Annenberg Adolescent Mental Health Initiative
One out of 10 adolescents in the U.S. struggles with a mental health problem severe enough to cause significant impairment, according to federal estimates. Yet those on the front lines of treatment and research encounter large gaps in knowledge about the problem.
In an attempt to improve understanding, the Annenberg Foundation Trust at Sunnylands, with support from the Annenberg Public Policy Center of the University of Pennsylvania, brought together more than 100 internationally respected experts in adolescent mental health as part of the Annenberg Adolescent Mental Health Initiative to assess what is known -- and not known -- about this important public health issue. Seven commissions were established, and consensus documents were written on disorders prevalent in adolescents. The commissions and their chairs included:
- Anxiety (Edna Foa, Ph.D.)
- Schizophrenia (Raquel Gur, M.D., Ph.D.)
- Substance and Alcohol Abuse (Charles O'Brien, M.D., Ph.D.)
- Depression and Bipolar Disorder (Dwight Evans, M.D.)
- Eating Disorders (B. Timothy Walsh, M.D.)
- Suicide (Herbert Hendin, M.D.)
- Positive Youth Development (Martin Seligman, Ph.D.)
Each commission's consensus document addressed the following topics:
- The disorder: clinical presentation, phenomenology, neurobiology, genetics, and pathophysiology
- Guidelines for treatment: pharmacology, psychosocial, and educational interventions
- Prevention. Three themes will be addressed throughout the document:
- Areas in which consensus is lacking
- The applicability of literature on adults to youth
- Unanswered research questions
The result of this dialogue among physicians, psychologists and scholars is Treating and Preventing Adolescent Mental Health Disorders, What We Know and What We Don't Know. The book is a groundbreaking, evidence-based review of prevention programs and treatments for adolescents suffering from depression, anxiety, substance abuse, schizophrenia and other mental disorders. AFSP played a key role in developing a section of the book on youth suicide. This comprehensive work was recently named the best book in clinical medicine published in 2005 by the Association of American Publishers, the principal trade association of the book publishing industry. The book, aimed at mental health practitioners and researchers.
Among the findings:
- Between 20 and 30 percent of adolescents report symptoms of depression. While depression once was considered an "adult" affliction, the mean age of onset today is 15.
- An estimated 1.1 million teenagers, ages 12 to 17, needed substance abuse treatment in 2001. Of that number, only 100,000 actually received it.
- Almost 9 percent of high school students have attempted suicide in the past year.
- Early diagnosis and treatment of mental health disorders increase the likelihood that the teenager can lead a productive adult life. And, the experts report, most prevalent adolescent disorders are treatable. But delivery of treatment is by no means assured. For example:
- Schools are the de facto mental health service delivery system for children and adolescents. But the level of services available is poor, and varies widely. Of 2,000 schools surveyed as part of this project, slightly more than half had full-time access to a mental health professional.
- Primary-care physicians -- who can serve as a gateway to specialized treatment -- often are inadequately trained to identify and diagnose mental health problems, according to another study conducted for the book. Many physicians expressed low confidence in their abilities to detect mental disorders among adolescents in their care.
