Research shows that globally, 10-20 per cent of children and adolescents experience mental health disorders, with rates in Ireland slightly higher.
The Department of Health’s report on the mental health of children and young people in Ireland, published in April 2023, revealed that 22 per cent of 15-19-year-olds in the country had a mental disorder. There was also a notable increase in the percentage of young people attempting suicide, rising from seven per cent to 10 per cent between 2012 and 2017. Additionally, it was found that 50 per cent of mental illness in adulthood, excluding dementia, begins before the age of 15, with 75 per cent starting before the age of 18.
A recent Vhi 360 Hot Topics session gathered experts in child and adolescent mental health from the Vhi 360 team to provide guidance to primary healthcare providers on diagnosing and treating young individuals with mental disorders.
The first speaker was Dr Ngozi Oketah, a consultant in general paediatric and adolescent medicine with a special focus on mental health at Children’s Health Ireland (CHI) Crumlin. Dr Oketah emphasized the importance of early detection of mental health issues in children and adolescents.
She highlighted common mental health concerns that may be seen in primary care, such as emotional disorders, attention deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), eating disorders, self-harm, suicide, conduct disorder, and risk-taking behaviors.
Anxiety
Anxiety and depression are the most prevalent issues, accounting for nearly two-thirds (63 per cent) of mental disorders in young individuals.
“During adolescence, many young people experience heightened anxiety. While some level of anxiety is normal, persistent and overwhelming worry that interferes with daily activities indicates a more serious problem that requires intervention,” Dr Oketah explained.
Anxiety can manifest in various ways, including panic attacks, obsessive-compulsive disorder (OCD), and generalized anxiety disorder (GAD). Physical symptoms such as chest pain, recurrent abdominal pain, constipation, headaches, dizziness, and fainting may also be present.
Preventing suicide is a key priority in managing mental illness in young individuals, as suicide is a leading cause of death among 15-19-year-olds. Ireland has the fourth highest rate of adolescent suicide in the EU.
“While we can’t guarantee prevention, we can take steps to identify and support those at risk,” Dr Oketah noted.
She highlighted the Ask Suicide-Screening Questions (ASQ) as a tool for identifying at-risk individuals and the modified teen patient’s health questionnaire 9 (PHQ-9M) for assessing depressive symptoms.
“Early intervention by healthcare professionals can help prevent mental illness in adulthood by addressing issues early on,” Dr Oketah added.
ADHD
Attention deficit/hyperactivity disorder (ADHD) affects approximately 2.8 per cent of adults globally and around five per cent of children. In Ireland, the prevalence is 1.5 per cent in adults and four per cent in children.
Dr Naazim Mohungoo, a child and adolescent psychiatrist with Vhi 360, discussed the complexities of diagnosing ADHD in primary care, as it shares symptoms with other conditions like ASD and learning disabilities.
For an ADHD diagnosis, symptoms must align with the criteria in the DSM 5 or ICD11 and cause significant impairment in various aspects of life.
“ADHD diagnosis is typically considered around age six, after ruling out other potential conditions,” Dr Mohungoo explained.
Other conditions that may mimic ADHD symptoms include learning disorders, sleep disorders, anxiety disorders, and mood disorders.
Early diagnosis is crucial to prevent potential negative outcomes such as conduct issues, mood disorders, substance abuse, and suicide.
Treatment for ADHD should only be pursued if it significantly impacts functioning. Non-pharmacological options include parental training and cognitive behavioral therapy (CBT), while stimulants are a common pharmacological treatment.
Dr Mohungoo emphasized the importance of accurate referrals to ensure individuals receive the appropriate care without delays.
The presentations were followed by a Q&A session led by Dr Dáire O’Leary, a consultant pediatrician, with additional insights from Dr Lieselot Tampere, a consultant pediatrician, and Regina Hardy, a clinical nurse specialist in pediatric mental health.
Information
Vhi 360 Hot Topics offers educational webinars to support primary care healthcare providers in enhancing patient care. These webinars are held in partnership with MedCafe.ie.
To watch the recording of the recent Vhi 360 Hot Topics in Child and Adolescent Mental Health Conditions Webinar, visit www.medcafe.ie/webinars/825
This is an advertorial on behalf of Vhi 360 Hot Topics.