Between 10-20% of children and adolescents worldwide 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, released in April 2023, revealed that 22% of 15-19-year-olds in the country had a mental disorder. Over a seven-year period from 2012 to 2017, the percentage of young people attempting suicide rose from seven to 10. Additionally, half of mental illnesses in adulthood (excluding dementia) begin before the age of 15, with 75% starting before 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 pediatric and adolescent medicine with a 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 seen in primary care, including emotional disorders, ADHD, ASD, eating disorders, self-harm, suicide, conduct disorder, and risky behaviors.
Anxiety
At the forefront of common presentations are anxiety and depression, accounting for nearly two-thirds (63%) of mental disorders in young people.
“During adolescence, many young individuals may experience heightened anxiety. While some level of anxiety is normal, persistent and debilitating anxiety that hinders daily functioning requires intervention,” Dr. Oketah explained.
Anxiety can manifest in various ways, such as panic attacks, OCD, and GAD. Physical symptoms like chest pain, abdominal pain, constipation, headaches, and dizziness can also accompany anxiety.
Preventing suicide is a priority in managing youth mental health, as it is the fourth leading cause of death in 15-19-year-olds. Ireland has the fourth-highest adolescent suicide rate in the EU.
“Suicide prevention is crucial. While not entirely preventable, it can be mitigated,” Dr. Oketah stated.
She highlighted the Ask Suicide-Screening Questions (ASQ) as a tool to identify at-risk individuals and the PHQ-9M for assessing depressive symptoms in teenagers.
ADHD
ADHD has a global prevalence of 2.8% in adults and around 5% in children. In Ireland, adult prevalence is 1.5% and child prevalence is 4%.
Dr Naazim Mohungoo, a child and adolescent psychiatrist with Vhi 360, discussed the challenges of diagnosing ADHD in primary care due to overlapping symptoms with other conditions like ASD and learning disabilities.
For an ADHD diagnosis, symptoms must meet specific criteria and cause moderate impairment in various aspects of life.
Dr. Mohungoo emphasized the importance of early diagnosis to prevent potential issues like conduct disorders, mood disorders, substance abuse, and suicide.
Management options include ADHD-focused training, CBT, and stimulant medications, with atomoxetine and guanfacine as alternative treatments.
Referring children to the appropriate pathway is crucial to avoid delays in diagnosis and treatment.
The presentations were followed by a Q&A session led by Dr Dáire O’Leary, with additional input from Dr Lieselot Tampere and Regina Hardy, focusing on pediatric mental health.
Information
Vhi 360 Hot Topics offers educational webinars to support primary care healthcare professionals in enhancing patient care. These sessions are carried out in collaboration with MedCafe.ie.
A recording of the recent Vhi 360 Hot Topics webinar on Child and Adolescent Mental Health Conditions is available at www.medcafe.ie/webinars/825
This is an advertorial on behalf of Vhi 360 Hot Topics.
