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The purpose of this study is threefold: Determine recent trends in several mental health problems in the USA, identify risk factors that may be responsible for the trends and evaluate intervention policies to reduce the consequences of these problems.

This study used data from the National Survey of Children's Health (NSCH), a nationally representative survey of children under the age of 17 that was conducted between 2016 and 2022. Prevalence rates in the data take into account the probability of selection and nonresponse. Because of the possible correlation in the longitudinal responses in the data, an appropriate extension of the generalized linear models (the marginal models) was used. Marginal models, also known as population-average models, do not require distributional assumptions for the observations, only a regression model for the mean response. The avoidance of distributional assumptions leads to the use of the generalized estimating equations (GEE) method.

The author found that the odds of children and adolescents experiencing mental health problems in the USA changed over a seven-year period, from 2016 to 2022. Anxiety and depression, in particular, have both increased, with anxiety increasing faster than depression; however, behavioral issues and attention deficit disorder/attention deficit hyperactivity disoder (ADD/ADHD) remained stable until 2020 (the start of COVID-19), when they began to rise. This paper also found a link between increased social media use and increased mental health problems, and bullying has a negative impact on the mental health of children and adolescents.

The NSCH, an annual representative survey, was used in this study to assess mental health problems among children and adolescents in the USA. Marginal models, which enable the capture of potential correlations among observations of the same subject, were used in conjunction with the GEE method. This study differs from previous research, which used other surveys, pre-COVID-19 data points and logistic regressions that assumed independence in repeated observations.

The risk factors related to the mental health issues of adolescents diagnosed with mild to moderate intellectual difficulties (MMID) are not consistently recognised in South Africa. This paper aims to address the scarcity of literature by examining the risk factors linked to the mental health issues of adolescents with MMID.

Four hundred and fourteen participants were sampled from adolescent learners attending three special educational needs schools in Gauteng, South Africa. The selected sample included 275 male and 139 female participants with a median age of 16.5 years. The three schools represented Grade 8 with 177 learners and Grade 9 with 237 learners. Data were collected through a biographical questionnaire and an Adverse Child Experiences Questionnaire. A quantitative approach was used to identify the risk factors impacting the mental health of adolescents with MMID. The findings were used to propose intervention programmes for the support of adolescents diagnosed with MMID.

The findings suggest that risk factors for mental health difficulties issues among adolescents with MMID include family dysfunction, along with experiences of physical, sexual and verbal abuse as well as emotional and physical neglect. The recommendations stemming from the findings advocate empowering teachers, parents and caregivers to provide support for the mental health of learners with MMID.

The study makes a valuable contribution to reducing the existing gap in the literature regarding risk factors impacting the mental health of adolescents with MMID in South Africa. The study served as a platform for adolescents diagnosed with MMID to articulate their challenges. This cohort is occasionally marginalised and this research acts as an active contribution to research that focuses on their experiences. Their insights are crucial for enhancing intervention programmes and promoting their overall well-being.

Adolescence is a time when a young person develops his or her identity, acquires greater autonomy and independence, experiments and takes risks and grows mentally and physically. To successfully navigate these changes, an accessible and health system when needed is essential.

We assessed the structure and content of national primary care services against these standards in the field of adolescent health services. The main criteria identified by adolescents as important for primary care are as follows: accessibility, staff attitude, communication in all its forms, staff competency and skills, confidential and continuous care, age appropriate environment, involvement in health care, equity and respect and a strong link with the community.

We found that although half of the Models of Child Health Appraised countries have adopted adolescent-specific policies or guidelines, many countries do not meet the current standards of quality health care for adolescents. For example, the ability to provide emergency mental health care or respond to life-threatening behaviour is limited. Many countries provide good access to contraception, but specialised care for a pregnant adolescent may be hard to find.

Access needs to be improved for vulnerable adolescents; greater advocacy should be given to adolescent health and the promotion of good health habits. Adolescent health services should be well publicised, and adolescents need to feel empowered to access them.

Given that the workforce constitutes a principal resource of primary care, appraisal of models of care requires thorough investigation of the health workforce in all Models of Child Health Appraised (MOCHA) countries. This chapter explores this in terms of workforce composition, remuneration, qualifications and training in relation to the needs of children and young people. We have focused on two principal disciplines of primary care; medicine and nursing, with a specific focus on training and skills to care for children in primary care, particularly those with complex care needs, adolescents and vulnerable groups. We found significant disparities in workforce provision and remuneration, in training curricula and in resultant skills of physicians and nurses in European Union and European Economic Area Countries. A lack of overarching standards and recognition of some of the specific needs of children reflected in training of physicians and nurses may lead to suboptimal care for children. There are, of course, many other professions that also contribute to primary care services for children, some of which are discussed in Chapter 15, but we have not had resources to study these to the same detail.

The purpose of this paper is to expand upon policy implications of a recent study assessing adolescent mental health service contact and subsequent depression.

Review of related evidence from academic and grey literature.

Studies assessing the role of mental health services in reducing mental disorder during adolescence are sparse, and even prevalence figures for adolescent mental disorders are out-of-date. Adolescent mental health service contact rates are shown to fall concurrent with budgetary decreases. School-based counselling is highlighted as an important source of help that may be at risk of being cut. Increased training of General Practitioners and school counsellors is needed to improve efficiency in specialist Child and Adolescent Mental Health Services (CAMHS).

Longitudinal studies of young people’s mental health should include mental health service usage and its relationship with subsequent mental health outcomes.

Funding cuts to CAMHS must be avoided, school-based counselling must be protected, and service referrers should be better trained.

This paper highlights the need for increased CAMHS data, sustained funding, and improved training for this vital service.

This study aims to gain a comprehensive understanding of adolescent’s experiences of individual school social work counselling in Swedish elementary schools.

The study encompasses interviews with 16 adolescents about their experiences of individual counselling with school social workers (SSWs). The data was analysed using conventional content analysis.

The main result was the adolescents’ desire “to navigate to shore” to speak freely about their whole lives with a professional SSW and find a “ safe haven,” […] where a trusting professional cared for and comforted them in counselling. The counselling contact contributed to increased knowledge about oneself. The results reveal the importance of the SSWs paying attention and listening to the adolescents’ narratives. The creation of a coherent life narrative enables to finally end counselling and “Cast off.”

The results highlight the importance of Swedish SSWs focusing on individual counselling sessions with adolescents to provide a setting for growth.

High school students are a common target group in initiatives addressing discriminatory attitudes towards people with mental illness. However, these initiatives are rarely evaluated and documented. The aim of our paper is to evaluate the effectiveness of a school-based educational intervention for improving adolescents' attitudes and reducing the desire for social distance from people with mental illness living in their community. A total of 161 students aged 16-18 years old were questioned at baseline assessment and 86 of them received a three-workshop educational intervention while 75 students comprised the control group. A follow-up assessment 1 month post intervention evaluated its impact. Attitudes and the social distance were assessed through the Community Attitudes towards the Mentally Ill scale and a 10-statement questionnaire based on the Self-report Inventory of Fear and Behavioural Intentions, respectively. Data from 140 subjects were analyzed. All attitude dimensions and half of the measured social distance statements were significantly improved in the intervention group at follow up assessment compared to controls. However, the statements measuring more intimate types of social relationships did not change significantly post intervention. In conclusion, short educational interventions can be effective to some extent in reducing discriminatory attitudes towards people with mental illness. However, effective interventions to address deeply held negative stereotypes will require further research.

Improvements in neonatal and paediatric care mean that many children with complex care needs (CCNs) now survive into adulthood. This cohort of children places great challenges on health and social care delivery in the community: they require dynamic and responsive health and social care over a long period of time; they require organisational and delivery coordination functions; and health issues such as minor illnesses, normally presented to primary care, must be addressed in the context of the complex health issues. Their clinical presentation may challenge local care management. The project explored the interface between primary care and specialised health services and found that it is not easily navigated by children with CCNs and their families across the European Union and the European Economic Area countries. We described the referral-discharge interface, the management of a child with CCNs at the acute–community interface, social care, nursing preparedness for practice and the experiences of the child and family in all Models of Child Health Appraised countries. We investigated data integration and the presence of validated standards of care, including governance and co-creation of care. A separate enquiry was conducted into how care is accessed for children with enduring mental health disorders. This included the level of parental involvement and the presence of multidisciplinary teams in their care. For all children with CCNs, we found wide variation in access to, and governance of, care. Effective communication between the child, family and health services remains challenging, often with fragmentation of care delivery across the health and social care sector and limited service availability.