Young Minds Matter: Mental disorders and risk-taking behaviour among 13-17 year-olds in Australia
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Sarah Johnson, David Lawrence
Results from Young Minds Matter, the second national survey of mental health and wellbeing of Australian children and adolescents conducted in 2013-141, showed that adolescents with mental disorders were significantly more likely to have engaged in problematic and risky behaviours (e.g. tobacco use, binge drinking, using cannabis, and risky sexual activity) than all 13-17 year-olds. This short article describes some of these findings in further detail.
Young Minds Matter collected information from both parents and young people. Parents undertook structured interviews to determine if their children had mental disorders (including anxiety disorders, ADHD or conduct disorder). Young people completed a structured interview about Major Depressive Disorder (MDD), and answered questions about drug use and sexual behaviours.
Highest rates of smoking, alcohol consumption and cannabis use among those with MDD
Compared to 7% of all 13-17 year-olds, about one quarter of adolescents with MDD and 17% with other mental disorders had smoked cigarettes in the past 30 days.
Around one-third of adolescents with MDD had consumed alcohol in the past 30 days, compared to 18% of all 13-17 year-olds. For adolescent girls, the difference was even greater, with 38% of females compared to 25% of males with MDD reporting that they had consumed alcohol in the past 30 days.
The rate of binge drinking in the previous month for those with MDD was more than twice that for all 13-17 year-olds (28% compared with 12%).
Cannabis and other drugs
Compared to all 13-17 year-olds, adolescents with MDD were significantly more likely to have used cannabis in the last 30 days (about 13% compared to 5%). Around 9% of adolescents with other mental disorders had used cannabis in the last 30 days. Rates of use were similar between males and females.
Between 4-6% of adolescents with MDD or any other mental disorder had used other drugs (e.g., prescription drugs for non-medical purposes, or ecstasy, amphetamines, or cocaine) in the last 30 days compared to 1% of 13-17 year-olds with no mental disorder.
Figure 1: Thirty-day prevalence of risk behaviours by 13-17 year-olds with Major Depressive Disorder (based on self-report) and for all 13-17 year-olds.
Depression among 13-17 year-olds who smoke and use drugs
With the exception of cigarette smoking among males, the proportion of adolescents with MDD was significantly higher amongst those who smoked cigarettes, consumed alcohol or used cannabis in the past 30 days compared to those who did not report doing so. The rates were particularly high among females. Nearly half of 13-17 year-olds females who had consumed alcohol in the past 30 days had MDD, along with 45% of those who had used cannabis and 31% of those who had smoked cigarettes.
Figure 2: Proportion of 13-17 year-olds with MDD (based on self-report) by 30-day risk behaviours.
Text for Figure 2: For 13-17 year-olds who smoked cigarettes in the past 30 days: 30.7% of females and 7.4% of males had MDD, compared with 11.3% of females and 4.8% of males among those who did not smoke cigarettes in the past 30 days. For 13-17 year-olds who consumed alcohol in the past 30 days: 48.2% of females and 14.4% of males had MDD, compared with 11.8% of females and 4.6% of males among those who did not consume alcohol in the past 30 days. For 13-17 year-olds who used cannabis in the past 30 days: 44.9% of females and 12.1% of males had MDD, compared with 13.4% of females and 4.9% of males among those who did not use cannabis in the past 30 days.
Adolescents were also asked about things that they did to help them manage any emotional or behavioural problems that they may have, or to avoid having problems. Around one-quarter of males and half of females who had MDD said that they smoked cigarettes or used alcohol or drugs to help them manage or avoid these problems.
Adolescents with mental disorders (especially MDD) are more sexually active and take greater risks
About two-fifths of 13-17 year-olds with MDD and one-fifth with another disorder had ever had sexual intercourse compared with 11% of young people with no mental disorder. The proportion of 13-17 year-olds with MDD who had sexual intercourse with four or more partners was three times that for all 13-17 year-olds (13% compared with 4%).
Young people with MDD were more likely to have consumed alcohol or used drugs before their last experience of sexual intercourse (26-28% compared with 21% of young people with no mental disorder). Almost 40% of young people with mental disorders other than MDD drank alcohol or used drugs before last sexual intercourse, compared with 24% of all 13-17 year-olds. This was highest for young people with ADHD (46%) and conduct disorder (44%).
These findings confirm an association between mental health problems and risky behaviours in 13-17 year-olds and provide strong evidence based on nationally representative data, including self-report. In particular, these data show such behaviours as most prevalent among young people with major depressive disorder.
A range of strategies have been developed to address health risk behaviours in adolescents, including interventions to reduce access to cigarettes, alcohol and other drugs (such as the alcopops tax), and public health campaigns designed to publicise the harms associated with risky behaviours, or to stigmatise these behaviours. Findings from Young Minds Matter suggest that there may be additional opportunities for reducing harms associated with risky behaviours with interventions that also focus on mental illness. The strong association between health risk behaviours and mental illness, particularly depression, suggests that mental health and wellbeing should be an issue of concern to those trying to reduce risky behaviours in children and adolescents.
The clinical implications are for the screening of risk-taking behaviours in adolescents identified with mental disorders in school, general health and specialist mental health settings. Due to the ubiquity of its use with adolescents, the online environment is also an important space to provide accurate information and support to young people with mental health problems about drug use, unsafe sexual behaviours and other risky behaviours.
If you are a young person aged 12-25 and are worried about your mental health or issues with drug use, you can also use eheadspace. eheadspace is a confidential, free and secure space where young people 12-25 or their family can chat, email or speak on the phone with a qualified youth mental health professional.
References and further information
- Young Minds Matter was a survey of the mental health and wellbeing of Australian children and adolescents. Some 6,310 families with children and adolescents aged 4-17 years participated in the survey, which included a face-to-face diagnostic interview with the parents or carers and a self-report on a tablet computer from 2,967 young people aged 11-17 years. The survey was funded by the Australian Government Department of Health and conducted by the University of Western Australia (UWA) through the Telethon Kids Institute, in collaboration with Roy Morgan Research. A copy of the main report from the Young Minds Matter survey The Mental Health of Children and Adolescents together with a survey results query tool can be found on the Young Minds Matter website. http://youngmindsmatter.org.au/