Tackling teenage turmoil: primary care recognition and management of mental ill health during adolescence

Abstract

This paper examines how primary care can improve for teenagers who are experiencing mental or emotional turmoil. This is an important health issue because at least 15% of teenagers experience mental health problems at any one time, there are indications that this proportion is rising, and there is evidence that suicide rates are rising in young people. The paper discusses how troubled teenagers can be identified, cared for and managed by primary care providers within the UK, although some of the information presented is from other countries. It identifies inter-relationships with other health behaviours and risk factors. The GP's role in assessing a troubled teenager is discussed, as well as a consideration of individual and contextual issues to frame a "triple" diagnosis, i.e. a diagnosis simultaneously in biomedical, individual and contextual terms. A review of present knowledge of management is presented. The paper concludes that there are several deficiencies at present, namely a lack of identification of teenage distress, a lack of training for GPs in teenage health, a lack of a research base, a lack of resources and finally a lack of information provided by any teenagers who have experienced turmoil and could give useful insights into their experience.

GPs’ responses to adolescents presenting with psychological difficulties: a conceptual model of fixers, future planners, and collaborators

“…5,14 Consultations for younger patients have been reported as being shorter, despite having to cover more complicated terrain such as confidentiality and consent. [16][17][18] At the same time there has been an increasing focus at policy level to describe a role for GPs in addressing emotional distress and responding early to psychological difficulties. [19][20][21] National Institute for Health and Care Excellence guidelines advocate GPs as front-line practitioners charged with identifying early indicators of difficulty.…”

Treading a fine line: is diagnosing depression in young people just medicalising moodiness?

“…7 There is some evidence that intervention can reduce psychological morbidity and it is therefore possible that early intervention could alter the experience of mental illhealth in later life. 8 However, young people with psychological morbidity are difficult to engage in psychological therapies, 9 even though such therapies appear to reduce symptoms and case prevalence. 10 This reluctance to engage reduces the capacity of GPs and their practice counsellors to review depressed teenagers.…”

Health Communication and Psychological Distress: Exploring the Language of Self-harm

“…Analysis of the health E-mail corpus revealed several significant patterns and commonalities in adolescents' accounts of self-harm, insights that further consolidate our understanding of self-injurious activity, which continues to remain under-researched (Mental Health Foundation, 2006). Consequently, this study addresses what is still missing from our conception of teenage turmoil: the voice of adolescents' themselves (Jacobson et al, 2002). Our research, we hope, can help equip health care providers to intervene most effectively in this enigmatic and disturbing area.…”