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Is Europe facing a youth mental health crisis?

When you ask ChatGPT whether the mental health of European youth is in crisis, the answer is a clear ‘yes’:

“Several reliable sources and recent studies underline the increased prevalence and severity of mental health problems in this demographic group,” it explains.

The results of the AI’s information search indicate that the World Health Organization (WHO) is reporting a significant increase in mental disorders among young people worldwide, including Europe. Anxiety, depression, and stress-related disorders are much more common now than they were 20 years ago.

The European Commission's observations regarding mental health highlight the impacts of the COVID-19 pandemic, which affected young people in particular. The restrictions imposed during the pandemic, the special arrangements of educational institutions and workplaces and the resulting social isolation made mental health problems among young people worse.

On the other hand, population-based epidemiological studies indicate that medically defined severe mental disorders, such as schizophrenia, have not significantly increased, meaning that the increase in mental health problems among young people seems to be caused specifically by an increase in anxiety and depression.

“Mental health problems among young people pose a real threat to society. For example, in Finland, a third of the disability pensions granted to young adults are related to mental health problems,” comments Specialist Doctor and Docent in Adolescent Medicine Silja Kosola.

Despite this, Kosola says that she is against the widespread use of the word ‘crisis’ because it causes conceptual inflation:

“If everything is in crisis, soon nothing will be.”

Does increased discussion about mental health cause mental health problems and overinterpretations?

A recent international study[1] that involved monitoring school classes in Finland indicates that young people's mental disorders tend to be socially ‘transmitted‘. The key finding was that the more people in a class exhibit symptoms mental disorder, the more likely it is for other people in the class to also develop mental disorders.

The findings have elicited some criticism of increased discussion about mental health. Experts estimate that dwelling in negative thoughts and experiences with others can cause disorders to spread, eventually making everyone feel worse.

On the other hand, increased discussion about mental health has also decreased the stigma associated with mental disorders and increased young people’s willingness to seek help for their symptoms, which can be considered positive developments.

Another worrying phenomenon is that an increasing number of young people feel anxiety over so-called ordinary everyday life. Sources of anxiety include pressure to succeed in studies or working life, pressure related to personal appearance, climate change, biodiversity loss, wars, politics, and other everyday issues.

At worst, anxiety can be paralysing and start to narrow down the person’s usual sphere of life. If a young person thinks that they cannot deal with certain social situations, for example, this can easily lead to avoidance behaviour. Anxiety is quite gendered; the prevalence of anxiety is significantly higher among young women than among young men.

According to researchers, it is possible that young people interpret the normal unpleasant feelings faced in life as symptoms of mental disorders. This kind of overinterpretation can blur the lines between uncertainty, nervousness, and typical worries of youth, turning them into a tangled knot of anxiety.

According to Docent Kosola, the fact that mental disorders are socially transmitted has been known for a long time. As such, we need to think about how to talk about the subject. It is up to adults to try to shift the focus from wallowing in misery to recovery, meaningful activities and increasing hope, which is no easy task. 

Statistics show that mental health phenomena are strongly gendered

However, the current situation should not be handwaved as young people simply being hypersensitive or under the impression that their mental health is deteriorating.

The Health at a Glance report compiled by the OECD indicates that anxiety and depression among young people increased in all EU countries during the COVID-19 pandemic. This increase was highest among girls and young women, members of minorities and young people struggling with financial difficulties.

According to the Institute for Health Metrics and Evaluation, in 2019 the number of young people in Europe suffering from mental disorders was over 14 million, accounting for 17.4% of all 15–29-year-olds. The number of young people suffering from mental disorders is estimated to have doubled in several EU countries during the pandemic.

The lockdowns imposed and the increasing need for mental health services during the pandemic congested already overstretched mental health services. As a result, in 2022 almost half (49%) of young people living in EU countries reported not having access to the support that they needed to maintain their mental health.

For now, it is too early to say what kinds of long-term effects the pandemic will have on young people's mental health. It is also impossible to specify which trends are the result of the pandemic and which are caused by other factors or the combined effect of several factors.

The Health at a Glance report indicates that there has also been an alarming increase in self-destructive thoughts among young people, which has fortunately not been reflected in statistics as increased suicide rates so far. According to Eurostat statistics, the absolute number of suicides committed by young people has decreased significantly since 2000.

Nevertheless, suicide remains one of the most common causes of death among young people. In 2021, nearly one in five deaths of 15–29-year-olds in EU countries occurred as a result of self-harm. The group with the highest suicide rate is men between the ages of 25 and 29.

A growing concern is the increased self-medication of mental disorders. Self-medication refers to the use of drugs or alcohol in an attempt to alleviate distress, anxiety or other unpleasant feelings and thoughts. In addition to this, people also use intoxicating substances for social courage, energy and to make themselves feel good.

Although intoxicating substances can provide temporary relief for the symptoms of mental disorders, their long-term effects are negative. Intoxicating substances not only weaken the overall health of young people, but also increase the risk of accidents and financial and life management challenges and deepen existing mental health problems.

That being said, Silja Kosola points out that a large proportion of young people are more sober than previous generations:

“Use of intoxicants is highly polarised, with a small number of young people using more and more substances. Studies show that young people's attitudes towards intoxicating substances have become more positive only regarding cannabis.”

While reliable statistics on the prevalence or increase of self-medication are almost impossible to come by, the phenomenon is discussed in the media and among young people. Some conclusions can also be drawn based on European statistics. According to European Drug Report 2022: Trends and Developments, drug-induced deaths have increased among both 15–19-year-olds and 20–24-year-olds between 2012 and 2020[2]. This increase has been the highest in the statistics of 15–19-year-old boys. On the other hand, the drug-induced deaths of older girls appear to be following a slightly decreasing trend.

Is depression caused by depression? Or by smartphones?

The root causes of the declining mental health of young people are not fully known or understood.

That being said, the list of suspected causes is long, including things such as technology and social media, the declining economy and employment, the erosion of social values and increased competition, the increase in general uncertainty and other global problems.

The fact is that the decline in youth mental health is one of those complex phenomena for which there are no simple solutions available.

“Depression is not just one illness, but rather a symptom that can be a part of a variety of different illnesses,” Kosola says.

Kosola stresses that social values and the economy have changed plenty of times in the past as well, but never before have these changes been so strongly reflected in the mental health of young people. That is why her critical eye is focused on social media, which she sees as a single clear change that society could easily tackle.

“The only new development that has occurred in all developed countries at the same time is the increased use of mobile social media. At the same time, social media has been developed to become increasingly addictive. Numerous studies show that the more young people use social media, the worse they feel. The psychological mechanisms behind this have also been extensively studied,” Kosola explains.

A recent Finnish study[3] also criticises the ways in which mental health diagnoses are discussed as if they would explain people's symptoms and problems. The authors of the study, Jussi Valtonen and Jani Kajanoja, emphasise that a psychiatric diagnosis alone does not explain the causes of an illness; it is simply a medical designation given to a specific set of symptoms.

According to them, presenting a depression diagnosis as a cause of depression symptoms is harmful circular reasoning that reinforces misconceptions about the nature of psychiatric diagnoses. Doing so can also weaken people's faith in their capacity to influence their own symptoms and recover from them and, at worst, even make it difficult to find societal solutions.

A lot can be done

No matter how you interpret the figures, studies, causes and consequences, it is clear that there is a lot that can be done to tackle young people's mental health problems outside of actual health care services in the context of educational institutions, homes, hobbies – and youth work.

Mild or moderate mental disorders often do not require medication or long-term therapy, but rather more hopeful visions for the future better self-knowledge, improved resilience and everyday mental health skills.

“And more sleep!” Kosola asserts and continues: “The number of young people who regularly sleep less than eight hours a night has been steadily increasing for over ten years. In Finland, 40% of lower secondary school pupils and half of upper secondary education students sleep less than eight hours a night.”

COVID-19 restrictions were also found to have had a negative effect on young people's physical activity, healthy diets and screen time.

Simply interacting with a young person with empathy and respect, supporting their sports and exercise hobbies or cooking food with them can be an important mental health act. In principle, anything that encourages young people to step away from screens, go outside and engage in social activities has a direct positive impact on their mental health.

The same message is being promoted by Mental Health in Youth Work, a long-term project of the National Agencies of Erasmus+ Youth and the European Solidarity Corps.

“Youth workers already have plenty of ways to support the mental health of young people,” says Paavo Pyykkönen, Finnish coordinator of the Mental Health in Youth Work project. “All they need is more information and practical tools to support the mental health of young people. The subject is such that it is easier to approach when you have gained some confidence in your own skills through training.”

Launched in 2021, the project will continue throughout the current EU project period until the end of 2027. The project involves developing training with the help of which youth workers can clarify their own role in supporting youth mental health. At the same time, participants gain practical skills that they utilise in their own work.

“The project also offers training opportunities for young people and encourages them to provide each other with peer support. In the future, the material produced in the project can be applied to both everyday youth work and international projects,” Pyykkönen promises.

Text: Hilma Ruokolainen

Links:

• Learn more about the Mental Health in Youth Work project: https://www.oph.fi/en/mental-health-in-youth-work
• The OECD’s Health at a Glance report: https://www.oecd-ilibrary.org/deliver/507433b0-en.pdf
• The European Union Drugs Agency’s European Drug Report 2022: Trends and Developments: https://www.euda.europa.eu/publications/edr/trends-developments/2022_en