Transforming Mental Health Systems for Youth: An Unavoidable Priority

The transition from adolescence to adulthood is the peak period for the onset of mental and substance use disorders that have a serious impact on the productive years of adult life. About 30 years ago, the “WHO Burden of Disease Study,” developed to estimate prevalence, severity, and treatment of mental disorders in 14 countries, suggested that “mental illnesses are the chronic diseases of the young,” and pointed out the needs to move to the value of treating mild cases, especially in young at risk for progressing to more serious disorders. In recent years, the mental health of young people has been steadily undermined by several socioeconomic forces, and concerns have increased during the coronavirus disease-2019 (COVID-19) pandemic, with data documenting the wave of distress, mental illness, and suicidal behavior flowing into emergency departments. Thinking about the reallocation of treatment resources, these early stages of illness need to be targeted for preventive interventions to be most effective. A clearer definition of these early stages is essential to guide clinicians in selecting the most appropriate treatments to the phase of the illness, with the assumption that interventions delivered during this period will be both more effective and less harmful than treatments delivered later. We must acknowledge the magnitude of the problem and reallocate treatment resources to substantially decrease the unmet needs of mental disorders, overcoming structural barriers to this reallocation. In an under-resourced mental health system, considering that young people are often reluctant to seek help from mainstream health services, digital technologies can be useful to detect emerging mental disorders outside established clinical pathways, and constitute an important prerequisite for population-based preventive approaches.