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Why adolescent mental health is an underestimated menace

Interventions on this front would considerably reduce mental & physical disability, meaning that people can lead more fruitful, productive lives, and contribute more to society, including economically

  Fifteen crore people in India are in need of mental health interventions and care, yet mental health is seldom part of the conversation on public priorities. Early intervention is particularly important: globally 10 to 20 percent of children and adolescents experience mental health disorders, and three-quarters of all mental illnesses emerge by the mid-20s.
 
According to the Copenhagen Consensus report, while the importance of physical health of adolescents, especially adolescent girls has been gaining ground in recent years, mental health remains a neglected and often taboo area.
 
Researchers (S.D Gupta, Md Mahbub Hossain, Neeraj Sharma, PR Sodani, and DK Mangal from IIHMR University, Jaipur) note that a lack of awareness about mental health often means that people do not access the services that they need, and only those patients with severe mental disorders are diagnosed and treated.
 
Untreated mental health conditions in adolescence can carry for-ward and worsen. It is extremely important to identify signs of trauma or disturbance and offer adequate counselling before these develop into a more serious condition requiring medication.
 
Abuse and violence often cause trauma and mental health conditions, and evidence shows that domestic violence for in-stance is one of the strongest predictors of suicide amongst girls.
 
While there are gaps in the evidence on adolescent mental health, the National Mental Health Survey of India showed mental disorders among 7.3 percent of children aged 13-17, with prevalence in urban metros nearly double (13.5 percent) that of rural areas (6.9 percent).
 
Major illnesses include depressive disorders (2.6 percent), disabilities affecting intellectual status (1.7 per-cent), agoraphobia (2.3 percent), autism (1.6 percent), psychotic disorders (1.3 percent) and phobic anxiety disorders (1.3 per-cent). Early recognition and intervention can improve outcomes.
 
 

 
 
The researchers propose a screening, referral and treatment intervention for classes VI to XII at private and public schools, roughly covering children aged 11-17. Participation would be voluntary, requiring the consent of the adolescent and their parent or guardian.
 
Costs would include human resources for screening, material development and dissemination, along with clinical assessment, linkage to specialized care providers, and mental health services. In Andhra Pradesh, assuming that 80% of adolescents took part, enrolment and screening would reach 32.57 lakh young people, and about 5.86 lakh youths would be expected to require clinical evaluation. Including treatment for the roughly two lakh adoles-cents that would be anticipated to require it, the total annual cost of the intervention amounts to ₹122 crores.
 
In Andhra Pradesh, it is reasonably expected to stop about 164 young deaths from self-harm each year.
 
Mental Health also adversely affects the learning, education and social development of children. Interventions on this front would therefore also considerably reduce mental and physical disability, meaning that people can lead more fruitful, productive lives, and contribute more to society, including economically. The researchers calculate that, put into monetary terms, all these benefits are worth ₹296 crores to the Andhra Pradesh economy.
 
Investment in adolescent mental health not only ‘breaks even’ but is a solid investment and generates returns to society worth more than two rupees for every rupee spent. Adolescent physical health is also crucial, and the researchers highlight the benefits from focusing on anaemia, which affects many Indian girls.
 
Iron deficiency reduces physical fitness, which affects academic performance. In the long run, this affects maternal and child health and further increases the burden of disease.
 
A notable measure to address this challenge across India among 10 to 19-year-olds is the Weekly Iron and Folic Acid Supplementation which includes supervised consumption of iron and folic acid supplements with biannual deworming medications.
 

 
The researchers conduct a cost-benefit analysis for a program similar to this, but focused just on girls, for whom anaemia is a larger problem.
 
In Andhra Pradesh, more than 30 lakh adolescent girls suffer from anaemia, and 80 thousand from severe anaemia. The intervention  is expected to reduce prevalence of all forms of anaemia from 69 percent to 40 percent, averting 13 lakh cases. With a total program cost of ₹44 crores each year, benefits would be worth nearly 15-times more.
 
This makes a strong case to take both adolescent physical and mental health seriously.
 

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