The Importance of Early Intervention in Adolescent Mental Disorders

Early intervention is key in providing the best outcomes for adolescents who are experiencing problems with their mental health.

Unfortunately, some families still do not feel comfortable talking about mental health and some people believe there is still a stigma surrounding it. This article aims to raise awareness about the prevalence of mental health issues in today’s youth and will highlight the importance of early intervention. 

Adolescents thrive in safe and supportive environments and are more likely to reach out for help if they feel they will be taken seriously and given access to the right resources. In addition, adults need to be able to recognise the warning signs that an adolescent is struggling and may require intervention before the situation gets out of hand. 

Prevalence of Mental Health Disorders in Adolescents

Recent NHS data suggests that up to one in five children and young people in the UK experiences some form of mental health disorder, slightly higher than the World Health Organization’s estimate that suggests one in seven 10- to 19-year-olds have a diagnosable mental health condition. 

Young people and adolescents can suffer from a range of different mental health disorders and conditions, with symptoms ranging from mild to severe.

Some common mental health issues that affect today’s youth include:

• Depression
• Anxiety
• Eating disorders (for example anorexia and bulimia)
• Behavioural disorders (such as ADHD)
• Substance abuse disorders

Some less common mental health disorders that may affect youngsters include:

• Bipolar disorder
• Borderline personality disorder
• Schizophrenia

There is not always a clear reason why a young person develops a mental health disorder and it may be down to a combination of biological and environmental factors or a reaction to stress or trauma.  

The Impact of Untreated Mental Health Disorders

Both globally and at home, research has highlighted some shocking statistics about young people’s mental health:

• Suicide is now the fourth leading cause of death among 15- to 29-year-olds in the world.
• Children in care are more likely than their peers to experience a mental health difficulty, according to the NSPCC.
• Children who have experienced living in care in the UK may be four times more likely to have a diagnosable mental health condition.
• More than 20% of 8- to 16-year-olds had a probable mental health disorder in 2023.
• American data suggests 2.7% of teens will experience an eating disorder in their lifetime.
• Anorexia nervosa has the highest mortality rate of any mental illness.

Untreated mental illness can have a serious impact on the lives of young people and can lead to severe emotional, behavioural and physical problems, such as: 

• Impact on academic performance
• Social problems
• Increased risk of antisocial behaviour

Failing to intervene and treat a mental health condition will often mean that symptoms get worse and that the chances of recovery are reduced. Inadequate resources or support for mental health problems can have a lasting impact on young people, which may cause issues that continue to affect them during their adult life. 

Mental health also puts a significant economic burden on the country; therefore, it stands to reason that early intervention and treatment will have long-term benefits for wider society.

A short snapshot of statistics relating to the cost of mental health:

• The cost of mental health problems is equivalent to around 5% of UK GDP.
• A report by The Mental Health Foundation and the London School of Economics and Political Science, suggests mental health costs the UK economy at least £117.9 billion each year.
• Economic activity due to long-term illness has reached a record high in 2023/24.
• Data from the ONS shows that more than 560,000 people aged 16-34 were economically inactive in the first three months of 2023, over a third of these citing mental health as a reason.
• The proportion of young people out of work due to mental health has almost doubled since 2012.
• Depression and anxiety are the most commonly cited conditions in young people who are out of work due to mental health reasons.

Early Warning Signs and Identification

The warning signs of a mental health problem may vary between young people and may depend on what specific disorder they have. It is also important not to over-medicalise children who are showing typical signs of teenage rebellion, self-expression or pushing boundaries. If you are concerned about a child or young person, the best thing to do is to let them know that you care and that they can talk to you without judgement.

Some of the potential early warning signs to watch out for that might suggest a child is struggling with mental health problems include:

• Decline in academic performance
• Truancy
• Outbursts and anger
• Loss of appetite
• Weight loss or gain
• Self-harm
• Suicidal ideation
• Dangerous or risky behaviour
• Drug and alcohol misuse
• Problems sleeping or constant fatigue
• Escalation of symptoms

Some symptoms are clear evidence of a mental health condition and require immediate intervention such as a psychotic episode (hallucinations, hearing voices, disconnection from reality) or irrational behaviour that indicates someone is going to be harmed. There are usually warning signs before things escalate to this level and this is why it is important to take mental health seriously and provide early intervention. 

In an emergency you can contact your local crisis team or call 999; if you need help but it is not an emergency you can call 111 or access NHS 111 online. For non-emergency mental health problems your first port of call will likely be a visit to your GP. Your doctor will listen to any concerns and may:

• Provide a referral to talking NHS therapies (including cognitive behavioural therapy (CBT), counselling, self-guided help)
• Write a prescription for medication (antidepressants, antipsychotics, mood stabilisers)
• Make a referral to a specialist (psychiatrist, social services, eating disorder team)
• Suggest resources (leaflets, websites, charity organisations, drop-in groups etc.)

Although anyone can develop mental health issues, some adolescents may be more susceptible to them than others. Factors that may put some young people more at risk include:

• Being part of disadvantaged or marginalised societies
• A turbulent or unstable home life
• Growing up in poverty
• Childhood trauma, neglect or abuse
• Having a parent or sibling with a mental health condition
• Being in care
• Undiagnosed learning difficulties or neurodivergence
• Serious accident or head trauma

We know that early intervention in adolescent mental health disorders is key, as is understanding how to identify the signs and recognise children who are vulnerable. However, it is also important to address the root cause of mental health problems in youngsters. We need to be able to have honest conversations with young people about the topics that affect their mental health in 2024. Common anxieties that affect today’s youth may include:

• Negative self-image
• Social isolation
• Bullying (including cyberbullying)
• Peer pressure
• Problems at home
• The climate crisis
• Revenge porn/sexual exploitation
• Cost of living crisis

We know that only some mental health disorders are caused due to chemical or hormonal imbalances, therefore it is vital to address the social and environmental factors that contribute to poor mental health. This gives anyone suffering from a mental health disorder the best chance of recovery. 

Benefits of Early Intervention 

Early intervention improves outcomes for young people with mental health disorders. Some benefits of early intervention include: 

• Increased chances of symptom management and sometimes a full recovery
• Reduced risk of harm
• Reduced risk of the young person using unhealthy coping mechanisms (drugs, alcohol, self-harm etc.)
• Reduced impact on schooling
• Cost benefits to the NHS and government

Interventions and treatment for mental illness may include:

• Medication
• Psychotherapy
• Talking therapy (CBT)
• Support groups
• Changes at school (reduced timetable, home-schooling options)
• Family counselling

Eating a healthy balanced diet, taking multivitamins to reduce the chance of having a vitamin deficiency and getting regular exercise can help to boost mental wellbeing. 

Hormonal imbalances impact cortisol and may reduce serotonin levels which can exacerbate some mental health symptoms. Adolescents already suffer from raging hormones that cause mood swings and intense emotions. In some extreme cases, some teens may benefit from taking medication or supplements to help harmonise hormone levels. 

Timely Access to Mental Health Services 

Urgent referrals of under-18s to NHS mental health crisis teams reached record highs in 2023. Young people are routinely expected to wait weeks, months or even longer to access some non-urgent NHS treatment that they require for their mental health. 

The NHS currently publish access and waiting time metrics in three key areas that relate to adolescent mental health care:

• NHS Talking Therapies, for anxiety and depression
• Children and Young People (CYP) with an Eating Disorder (ED)
• Early Intervention in Psychosis (EIP)

When adolescents are experiencing mental health challenges it is vital that they receive help as soon as possible. Given the state of waiting times for NHS treatment, a holistic approach to adolescent mental health is necessary to provide much needed advice, support and intervention for children and their families. This may include support from:

• Schools and other academic institutions
• Community organisations and outreach programmes
• Charities
• Friends, peers and wider society

Children and young people spend up to 39 weeks a year in school. Teachers and other school staff have a responsibility to ensure that school is a safe and supportive environment. They also have a role to play in spotting the warning signs that a student is struggling with their mental health. 

Conversations about mental health can be built into the curriculum in RSHE lessons to open up discussion and reduce the stigma attached to talking about mental health. 

Schools also have a duty to involve parents in conversations about their child’s mental health (where appropriate), identify at-risk children and know how to signpost youngsters to the appropriate local services.

Both community organisations and charities have a role to play in reducing the barriers to care, in particular offering interim support whilst children languish on waiting lists. This support can take multiple forms including informal groups where people can talk about their feelings, art therapy sessions, nature therapy, mentoring programmes, outings etc. 

Teletherapy may also have a role to play in supporting young people with their mental health. Teletherapy can provide an accessible alternative to long waiting lists for in-person therapy. It is usually significantly more cost effective than other private therapy options. 

Teletherapy, also called online therapy or e-therapy, is accessed online via a computer or other mobile device. It allows people to receive their therapy sessions from a licensed professional in the comfort of their own home. Adolescents, who are digital natives, may feel less anxious and more open to engaging with therapy that is technology assisted.

Teletherapy services may be offered in a variety of ways, such as: 

• Via video link/webcam chat
• Online voice call
• Email
• Text message
• Online chat
• Via an app

Youngsters can make use of teletherapy options for a number of conditions such as anxiety, depression, anger management, addiction issues and eating disorders. Fans of teletherapy often highlight its:

• Affordability (in comparison with some private services)
• Privacy
• Accessibility
• Convenience

Some research has found that e-therapy is as effective as traditional, in-person therapy. Some studies have found that online cognitive behavioural therapy for depression can be even more effective than in-person CBT. 

Teletherapy isn’t for everyone and some youngsters may find a greater benefit from in-person sessions or from using e-therapy in conjunction with other interventions, such as taking medication and attending support groups. 

Despite the vital roles that schools, charities, grass roots organisations and online therapy can play in supporting young people with their mental health, some adolescents will still require specialist care from a clinician. Therefore, reducing the long waiting times that act as a barrier for young people to get the care they need is crucial. 

At the end of 2023 there were more than 1.8 million people waiting for appointments for NHS mental health services. Exactly how these waiting times will be reduced remains to be seen, although some options include the recruitment of more specialists in this area, better training, a cash injection from the government or the opening up of private services for some NHS patients.