How can we improve young people's mental health?
PodcastsThe Naked ScientistsHow can we improve young people's mental health?Mind the gap: how mental health has always been the poor relation of physical health. . . 10 June 2025The mental health of the young is. . .
PodcastsThe Naked ScientistsHow can we improve young people's mental health?Mind the gap: how mental health has always been the poor relation of physical health. . . 10 June 2025The mental health of the young is reaching breaking point, globally. A recent analysis by a panel of leading researchers, young people, and policy experts, has warned that, without targeted action, by 2030, 42 million years of healthy life could be lost to mental illness or suicide; that’s two million more than ten years ago. So today we're asking, why are so many young people suddenly afflicted by a decline in their mental health and wellbeing, and what are the solutions?Lancet Commission cause for adolescent mental health concernSarah Baird, George Washington UniversityThe latest Lancet Commission on Adolescent Health and Wellbeing found that rates of anxiety, depression, and other mental disorders are rising across every region in the world. The key aggravating factors appear to be constant digital exposure, climate anxiety, and social instability, which are not only reshaping the world we live in, but the landscape of youth mental health. Sarah Baird, at George Washington University, is the Commission’s co-chair…Sarah - Mental disorders and expressions of distress, such as self-harm, are the largest cause of disease burden among adolescents across all countries. We use the term "disability-adjusted life years", and they were associated with 42. 4 million disability-adjusted life years as of 2022, which is close to a fifth of the total disease burden among adolescents, so really driving their wellbeing today. James - Those are big numbers. Is this a problem that's getting worse?Sarah - Yes, 100%. I think there are still challenges with data collection, particularly in low and middle-income countries. But without a doubt, there are increases in mental ill health across the board. We're seeing increases, whether it's in anxiety or suicide. It's really across the spectrum of mental health disorders. We also see that it manifests differently between boys and girls, with increases among girls particularly around depression and what are called more internalising behaviours, while for boys, it tends to present more in conduct disorder and misbehaving — these more external expressions. James - That's interesting. If you were to listen to the public conversation around this, you'd get the impression that the digital environment is potentially a big factor — the one that our children are growing up in now. Is that something the commission looked into?Sarah - Yes. We spent quite a bit of time discussing the role of the digital transition and its connection to increases in mental health issues. It's a very complicated space with, as I'm sure you know, many people on both sides of the debate. My sense is that there are components of the digital space that are likely harmful for young people — whether that's misinformation, harmful content, or links to physical activity (i. e. screen time replacing time outdoors). But we also see a lot of benefits from access to digital technology, and the increasing trend in mental health issues began well before this massive growth in digital use. So I think there are some important linkages, but it would be incorrect to say that the digital transition alone has caused this increase in mental health problems. James - So it's not all social media. What other factors have you identified as responsible for the growing disease burden of mental health in adolescents?Sarah - Another thing to consider are what we call "megatrends": climate change, conflict, and the COVID-19 pandemic, and the roles they play in adolescent mental health. Decreases in biodiversity and declining green space have adverse impacts on mental health. The effects of the COVID-19 pandemic are still very present today; social isolation, lack of access to schools, and what seems like a daily increase in global conflict are all directly linked to mental health. These megatrends are clearly playing a strong role in influencing adolescent mental wellbeing. James - Aside from being the source of a lot of suffering for young people, what's the effect of poor mental health in youth on someone's prospects across their life?Sarah - One of the reviews we conducted looked for high-quality longitudinal studies, and we found strong associations between adolescent mental ill health and a wide range of outcomes in adulthood — including adult mental health issues, and a broad set of physical outcomes. For example, issues with sleep, obesity, blood pressure, or migraines in adulthood. James - Purely from an economic standpoint, then, it makes sense to invest in young people's mental health. Is that reflected in the provision of services?Sarah - No, and for those of us working in the adolescent space, that's the argument we've been trying to make — this is a win-win. You're improving their mental health now, which has long-lasting effects throughout adulthood, including their productivity and the well-being of the next generation. But investments in adolescent health and well-being overall are dire. When you look specifically at mental health, the global funding for adolescent mental health is shockingly low. For example, when we look at development assistance — investments by high-income governments or multilaterals into mental health in low and middle-income countries — we find that, on average, investment is only about 7 cents per adolescent. James - We're exploring the idea that disentangling physical and mental ill health is less clear-cut than previously thought. I know your commission focuses on well-being overall as well. Sarah - Yes, and I think when you reflect on how our day-to-day lives function, these aspects are intricately linked. Another trend we note in the commission is the extremely high rates of overweight and obesity, which are projected to increase in future. There are strong links between obesity and adverse mental health outcomes. So ultimately, investing in mental health is beneficial for physical health, and vice versa. The more we consider these linkages, the more progress we can make — especially in preventative measures that address both mental and physical health. Early interventions for young people's mental healthTamsin Ford, University of CambridgeNow we know the scale and some of the causes and outcomes linked to the problem, how should we go about fixing it? Tamsin Ford is a professor of child and adolescent psychiatry at the University of Cambridge. She argues that we need to become much better at spotting the problem in the first place, perhaps before it becomes severe and harder to manage. But we seem to have a problem doing that. Why? And, on the flip side, are we overdiagnosing variants of normal?Tamsin - I think they're harder to spot because we don't train people and encourage people to look for them, because actually some physical health conditions are very subtle. You can't go anywhere near a hospital or a clinic or a GP surgery without someone taking your blood pressure, and that is because we know strokes and heart attacks are so devastating. There are simple questions you can ask and simple assessments that can be done that would quickly, efficiently and effectively identify the children who are struggling. It's just that we need to make it part of the care that we offer everybody. James - We're talking about interventions. With limited resources and the interplay we're keen to stress in physical and mental health, perhaps those who we've identified who have physical health conditions might be appropriate to target. Tamsin - Yes, it depends a little bit on what condition you have. If you have a condition that involves your brain or spinal cord, the likelihood of having a mental health condition is huge. It's approaching half of those affected in childhood and adolescence. For pretty much every medical condition, it's two or three times more common. James - Given all that, where is the best place that we can direct our resources to be able to make the crucial differences?Tamsin - I think we need to go to where children and young people are. If they're ill enough to require admission to hospital, that places them at quite high risk. Every contact between a child and their family and a practitioner is an opportunity to detect a child who's struggling and to intervene, to alter their developmental trajectory for the better. We are really lucky in the mental health field in that we have a lot of evidence-based interventions that are highly effective. I think where we lack sometimes is the workforce, and we need to get smart. So Cambridge was involved as a site in a study where we trained epilepsy nurses to deliver from a manual of evidence-based treatments for anxiety, depression, and behaviour problems. There were almost no exclusions to that trial, so any child with epilepsy who had a mental health condition on a standardised assessment got access to the intervention, and it was effective and cost-effective a year or two later. James - There are going to be children with specific needs that we need to target as well as those broader ones. How would we go about that?Tamsin - Well, I think coming back to this mental health intervention and children with epilepsy, there were children who had autism in that trial. You don't necessarily have to personalise a huge amount or adapt a huge amount in order for the treatment to be effective. So I think adaptation with fidelity to the context that the child is in is really important. It's part of having personalised interventions. However, it is important that you follow the manual. You can't completely throw the manual out the window. You do need to stick to what the evidence is. I think being aware and being able to deliver a psychological therapy, a talking therapy, from a manual to different people—whether they have autism, whether they have ADHD—you know, medicine is both an art and a science, and part of the art of mental health is being able to do that personalisation whilst keeping the evidence-based core of the intervention. James - Are you therefore encouraged, not encouraged by the increase in diagnosis itself, but the increase, I suppose, in ascertainment of neurodivergence—autism, ADHD—because there are some voices who would argue that we're starting to pathologise what are natural differences in young people especially. So keen to get your views on that. Tamsin - It is a really hot topic. It is one that deeply worries me. There is no doubt we've had a massive increase in diagnoses of both autism and ADHD. We've also had a massive increase in prescriptions of ADHD medication, which we should be right to examine. In fact, our own government-supported official statistics on the number of children with mental health conditions demonstrate that there hasn't been an increase in the number of children in the population who have ADHD or autism, but those who are getting medication for ADHD have gone from 30% to 60%. There was no evidence of over-prescription. So there wasn't a single child in this national survey of more than 9,000 children—there was no evidence of children who didn't have ADHD being prescribed ADHD medication. So yes, our prescriptions have gone up and the demands for diagnosis have gone up, but we are not seeing evidence that we are pathologising people who do not have problems. We have more people coming forward because I think people are more aware, and that is a good thing, but we do need to try and sort the problem out with assessment taking years, because whilst people are waiting for that diagnosis, they're often not getting the support they need. And that's another thing we can correct—helping empower schools and other places to put in support for people before they get the diagnosis. Why wait, particularly if it's going to take years? If you think there is a problem for a child with their attention, there's lots of stuff you can do.