Intended for healthcare professionals

Head To Head

Should youth mental health become a specialty in its own right? Yes

BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b3373 (Published 26 August 2009) Cite this as: BMJ 2009;339:b3373

Chicken and egg

The concept of mental health services specifically designed to
address
previously unmet needs of young people makes sense. But there is always
concern when promotion of this concept is accompanied by a statement
about mental illness as the "chronic disease of the young."

As we focus on risk prevention for many other diseases, we should be
asking
ourselves why this is so. This is not an invitation for mass screening
with
simplistic questionnaires, or dubious diagnoses of bipolar disorder--and a

need for antipsychotic medications--in 3 year olds.

Rather, it is the question of "who says?" Are young people fed up
with
whatever lives have been designed for them by the adults in charge? If a
large
number of adults in a country with poor leadership felt depressed and
hopeless because the economy was tanking and personal worth declining,
would you say the problem was "mass depression" and prescribe
antidepressants for all?

The old concept of exogenous and endogenous depression--and other
mood
disorders--needs to be re-examined, particularly with regard to the young.

When the philosophy is "it doesn't matter what caused it, it needs
treatment"
it lets those in charge--in this case the adults--off the hook.

We need to spend a lot more time asking and investigating why young
people
are being diagnosed with mental illness in increasing rates, and
addressing
that as much or more than simply treating whatever can be identified.

Competing interests:
None declared

Competing interests: No competing interests

12 October 2009
Joan McClusky
Medical writer
New York, NY 10003