01. Youth mental health and wellbeing
Youth mental health is conceptualised as a state of well-being in which a youth realises his or her own abilities, can cope with normal stresses of life, can work productively and fruitfully, and is able to make some contributions to his or her community. An emphasis is placed on developmental aspects, such as having a positive sense of identity, the ability to manage thoughts, emotions, as well as to build social relationships, and the aptitude to learn and acquire an education, ultimately enabling youth full and meaningful participation in society. Whereas youth mental wellbeing is the combination of feeling good, which incorporates not only the positive emotions of happiness and contentment, but also such emotions as interest, engagement, confidence, and affection; and functioning effectively, which incorporates the development of one’s potential, having some control over one’s life, having a sense of purpose and experiencing positive relationships.
A mental illness is when a person has the ongoing symptoms that cause frequent distress and affect his or her ability to function. Mental illness can influence the way a person thinks, feels, behaves and/or relates to others. Mental illness can refer to a wide range of conditions that affect a person’s mood, thinking, behaviour. And if ongoing symptoms become more severe, a person may then meet the definition of having a mental disorder, which is the legal definition. The presence of a mental, emotional, behavioural, substance use disorder is described as clinically significant condition characterised by alterations in thinking, emotions, behaviour associated with personal distress and/or impaired functioning. Such abnormalities must be sustained or recurring, and they must result in some personal distress or impaired functioning in one or more areas. They are characterised by specific symptoms, and usually follow a more or less predictable natural course, unless interventions are made (WHO, 2001).
So, the more risk factors youth are exposed to, the greater the potential impact on their mental health. The factors which can contribute to stress include exposure to adversity, pressure to conform with peers and exploration of identity. Media influence and gender norms, and quality of peer relationships can exacerbate the disparity between a youth's lived reality and their aspirations for the future. Exposure to racial and gender discrimination, racism, violence (especially bullying as well as sexual and gender-based violence), harsh parenting and socioeconomic problems are recognised risks to youth mental health. Hence, determinants of youth mental health and wellbeing include not only individual attributes such as the ability to manage one’s thoughts, emotions, behaviours, and interactions with others, but also the social, cultural, economic, political, and environmental factors such as national policies, social protection, living standards, working conditions, and community social supports.
02. Mental health risk and protective factors
Mental illnesses are mental health problems that affect the way we think about ourselves, relate to others, and interact with the world around us. They affect our thoughts, emotions, feelings, and behaviours. Mental illnesses can disrupt a person’s life or create severe challenges, but with the right supports, a person can get back on a path to recovery and wellness. It is important to understand that there are many and different types of mental illnesses that affect people in different ways. So, within each mental illness, people might have very different symptoms and challenges. However, symptoms are just one piece. Access to services, support from loved ones, and the ability to participate in communities play a big part in the way people experience mental illnesses. Moreover, culture values, social and gender norms, and personal beliefs also shape the way people understand and deal with mental illnesses.
But no matter how people talk about their experiences, they will likely need to use medical terms if they seek help in the health system. This is just how the system works, mental illnesses are just like any other illness, and everyone deserves care, help, and support. As young people grow and reach their developmental competencies, there are contextual variables that promote or hinder the process. These are frequently referred to as protective and risk factors. The presence or absence and various combinations of protective and risk factors contribute to youth mental health. Protective and risk factors may also influence the course mental health disorders might take if present: (a). A protective factor can be defined as a characteristic at the biological, psychological, family, or community (including peers and culture) level that is associated with a lower likelihood of problem outcomes or that reduces the negative impact of a risk factor on problem outcomes. And (b). A risk factor can be defined as a characteristic at the biological, psychological, family, community, or cultural level that precedes and is associated with a higher likelihood of problem outcomes.
In light of widespread human rights violations and discrimination experienced by young people with mental disorders, a human rights perspective is essential in responding to such a global burden, stigmatisation of mental disorders. This emphasises the need for services, policies, legislations, plans, strategies, and programmes to protect, promote and respect the rights of all persons with any mental disorders in line with International human rights law. However, despite widespread human rights violations and discrimination experienced by youth with mental disorders, the impacts of systemic racial, gender discrimination underlie or exacerbate mental health and well-being conditions of racialised and LGBTIQ young adults: the largest group of youth with poor mental health and wellbeing and the most vulnerable to risk factors for mental, emotional, behavioural, and substance use disorders.
03. Mental health promotion and prevention
Adverse youthhood experiences are associated with poor youth mental health and wellbeing. Youthhood experiences of both racial and gender discrimination and other forms of racism may underlie or exacerbate other adverse youthhood experiences. We explored mental health-issues associations with experienced racial, gender discrimination relative to other adverse youthhood experiences, using data from open-ended consultations with a group of 20 racial and gender minority young adults. Participants responses were used to assess associations between racial, gender discrimination and mental health conditions relative to other adverse youthhood experiences. Workshops conversations indicated that prevalence of other adverse youthhood experiences was highest among youth who belong to a racial or gender minority group; both racism and racial, gender discrimination and other adverse youthhood experiences were associated with a higher likelihood of developing one or more risk factors for mental, emotional, or behavioural disorders. That is, adjusted associations between racial, gender discrimination and mental health conditions differed by race, gender and were strongest for mental health conditions among young adults who belong to racial and/or gender minority groups.
Thus public mental health efforts are crucial implementing mental health promotion and prevention interventions aiming to strengthen racial and gender minority youth capacity to regulate emotions, enhance alternatives to risk-taking behaviours, build resilience for managing difficult situations and adversity, and promote supportive, diverse, and inclusive social environments or social networks. These programmes require a multi-level approach with varied delivery platforms; for example, digital media, health or social care settings, schools or the community, and varied strategies to reach racialised youth, particularly the most vulnerable racialised youth in the LGBTIQA community. Racialised young people develop in the contexts of their family, their school, their community, and the larger culture, which offer multiple opportunities to support good mental healthy development and to prevent or to address risk factors for mental, emotional, and behavioural disorders and problems by focusing on change in developmental processes.
But what do we mean by mental health promotion and prevention: (a). Mental health promotion is defined as intervening to optimise positive mental health by addressing the determinants of positive mental health before a specific mental health problem has been identified, with the ultimate goal of improving positive mental health of youth. (b). Mental health prevention is defined as intervening to minimise mental health problems by addressing determinants of mental health problems before a specific mental health problem has been identified, with the ultimate goal of reducing the number of future mental health problems among youth.
04. Rights-based approach to youth mental health
Applying the rights-based approach to youth mental health and wellbeing should start by looking at how racial and gender discrimination as human rights violations, and as a psychological process in the creation of risk factors for mental, emotional, behavioural, and substance use disorders that affects racialised and LGBTIQ young adults in different ways. Though adjusted associations between racial, gender discrimination and mental health conditions differ by race and gender and are strongest for mental health conditions among the youth who belong to racial and/or gender minority groups. That is, systemic racial and gender discrimination becomes a psychological factor in the production and the manifestation of mental, emotional, behavioural, and substance use disorders that affect mental health and wellbeing of racialised and LGBTQ young adults who are submerged in victimhood of lived experiences of discriminatory, racist, and gender-based violence incidents.
That is to say, depression, anxiety, depersonalisation, loneliness, disconnection, identity abandonment, drug abuse, etc. are common among the youth who belong to racial and/or gender minority groups who have experienced one or more of incidents of racism, discrimination, and/or gender-based violence. Thus, the most far-reaching advantage in applying the rights-based approach in youth mental health promotion and prevention is the way youth organisations should interact with and create interventions for the racialised and LGBTQ youth, making sure that all young people in all their diversity can equally participate in the set-up of a mental health promotion and prevention intervention. Ensuring racialised and LGBTIQ youth’s participation entails transitioning from perceiving racialised and LGBTIQ young adults as passive beneficiaries to recognising them as the rights-holders, and active agents in social transformation process.
Hence, inclusive, and meaningful participation of racialised and LGBTIQ youth in mental health promotion and prevention is both a means and an end in itself. It means putting racialised and LGBTIQ young adults at the centre of a youth intervention by empowering them to identify and helping to address the main obstacles and structural barriers preventing them from achieving the desired positive mental health outcomes. Indeed, since the promise and the potential lifetime benefits of preventing mental, emotional, behavioural, and substance use disorders are greatest by focusing on young people, that early interventions can be effective in preventing the onset of such disorders; integrating the rights-based approach in youth mental health promotion and prevention ensures that: (1) racialised and LGBTIQ youth who are at risk and the most vulnerable receive the best available evidence-based interventions prior to the onset of a disorder and (2) promotion of positive mental, emotional, and behavioural development for racialised and LGBTIQ youth is a mental health priority.
05. Risk factors for mental health: Racial discrimination
Racism and sexism lie at the intersection of the problem of sex, gender, and race. At that very intersection there are different types of sexual, gender, and/or racial stereotypes and prejudices that young people of colour or African descent face. People who have two oppressed identities (for example a queer person of colour who belongs to a racial and gender minority group) do not only experience the sum of those oppressions, but also different kinds of oppressions. And if it is a person with even more identities, a transgender woman of colour for example, therefore, multiple systems in her life are intersecting to create unique brand of racial, gender, sexual discriminations. So, we need to understand race, gender, and sex since they form overlapping forms of discrimination on grounds of race, sex, gender.
Racial discrimination, in the general sense, incorporates three elements, which hold true in every situation or setting: (1). Attitudes: our racial stereotypes and racial prejudices of how we see or perceive ourselves; how we see or perceive others; and of how we see or perceive the context. Here, the orientation of feelings of anger and frustrations are turned inwards. (2). Behaviours: our actions in relation to our attitudes. Behaviours can be hostile and aggressive, or in contrast, they can be more peaceful and understanding. If hostile and aggressive, the orientation of feelings of anger and frustration are turned outward, in verbal or physical form. (3). Sources: are the elements such as poverty and inequality, social and cultural norms, cultural and social values, patriarchy or power relations, and oppressive laws, policies, and institutions. It is when our assumptions and beliefs about ourselves, others, and the context are fuelled and supported by Sources that our Attitudes and Behaviours become the contributing factors in the production, the reproduction, or the perpetuation of racial discrimination. That is: Attitudes + Behaviours + Sources = Racial discrimination.
Racial discrimination often occurs without amounting to racism. So, it is not racism that determines whether racial discrimination exists or not. So, what amounts to racism: Racial discrimination and racism do not occur together, so it is crucial to identify them as separate elements. Racism occurs when racial discrimination exists and the measures or the means to curb or transform it have failed. (1). From the above example of racial discrimination, it can be observed that if the Sources could be developed and gain sufficient negative, contradictory attitudes and behaviours, then, the situation evolves into racial discrimination, but not necessary into racism. (2). It is when one’s attitudes and behaviours result in abusive reactions in a verbal, physical, or psychological form toward a racialised individual, and they are supported by emerging sources that an identifiable situation of racism is born. Attitudes + Behaviours + Sources + Discriminated against = Racism.
06. Risk factors for mental health: Internalised racism
Internalised racism is the acceptance, by a stigmatised, marginalised member of a non-elite racial group of negative societal beliefs, stereotypes, prejudices, and discriminatory behaviour about them, which might further lead to the rejection of cultural or religious practices of their own racial group. Though individual may or may not be aware of his/her own acceptance of those negative beliefs about him/her, other components that are considered part of racial, gender expression, sexual identity doubt, are also considered part of the construction of internalised racism. Hence, Internalised racism is a psychological process that affects all non-elite racial, gender and sexual minority groups. It involves the acceptance of the typical conventional representation of race, gender that places racial and gender minority groups beneath a privileged racial group or the persons conforming to socially constructed hegemonic expressions of gender and sexual identities.
This tolerance of negative stereotypes about one’s racial, gender, sexual group might lead to self-degradation, self-alienation incorporating shame about one’s racial, gender, or sexual identity; specifically, the acceptance of prejudices about one’s abilities, beauty, sexuality, gender expression, body, and/or intellect worth. Therefore, one of the manifestations of internalised racism is the abandonment of the characteristics associated with one’s racial, gender, and/or sexual identity in favour of the privileged racial group’s culture and/or values, or the hegemonic expression of gender and sexual identities in the efforts to acculturate to a racist and/or homophobic society. Thus, this can lead to devaluing of the heritage of one’s racial and gender group in favour of acculturating to societal conservative cultural and/or religious beliefs that have been shown to have negative impacts on the mental health and well-being of racial, gender, and sexual minorities.
So, a victim of internalised racism is a person that personalises hatred narratives, discriminatory stereotypes, and racial prejudices which are coming at them from society without having a framework for understanding and dealing with such a hate speech, discrimination, and racism. We sought to examine the associations of lived racism to racialised youth’s mental health outcomes among a representative sample of 20 participants. Taking into account previously documented negative impacts of racial discrimination on social and environmental contexts and mental health across the life course, we can hypothesise that lived youthhood adverse experiences of racism are underlying and significant factors in the associations between adversity and mental health during youthhood among racialised youth. Overall, greater exposure to youthhood adverse experiences of racism and racial, gender discrimination can positively be associated with a high rate of mental, emotional, behavioural, and substance use disorders among racialised, LGBTIQ youth.
07. Stigmatisation of youth mental health
More than half of young people with mental illness do not receive help for their disorders. Often, young people avoid or delay seeking treatment due to concerns about being treated differently or fears of losing their jobs and livelihood. That is because stigma, prejudice, and discrimination against youth with mental illness is a very big problem. Stigma, prejudice, discrimination against youth with mental illness can be subtle or it can be obvious, though no matter the magnitude, it can lead to more harm. Thus, discrimination associated with mental disorders poses a large barrier to recovery and is one of the main reasons why young people do not seek help and treatment. Further, the unwillingness to seek help because of the negative attitudes attached to mental health and substance abuse disorders has been found to be one of the risk factors associated with suicidal thoughts.
People with mental illness are marginalised and discriminated against in various ways but understanding what that looks like and how to address and eradicate it can help. However, this creates a far more complex problem and compounded discrimination for racialised and LGBTIQ young adults whose mental, emotional, behavioural, and substance use disorders are largely associated with youthhood adverse experiences of racism and racial, gender discrimination. Stigma often comes from lack of understanding or fear. Inaccurate or misleading media representations of mental illness, which contribute to both those factors. Moreover, while the public may accept the medical or genetic nature of a mental health disorder and the need for a treatment, many people still have a negative view of youth with mental illness; especially, racialised and LGBTIQ youth, such Self-stigma, which refers to negative attitudes, including internalised shame, that racialised, LGBTIQ youth with mental illness have about their own conditions.
On the other hand, stigma around mental illness, especially within and among racial and gender minority communities can be a major barrier to racialised, and LGBTIQ youth from those cultures accessing mental health services. For example, in some cultures, seeking professional help for mental illness may be counter to cultural values of strong family, emotional restraint and avoiding shame. Among some groups, including African and Asian communities, distrust of the mental healthcare system can also be a barrier to seeking help. So, in all these contexts, stigma and discrimination can contribute to worsening symptoms and reduced likelihood of getting treatment. Indeed, self-stigma leads to negative effects on recovery for racialised and LGBTIQ youth diagnosed with severe mental illnesses. Looking at a positive side, our research found that youths who are informed with facts about racism or racial, gender discrimination are able to dispel myths about racialised and LGBTIQ youth with a mental health condition and are less likely to discriminate against them.
08. Non-formal mental health education
In youth work carried in the context of non-formal education, prevention is seen as distinct from treatment, but complementary in a common goal of reducing the burden of mental, emotional, and behavioural disorders on the healthy development of young people. By contrast, promotion, which some consider as separate from prevention, is viewed as so closely related that it should be considered a component of prevention. Prevention and promotion both focus on changing common influences on the development of youth to aid them in functioning well in meeting life’s tasks and challenges and remaining free of cognitive, emotional, and behavioural problems that would impair their functioning.
Mental health promotion is characterised by a focus on well-being rather than prevention of illness and disorder, although it may also decrease the likelihood of disorder. Indeed, health is more than just the absence of disease and so the goals and methods of prevention and promotion overlap, but the evidence of effectiveness of mental health promotion is sparse, particularly in comparison to that for prevention. There is agreement that mental health promotion can be distinguished from prevention of mental disorders by its focus on health outcomes, such as competence and well-being, and that many of these outcomes are intrinsically valued in their own right. Mental health is a critical component of young people’s learning and general health. Fostering social and emotional health in youth as part of healthy youthhood development must therefore be a national priority. There is also increasing evidence that promotion of positive aspects of mental health is an important approach to reducing mental, emotional, and behavioural disorders and related problems as well.
For example: mental health promotion interventions targeted to the general public or a whole population. Mental health promotion interventions aim to enhance individuals’ ability to achieve developmentally appropriate tasks (competence) and a positive sense of self-esteem, mastery, well-being, and social inclusion, and strengthen their ability to cope with adversity. programmes based in schools, community centres, or other community-based settings that promote emotional and social competence through activities emphasising self-control and problem solving. Or a universal preventive interventions targeted to the general public or a whole population that has not been identified on the basis of individual risk. A universal preventive intervention is desirable for everyone in that group. Universal interventions have advantages when their costs per individual are low, the intervention is effective and acceptable to the population, and there is a low risk from the intervention. School-based programmes offered to young people to teach them social and emotional skills or to avoid substance abuse. Or programmes offered to the parents to provide them with skills to communicate to their children about resisting substance use.
09. Youth work and mental health education
In the context of youth work, mental health prevention and promotion for young people involve educational and/or training interventions to alter developmental processes. That makes it important for the field of youth education and training to be grounded in a conceptual framework that both emphasises and reflects a developmental perspective in youth work. Four key features of a developmental framework in youth work for mental health education are hence important as a basis for both mental health prevention and promotion: (1) age-related patterns of competence and disorder, (2) multiple contexts, (3) developmental tasks, and (4) interactions among biological, psychological, and social factors. Mental health promotion includes efforts to enhance youth ability to achieve developmentally appropriate tasks (developmental competence) and a positive sense of self-esteem, mastery, well-being, and social inclusion and to strengthen their ability to cope with adversity.
Mental health prevention interventions for young people are intended to avert mental, emotional, and behavioural problems throughout the life span. These interventions must be shaped by developmental and contextual considerations, many of which change as young people progress from children into young adulthood. So, to develop effective interventions in youth work, it is essential to understand both how the developmental and contextual factors at younger ages influence youth mental health outcomes at older ages and how to influence those factors. The concept of risk and protective factors is central to framing and interpreting the research and context analysis needed to develop and evaluate mental health prevention interventions in youth work. So, considering risk and protective factors in the design and evaluation of youth work mental health promotion and prevention interventions is therefore very important.
Over the past decades a voluminous literature has emerged on risk and protective factors associated with specific mental health disorders and on the multiple disorders and problems associated with exposure to specific risk and protective factors. When potentially modifiable risk and protective factors are identified through research, preventive approaches can be developed to change those risk factors to prevent or reduce the development of mental, emotional, and behavioural problems. So, the adapting research in youth work is essential as it helps to understand the targeted groups and the risk factors, such as young people exposed to divorce; poverty; bereavement; racism; racial/gender discrimination; substance-abusing parent; abuse or neglect. And although the interventions aimed at these young people typically do not target the risk factor itself (e.g., a divorce has already occurred; they have been exposed to racism or racial/gender discrimination; they have abused drugs), they can be designed to reduce the likelihood of mental health problem outcomes given elevated risk.
10. Community-based mental health interventions
A major implementation issue in youth work is the balance between delivering an evidence-based mental health promotion and prevention interventions and adapting the intervention over time to meet specific needs of the community. To address this issue, community-based mental health interventions in a context of youth work, must integrate preventive intervention trial. The aim of preventive intervention trial is to test whether the intervention is effective in changing the initially targeted risk and protective factors and whether change in these factors mediates, or accounts for, changes in the problem outcome. Since prevention is aimed at averting mental health problems that may occur across developmental stages, a critical feature of the prevention trial is the longitudinal follow-up of participants to assess the intervention’s impact on trajectories of development. Further, community-based mental health interventions in a context of youth work, must integrate randomised preventive trial.
This section describes three alternative implementation approaches: (1). Direct adoption of a specific evidence-based prevention programme, (2). Adaptation of an evidence-based intervention to community needs, and (3). Community-driven implementation. These three approaches are not mutually exclusive or exhaustive of all potential approaches. Each requires an active partnership among the targeted groups, the community leaders, youth-based organisations, and researchers and must address issues of trust, power, racism, gender disparity, priority, and action. Thus, the appropriate approach in a given community will depend on its characteristics and priorities and the availability of an existing evidence-based programme that matches its needs. Ideally, the need assessment and evaluation are components of all three approaches to shed light on why a specific approach works in a particular community or how to generalise knowledge and skills about successful implementation to other communities settings.
Adoption of a specific community-based mental health prevention intervention involves delivering that intervention with high fidelity, increasing the likelihood that its impact will be similar to that found in the original intervention. Typically, the intervention should have met specific standard of evidence often articulated and approved by the funding agencies. The outputs of the original intervention, such as standardised educational resources, and teaching, or training manuals, or created and produced media help deliver the intervention in a manner similar to that used by the original intervention. Generally, there is limited adaptation of the intervention due to cultural or historical characteristics or the particular interests of the community. Hence, the new implementing organisation, typically needs sufficient mental health education capacity and resources and know-how to ensure fidelity, monitoring, and sustainability.
11. Youth-friendly mental health interventions
A youth-friendly mental health intervention is a community-based intervention that integrates the needs and interests of young people in all their diversity. It is a process done through screening for prevention. Prevention screening is a two-part process that first identifies risk factors whose presence in individuals makes the development of psychological or behavioural problems more likely, and then segments the relevant subset of the population to receive a unique preventive intervention. Screening is carried out: (1). At community level, focused on youth-based risks (for universal prevention efforts, e.g., training of youth workers to talk about the effect of racism and racial discrimination on the mental health of racialised young adults); (2). At group/individual levels (for selective prevention efforts, e.g., screening for the risk factor, depression, when racialised and LGBTQI young adults are exposed to racism or racial discrimination); or (3). At individuals based on their unique behaviours that may be prodromal features of mental, emotional, or behavioural disorders.
Screening for both community-level and group or individual-level risks is based on identification of risk exposures. Indicated prevention requires screening for individual characteristics. Indeed, there is a long list of possible community-level exposures that represent risks. Examples include poverty, violence and other neighbourhood stressors, lack of safe schools, and lack of access to health care for racialised and LGBTQI young adults. High-risk exposures for subsets of the racialised and LGBTQI young adults include depression due to physical or sexual maltreatment based on race, gender, and sex. To address such risk factors, could for example be effective through a prevention community-based system that is designed to reduce adolescent delinquency and/or substance abuse that are connected to experiences of racism or racial discrimination among racialised young adults.
If used by youth organisations, this Substance Abuse Prevention approach provides a process for communities, through a community prevention board, to identify their prevention priorities and develop a profile of community risk and protective factors. The logic model involves community-level training and technical assistance on three steps: (1). community adoption of an evidence-based prevention framework; (2). The creation of a plan for changing outcomes through an evidence-based programmes that target risk and protective factors identified by the community, and (3). implementation and evaluation of these programmes using both process and outcome evaluations. Its theory of change hypothesises that it takes two to five years to observe changes in prioritised risk factors and five or more years to observe effects on delinquency or substance use. Thus, in the longer-term perspective, it has positive effects on targeted risk factors and delinquent behaviour as well as alcohol use and binge drinking.
12. Youth addressing mental health stigma
Herein, stigma refers to when someone is viewed with disapproval because of a particular characteristic, such as having a mental health issue. Stigma relating to mental health means that people with a mental health condition may be viewed negatively, have negative assumptions made about them or just discriminated against because of their mental health. It can also result in people with mental health concerns feeling shame, guilt, and being afraid to tell others about their experiences. This can make it hard for them to access support and help. The way people view mental health, and how they respond can be influenced by cultural beliefs, knowledge of mental health and the amount of contact they have had and the type of contact they have had with people with mental health problems.
So, stigma associated with mental health challenges is a major barrier to service seeking among youth, particularly among racialised and LGBTQI+ young adults. Thus, building awareness around the invisibility of mental health challenges and the continuum of wellness to illness may help to break down stigma’s impact as a barrier to service seeking. Indeed, stigma around mental illness puts youth at risk for not seeking help for themselves or not helping peers dealing with mental distress. Often due to a variety of harmful stereotypical attitudes and behaviours enacted against youth who are labelled as mentally ill. Common stigmatising beliefs include the notion that mental illness signals personal deficits, weakness, difference, and a lack of self-control, and that youth with mental illness cannot recover and are dangerous and violent. Stigma intersects with culture and is found throughout all levels of society. It can be understood at three intersecting levels: structural; social; and self-stigma. (1). Structural stigma refers to policies or practices of institutions that systematically restrict the rights and opportunities for young people living with mental health disorders. (2). Social stigma refers to the process whereby social groups endorse stereotypes about the youth with a mental health disorder and act against them. (3). Self-stigma occurs when youth living with mental health disorders internalise societal attitudes and discriminatory practices.
Youth are a critically important population in terms of mental health promotion, prevention, and treatment from a developmental perspective. About half of all mental health disorders first arise by about mid-adolescence. Suicidal ideation and attempts are particularly high among youth. Negative impacts of mental health challenges on developmental trajectories make adolescence and youthhood optimal times to intervene, both for full threshold mental disorders and subthreshold mental health challenges. So, this calls for greater investment in mental health promotion and prevention efforts. Early intervention approaches connect youth with services before a full-threshold disorder develops.