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Part 2: Experiences of Adolescents and Young Adults with Mental Health Concerns

This is part 2 of a 4-part blog series about research done at the First Episode Mood and Anxiety Program (FEMAP) at London Health Sciences Centre (LHSC). FEMAP is a program helping older teens and young adults with emotional concerns which fall into the categories of mood and/or anxiety symptoms. They provide a safe and confidential place for youth to get help early, before symptoms begin to disrupt lives. Research at FEMAP is conducted by researchers at Lawson Health Research Institute and Western University.

It is becoming much more widely known that teens and young adults are experiencing mental health struggles at an increasing rate. According to the Canadian Mental Health Association, about 10 to 20 percent of Canadian youth have a mental health problem. Yet, statistics show that almost half of those young people who are struggling aren’t seeking professional help. There is also a documented pattern showing that those who do seek help often leave treatment too early. Researchers at FEMAP and LHSC wanted greater insight into some of the reasons that this may be, in the hopes that they can make changes to the system in ways that better suit these young people’s needs. Part of their research process involved the recruitment of 37 young people aged 16-25 who reported having mood and anxiety concerns, and then interviewing them to explore how they understand and experience mental health problems. Throughout the paper, the authors use the term “affective illness” to describe the spectrum of mood and anxiety disorders, which is a standard term used in psychiatric practice.

Below we have summarized key themes identified by the researchers based on what the youth expressed regarding their understanding of affective illness and their management of the experience.

Understanding Affective Illness:

  • These youth participants generally displayed a good understanding when it came to the complexity in causes of mental illness, noting a combination of environmental factors (life experiences) and biological factors (physical changes in the brain or predispositions in our DNA).
  • They also strongly felt that a person must have personal experience with mental illness, be it themselves or a close friend or family member, in order to truly understand it. In fact, many admitted that their own attitudes towards mental illness changed after their personal experiences with it.
  • The main issue gathered from the participants in terms of understanding affective illness (mood and anxiety disorders), which in turn was identified by the youth as one of the main barriers that held them back from getting help, was being unsure of whether what they were experiencing was an illness or simply a normal adolescent experience and/or reaction to life stressors. There did not seem to be a specific event that caused a shift in participants’ thinking and made them decide it was serious enough to seek help.

Note: This is a valuable takeaway for public education campaigns to consider: in order to encourage more of these individuals to seek help, it might be important to really emphasize that prolonged periods of low mood or anxiety that impair functioning is not just something everyone experiences or something to deal with on your own.

Managing the Experience of Affective Illness:

  • Active Participation - many expressed a desire to have some control over their condition, an active role in their treatment, and a clinician who works with them rather than making decisions for them. Therefore, it may be important for clinicians to focus on making sure patients in this age group feel empowered when it comes to their treatment.
  • Medication - a lot of the youth mentioned being reluctant to take medication for their disorder in fear of stigma, whereas some reported that medication made them feel like their diagnosis was more “real” and valid. Also, participants who were initially worried that taking medication would cause a “loss of self” found that this did not end up being the case and instead agreed that medication was helpful, but that it’s important for it to be paired with some sort of talk therapy.

Note: This is another takeaway for clinicians: it may be crucial to have open discussions with their young patients about the purpose and implications of medication use.

  • Relationships - the importance of relationships, both with health providers and with family and friends, was clearly expressed.
  • Stigma - both perceived stigma (worries about other people holding negative attitudes towards them) and self stigma (internalized negative beliefs held by society that affects the young person’s attitude toward themselves) influenced help-seeking

Note: One finding that particularly interested me, and that I feel really speaks to how society holds mental health as less legitimate than physical health, is that the participants felt there was less stigma when people understood and acknowledged the genetic and/or biochemical factors that can lead to mental illness.

The study hoped to gain a better understanding of systemic barriers young people experience when seeking help, such as lack of services, wait lists, etc., but participants didn’t really mention these factors. The researchers thought this might be because most of the participants were currently receiving treatment and perhaps weren’t thinking about the barriers they may have experienced after making the decision to reach out. However, there are still some important takeaways as previously noted!

For part one of this series, click here

You can find more information about FEMAP here, and if you’re interested in looking up the article, you can find the reference information below!

Bluhm, R. L., Covin, R., Chow, M., Wrath, A., & Osuch, E. A. (2014). “I just have to stick with it and it’ll work”: Experiences of adolescents and young adults with mental health concerns. Community Mental Health Journal, 50(7), 778-786. DOI: 10.1007/s10597-014-9695-x