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      A growing need for youth mental health services in Canada: examining trends in youth mental health from 2011 to 2018

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      , , , , , ,
      Epidemiology and Psychiatric Sciences
      Cambridge University Press
      Adolescents, mental health, population survey, psychiatric services

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          Abstract

          Aims

          The mental health of youth is continually changing and requires reliable monitoring to ensure that adequate social and economic resources are allocated. This study assessed trends in mental health among Canadian youth, 12–24 years old. Specifically, we examined the prevalence of poor/fair perceived mental health, diagnosis of mood and anxiety disorders, suicidality, perceived stress and sleep problems, substance use, and mental health consultations.

          Methods

          Data were collected from eight cycles of the annual Canadian Community Health Survey (2011–2018). Prevalence of mental health outcomes was calculated from each survey, and meta-regression was used to assess trends over time. In the absence of a significant trend over time, the eight cycles were pooled together using meta-analysis techniques to gain precision. Trends in prevalence were assessed for the overall sample of youth (12–24 years) and separately for male and female adolescents (12–18 years) and young adults (19–24 years).

          Results

          The prevalence of poor/fair perceived mental health, diagnosed mood and anxiety disorders, and past-year mental health consultations increased from 2011 to 2018, most strongly among young adult females. Past-year suicidality increased among young adult females but did not change for other age and sex groups. Notably, the prevalence of binge drinking decreased by 2.4% per year for young adult males, 1.0% for young adult females and 0.7% per year for adolescent males, while staying relatively stable for adolescent females. Prevalence of cannabis use declined among adolescents before legalisation (2011–2017); however, this trend did not persist in 2018. Instead, the 2018 prevalence was 5.6% higher than the 2017 prevalence (16.3 v. 10.7%). The combined prevalence of other illicit drug use was stable at 4.6%; however, cocaine use and hallucinogens increased by approximately 0.2% per year.

          Conclusions

          Our findings highlight a growing need for youth mental health services, as indicated by a rise in the prevalence of diagnosed mood and anxiety disorders and past-year mental health consultations. The reason for these observed increases is less apparent – it may represent a true rise in the prevalence of mental illness, or be an artefact of change in diagnostic practices, mental health literacy or diminishing stigma. Nonetheless, the findings indicate a need for the health care system to respond to the rising demand for mental health services among youth.

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          Most cited references33

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          Sex differences in anxiety and depression clinical perspectives.

          Sex differences are prominent in mood and anxiety disorders and may provide a window into mechanisms of onset and maintenance of affective disturbances in both men and women. With the plethora of sex differences in brain structure, function, and stress responsivity, as well as differences in exposure to reproductive hormones, social expectations and experiences, the challenge is to understand which sex differences are relevant to affective illness. This review will focus on clinical aspects of sex differences in affective disorders including the emergence of sex differences across developmental stages and the impact of reproductive events. Biological, cultural, and experiential factors that may underlie sex differences in the phenomenology of mood and anxiety disorders are discussed.
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            • Abstract: not found
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            Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005–2017.

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              Recent increases in depressive symptoms among US adolescents: trends from 1991 to 2018

              Mental health problems and mental health related mortality have increased among adolescents, particularly girls. These trends have implications for etiology and prevention and suggest new and emerging risk factors in need of attention. The present study estimated age, period, and cohort effects in depressive symptoms among US nationally representative samples of school attending adolescents from 1991 to 2018. Data are drawn from 1991 to 2018 Monitoring the Future yearly cross-sectional surveys of 8th, 10th, and 12th grade students ( N = 1,260,159). Depressive symptoms measured with four questions that had consistent wording and data collection procedures across all 28 years. Age–period–cohort effects estimated using the hierarchical age–period–cohort models. Among girls, depressive symptoms decreased from 1991 to 2011, then reversed course, peaking in 2018; these increases reflected primarily period effects, which compared to the mean of all periods showed a gradual increase starting in 2012 and peaked in 2018 (estimate = 1.15, p < 0.01). Cohort effects were minimal, indicating that increases are observed across all age groups. Among boys, trends were similar although the extent of the increase is less marked compared to girls; there was a declining cohort effect among recently born cohorts, suggesting that increases in depressive symptoms among boys are slower for younger boys compared to older boys in recent years. Trends were generally similar by race/ethnicity and parental education, with a positive cohort effect for Hispanic girls born 1999–2004. Depressive symptoms are increasing among teens, especially among girls, consistent with increases in depression and suicide. Population variation in psychiatric disorder symptoms highlight the importance of current environmental determinants of psychiatric disorder risk, and provide evidence of emerging risk factors that may be shaping a new and concerning trend in adolescent mental health.
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                Author and article information

                Journal
                Epidemiol Psychiatr Sci
                Epidemiol Psychiatr Sci
                EPS
                Epidemiology and Psychiatric Sciences
                Cambridge University Press (Cambridge, UK )
                2045-7960
                2045-7979
                2020
                17 April 2020
                : 29
                : e115
                Affiliations
                [1]Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary , Calgary, Alberta, Canada
                Author notes
                Author for correspondence: Kathryn Wiens, E-mail: kathryn.wiens@ 123456mail.utoronto.ca
                Author information
                https://orcid.org/0000-0003-3451-6788
                https://orcid.org/0000-0001-9871-4041
                Article
                S2045796020000281
                10.1017/S2045796020000281
                7214527
                32299531
                e23da6ae-3a2d-4efa-9d7f-f0ecb327eeb3
                © The Author(s) 2020

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence ( http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.

                History
                : 01 October 2019
                : 22 February 2020
                : 09 March 2020
                Page count
                Figures: 5, Tables: 1, References: 40, Pages: 9
                Categories
                Original Articles

                adolescents,mental health,population survey,psychiatric services

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