According to a recently release United Nations report, depression is the number one cause of illness and disability globally among adolescents (10-19 yrs old):
We hope this report will focus high-level attention on the health needs of 10 to 19-year-olds and serve as a springboard for accelerated action on adolescent health,” said Flavia Bustreo, Assistant Director-General for Family, Women and Children’s Health at the UN World Health Organization (WHO).
An estimated 1.3 million adolescents died in 2012, largely from preventable causes, according to the UN agency’s Health for the world’s adolescents online report released today.
Depression was found to the be the greatest cause of illness and disability in this age group, with suicide raking third as the cause of death among young people.
This report reminded me of a journal article I read during my studies, “Development Economics Through the Lense of Psychology” (abstract excerpt below):
Economists conceptualize a world populated by calculating, unemotional maximizers. This view shapes our understanding of many crucial elements of development economics–from how rural villagers save, to how parents decide on whether to send their children to school.
Psychological research, however, has documented the incompleteness of this perspective. Individuals have self-control and time inconsistency problems. They can give into shortrun temptations and later regret it. They can have strong feelings about others that drive them to commit both generous and spiteful acts. They often passively accept defaults rather than make active choices. They let the institutions around them make choices for them. And they may misread new data in a ways that fit their beliefs. In short, the rational maximization model may not be a very good approximation of human behavior.
While this journal article does not explicitly cite mental illness or depression, due to my own experiences with depression my thoughts turned to the subject. There is no one cause of depression; there are elements of both “nature” (genetic predisposition) and “nurture” (experiences in life). However, “nurture” causes tend to be more direct and therefore preventable: dehumanization / pessimism related to poverty, uncertainty about the future, and unemployment:
In the shadow of the Great Recession lies a deep depression: Youths in their 20s and early 30s are hitting new lows. Compared with older workers who have lost their jobs, young people face more complex and layered hardships that could last most of their lives. They are experiencing disproportionately high unemployment, stretching indefinitely into the future, in an increasingly unequal and uncertain social landscape. And just when they are most in need of social support, the recession has led lawmakers to erode the welfare and employment programs that youths need to move themselves — and the economy they have inherited — toward recovery.
For young people in the United States and Europe, there is an emotional layer to this economic malaise. According to a recent U.K. survey of 2,161 people ages 16 to 25 by nonprofit advocacy group the Prince’s Trust, the unemployment epidemic is driving a mental-health crisis. While overall happiness levels for the surveyed youths stayed about level over the past year, reported emotional health fell significantly for the segment that is out of the workforce and not in school or job training. These young people experienced feelings of despondency and hopelessness at a higher rate than their peers. Chronically unemployed youths were more likely to have experienced panic attacks, engaged in self-harming behavior or felt suicidal. Mental-health problems struck 4 in 10 jobless young people “as a direct result of unemployment,” according to the Prince’s Trust.
One woman interviewed for the study said, “Being out of work stripped away my self-worth and made me feel like a waste of space.”
While this study considers young people in the U.S. and Europe, one can assume that young people in the developing world experience similar issues, as youth unemployment is expectedly worse in many less developed countries.
Depression stunts personal development; how can someone invest in themselves or act as a long-term “rational maximizer” when they cannot see any hope in their future? But children are the future, and the number one illness affecting them is depression. To not pay the price to treat depression in adolescents is incredibly shortsighted–perhaps policy makers also do not act as “rational maximizers”, at least if the thing we hope to maximize is long-term social welfare.
The costs of inaction are not limited to lost economic output, human suffering and suicide, there are also security risks associated with leaving depression untreated:
Adam Lankford, a professor from the University of Alabama, concluded that many suicide terrorists weren’t ideologues at all—but were, in fact, classically suicidal. He cited Israeli scholarly research of would-be Palestinian bombers: Forty percent of them exhibited suicidal tendencies; 13 percent had already attempted suicide, unrelated to terrorism. Lankford went on to mention a 9/11 hijacker who wrote a final note to his wife and lamented how he never lived up to her expectations. Lankford described other terrorists in Palestine and Chechnya who were in poor health, recently divorced, or financially insolvent in the months prior to an attack. He also talked about the terrorist recruiters who admitted to looking for the “sad guys” for martyrdom.
While this study is far from conclusive, it would be closed-minded to refuse to consider the relationship between mental illness and terrorism. People with depression are often looking for meaning and companionship; joining a terrorist organization provides both.
And this security risk is hardly confined to the developing world; one would be hard pressed to find a mass killing anywhere in the world that is not linked to some form of mental illness. To be fair, no statistical relationship between teen depression and violent crime has been established, although this does not rule out the strong possibility that there is some relationship between mental illness and violence.
As someone who has experienced depression, this reports findings hit close to home. I am fortunate to have been born into an upper-middle class American family and receive top notch treatment–most people are not so lucky. Depression and other forms of mental illness are often seen as a “rich person’s disease”, and treatment as a luxury. This study refutes this misconception–depression can affect anyone; old or young, rich or poor. The universality of depression gives hope that it is an issue the global community can rally around and adequately address.
Increased access to mental healthcare must be part of healthcare reforms in both developed and developing nations. This is not an abstract concept, inaction has real costs that affect many people. Further compounding this problem is the existence of a stigma against people with mental illnesses (which is likely more prevalent in less developed places). When one feels ashamed of having a mental illness, the condition generally becomes worse and treatment is not sought. Part of the solution may be educating people to break this stigma.
The prevalence of depression amongst the world’s youth is alarming, but unfortunately to this social scientist / previously depressed young adult, it is not surprising. If depression can affect people who have had all their needs met, imagine how prevalent (and under-diagnosed) it must be the world’s most impoverished areas. Failure to treat mental illness not only impedes an individual’s positive liberties, it can also result in the most grievous violation of ones negative liberties possible–murder.
For some, finding employment is enough to alleviate the symptoms of depression. For others, treatment and therapy are required. Many anti-social behaviors can be tempered by a global push to address depression in adolescents, hopefully this U.N. report focuses a stronger spotlight on preventing and treating adolescent depression.