOUTHS ARE MORE DEPRESSED THAN EVER

Prof McGorry said that today’s young people are more anxious and depressed because they have inherited a “raw deal” from previous generations. 

He cited factors such as the impending climate crisis, rising housing costs and university fees, the treacherous landscape of social media and growing inequality — all of which have taken a toll on youths.

“It’s not that they are a soft generation. They were just the same as us when we were young. But the situation changed around them. Sure, there isn’t a world war. But the insecurities around young people are unprecedented, and it’s really affecting them,” said Prof McGorry, who is also the executive director of Orygen, a non-profit research institute and platform for preventive clinical care in young people. 

Furthermore, youth mental health was a neglected area within psychiatry for a long time, as mental health services tend to focus more on young children and adults, he noted.

Assoc Prof Verma noted that in Singapore, the age group of 18 to 34 had the highest prevalence of mental health disorders such as depression, bipolar and obsessive-compulsive disorders, anxiety, and alcoholism, according to the 2016 Singapore Mental Health Study. 

While the median age of onset for mental illness in Singapore was 22 in 2010, much later than the World Health Organization (WHO) figure of 15, a second study in 2016 found that the age of onset for mental illness had gotten younger at 21.

“It’s probably the most important public health crisis,” said Prof McGorry.

“If you don’t (help them) get better, you’re left with a whole cohort of middle-aged people who have got chronic medical illnesses. How do we turn off that tap? How do we shrink that cohort of people who struggle their whole lives with mental illness?”

YOUTHS ARE THE MAIN STAKEHOLDERS

When designing ideal mental health services, young people’s needs and perspectives have to be prioritised alongside expert input, the experts said.

“A lot of them (youths) are worried that what they share during this session will be shared with their teachers and parents without their knowledge,” said Ms Janhavi.

To create safe sharing spaces, youths should be able to choose who they feel most comfortable to share information with, be it a trusted teacher or an adult and not be made to explain their choice. While teachers, parents and school counsellors can work together to help the young person they are responsible for, information shouldn’t be an “open book” between the adults, says Ms Janhavi.

She added that mental health services should also have flexible hours with 24-hour care plans and services at night, seeing as youths with anxiety tend to have issues crop up at night when most mental health services are unavailable.

Prof McGorry, meanwhile, suggested using the medical concept of clinical staging, which is used to treat severe medical conditions such as cancer.

Under this concept, each stage of mental illness is identified correctly and given the appropriate treatment.

He cited Headspace, an Australian non-profit organisation for youth mental health, where the first stage is a “stigma-free” entry into enhanced primary care for youths with mild to moderate mental health conditions or early stages of disorders. 

With more serious conditions such as psychosis, borderline personality disorder, anorexia or complex mood disorders, patients would be given the next tier of care, which is more specialised and sustained, Prof McGorry added.

Besides accessibility and creating psychological safety, the difficulty in getting consent is one of the barriers for youths to come forward, said Assoc Prof Swapna.

“(Youths) still have difficulty accessing services without parents’ consent,” she said. “Stigma and lack of mental health literacy, especially with parents, really seem to be barriers to mental health services.” 

This is one reason why the Centre of Excellence for Youth Mental Health has launched a chat service available from Tuesday to Saturdays, 12pm to 9pm to allow youths aged 16 to 30 here with mental health issues to get help.

“We want to kind of build that scaffolding around them and train new workers and caregivers as well,” said Assoc Prof Swapna. 

She stressed the importance of visibility of mental health services, saying that social media, student campaigns, talks and workshops conducted in schools are instrumental in building awareness among youths. 

“When we are building up services for youth mental health, the key stakeholders are the young people and their parents, and it’s very important to listen to them.”