One half of all mental illnesses begin before the age of 14. If we are serious about preventing and treating mental illness, we must seriously re-evaluate how we raise our children, care for them, teach them to take up supportive and loving relationships, and protect them.
With this in mind, the 3rd World Congress of Cultural Psychiatry, being held this weekend at Queen Mary University of London, is focusing on young people. More than 350 academics, clinicians, practitioners, policy-makers and commissioners from around the globe will consider the best ways of protecting and promoting the mental health and wellbeing of young people, as well as highlight the inequalities they face.
A Unicef survey in 2007 ranked the UK bottom on children's wellbeing compared with north America and 18 other European countries. The UK ranked 24th out of 29 European countries in a similar survey in 2009. Between 60% and 70% of children and adolescents who experience clinically significant mental health problems have not been offered evidence-based interventions at the earliest opportunity, which would help maximise their lifetime benefits.
Adolescents with emotional or conduct disorders are four to six times more likely to smoke, and up to three and a half times more likely to take drugs. Young people with emotional and conduct disorders represent 43% of smokers under the age of 17. In addition, children who are obese are at higher risk of psychological and psychiatric problems as weight gain is associated with discrimination, social rejection and depression.
As these statistics show, young people are operating in stressful situations. The riots of last August and their impact on how young people perceive themselves and are viewed by wider society will be explored at the world congress. Refugees and unaccompanied minors are still on the frontline of risk when it comes to mental health.
What is clear is that young people from diverse cultural backgrounds can benefit society and themselves if they have a fair chance of good health, as well as social and political engagement. When that happens they are less likely (at important points of emotional and social transition) to end up in gangs or be vulnerable to radicalising influences, particularly through the internet and computer-mediated communication.
We know that young people of black Caribbean and black African origin in England and Wales have higher suicide rates in the UK than their white British counterparts. But what is being done about this? On the face of it, very little, which is worrying.
While mental illness costs the economy more than £105bn a year, with £10bn spent on the NHS, less than 0.001% of the mental health budget is spent on prevention. Young people were only last year brought into the fold under No health without mental health, the national mental health strategy, so there is some serious catching up to do.
Prevention is essential as adult mental illness is more common among those experiencing childhood dangers, adversity, discrimination and poverty. Often poor and risky environments bring with them easy access to alcohol, cigarettes, other psycho-stimulant drugs and a collection of unhealthy lifestyles from eating habits, little physical activity and emotional, physical or sexual abuse.
Childhood mental illness is also predictive of adult unemployment and low educational outcomes. This is why it is important to have a public health approach to protect young people from harm as early as possible, and to educate them about emotional regulation and resilience, and how to manage life's difficulties.
Providing appropriate interventions and protection in a culturally diverse and unequal society is not easy. We know that some young people and groups, who are among the most vulnerable in society, do not benefit from programmes directed at improving their health. Indeed, they are usually left behind to become even more marginalised. This can no longer be allowed to continue.
Professor Kamaldeep Bhui is president-elect of the World Association of Cultural Psychiatry, director of the Cultural Consultation Service and the public health lead at the Royal College of Psychiatrists.
Guardian Professional.
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