Guidelines on mental health promotive and preventive interventions for adolescents

Guidelines on mental health promotive and preventive interventions for adolescents

The Guidelines on promotive and preventive mental health interventions for adolescents – Helping Adolescents thrive (HAT), provide evidence-informed recommendations on psychosocial interventions to promote mental health, prevent mental disorders, and reduce self-harm and other risk behaviours among adolescents.

The HAT Guidelines aims to inform policy development, service planning and the strengthening of health and education systems, and facilitate mainstreaming of adolescent mental health promotion and prevention strategies across sectors and delivery platforms.

Background

The need to focus on the mental health of adolescents is gaining increasing recognition as the global community looks to achieve the Sustainable Development Goals (SDGs), in particular SDG 3: “Ensure healthy lives and promote well-being for all at all ages” and SDG 10: “Reduce inequalities within and among countries”. With adolescents comprising 16% of the global population, it is vital to address the main threats to their health in order to achieve the SDG targets.

Mental health conditions account for a considerable proportion of the global disease burden during adolescence and are the leading cause of disability in young people. Up to half of all mental health conditions start before the age of 14 years. Suicide is one of the three leading causes of death among older adolescents. Poor mental health in adolescence portends a range of high-risk behaviours, including self-harm, tobacco, alcohol and other substance use, risky sexual behaviours and exposure to violence, the effects of which persist and have serious implications throughout the life-course.

There are multiple opportunities for health promotion and disease prevention in adolescence, which could benefit young lives in the short and long term. This stage is deemed as one of the optimal timeframes for intervention, given the neuroplasticity evident in adolescence and the opportunity to step in at a time when the majority of mental health conditions and risky behaviours have their onset.

Aim, scope and target audience

These Guidelines on promotive and preventive mental health interventions for adolescents: helping adolescent thrive (HAT guidelines) provide evidence-informed recommendations on psychosocial interventions to promote positive mental health and prevent mental disorders among adolescents. These guidelines, the UNICEF/WHO HAT toolkit and other related implementation tools aim to support evidence-informed programming to achieve that goal. The HAT guidelines have been prioritized by WHO as one of its global public goods for health.

The guidelines are based on evidence from studies of interventions delivered to 10–19 year-olds, with particular attention to: (i) universal interventions delivered to unselected adolescents; (ii) targeted interventions delivered to adolescents who are known to be at increased risk of mental disorders or self-harm, because of exposure to specific adversities (violence, poverty and humanitarian emergencies), chronic illness (HIV/AIDS) and/or particular life circumstances (adolescent pregnancy and/or parenthood); and (iii) indicated interventions delivered to adolescents who present early signs and/or symptoms of emotional and/or behavioural problems but do not have a formal diagnosis of an emotional and/or behavioural disorder. In reviewing the evidence, the primary outcomes of interest were improved well-being and functioning, reduced symptoms and incidences of mental disorders, and reduction in self-harm among adolescents. Other outcomes of interest included reduced risky behaviours (substance use and aggression), improved school retention, and healthier sexual and reproductive behaviours.

The primary target audience of the guidelines includes national policy-makers, planners, and managers of government and nongovernmental health care programmes, along with people working in international health and development agencies.