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In the world, at least 13% of the population between 10 and 19 have mental-health disorders that are diagnosed in the latest State of the World's Children report released in the last week of United Nations children's charity UNICEF. This is the very first time in the organisation's history that its flagship report has addressed the issues in the prevention and treatment of mental-health issues in youngsters. It shows that adolescent mental health is a complex area and understudied, as well as underfunded. These findings are confirmed in a collection of review articles that were published today in a variety in Springer Nature journals.

Depression and anxiety comprise over 40% of mental health disorders in young people (those between the ages of 10 and 19). UNICEF is also reporting that all over the world suicide is the 4th most common cause of deaths (after injuries from a vehicle tuberculosis, violence in the workplace and road accidents) in adolescents (aged between 15 and 19). In the eastern part of Europe and Central Asia suicide is the most common cause of death among youngsters in this age bracket -- and it's the second most-caused cause of death in the western regions of Europe as well as North America.

Sadly, the amount of psychological stress among adolescents appears to be on the rise. A study revealed that rates of depression in a nationally comparable sample of US teenagers (aged 12-17) rose from 8.5 percent of adolescents to 13.2 percent between 2005 and 2017.  There is also evidence to suggest that the coronavirus epidemic is accelerating this pattern in some countries. In an all-encompassing research study two from Iceland teens (aged 13-18) had significantly more signs of mental illness during the time of the pandemic compared to their counterparts prior to it. In addition, girls were more likely to suffer from the symptoms than males.

While the majority of mental health disorders develop in the adolescent years, UNICEF states that only one-third of the research funding is geared towards children. Furthermore, the research itself is fragmented Scientists involved are typically part of important disciplines, like paediatrics, psychiatry and epidemiology. The connections between health care and research services are usually weak. Therefore, effective methods of treatment and prevention are sporadic and lacking an accurate knowledge of what works in what context, and why.

The current collection of reviews dives into the current state of knowledge of the various interventions -- the ones that work as well as those that don't to prevent and treat depression and anxiety among teenagers aged 14-24. In some of the studies that included young people who had an experience of anxiety and depression were involved as co-investigators in the creation and implementation of the review as well as the their interpretation of the findings.

Search for innovative therapies

The most widely used treatment for depression and anxiety is a type of medication called selective serotonin-reuptake inhibitors. These drugs enhance serotonin levels within the brain. They are designed to improve mood and emotion. However, their limited efficacy and significant side negative effects  have led to the research of other physiological mechanisms responsible for anxiety and depression among teenagers to ensure that innovative therapeutics could be developed.

Researchers are studying possible links with depression as well as inflammatory diseases including asthma as well as cardiovascular diseases and IBD. This is due to the fact that often, people who suffer from depression are also affected by these conditions. Furthermore, evidence suggests that, in rodents, changes in the gut microbiota throughout development decrease behaviors that are similar to those associated with depression and anxiety in individuals It suggests that focusing on the gut microbiome in adolescents could be a viable method to reduce anxiety in young people. Kathrin Cohen Kadosh at the University of Surrey in Guildford, UK, and colleagues looked over the existing research on interventions where diets were modified to improve the microbiome in the gut. The results showed that these interventions only a minimal impact on the development of anxiousness However, the authors recommend caution before making a decision that is confirmed by pointing out the limitations of their methodological approach (including tiny samples) in the studies they looked at. They suggest that the next batch of research will have to include larger-scale clinical studies.

However, research has observed that developing youngsters' cognitive and interpersonal skills may be more efficient in treating and preventing depression and anxiety under certain circumstances, though the reasons behind this are not yet understood. For example, a concept that is referred to as decentring or psychological distancing (that is, assisting individuals to have an objective view of negative emotions and thoughts) could help reduce depression and anxiety, according to Marc Bennett at the University of Cambridge, UK, as well as colleagues 6 however the neurobiological processes that underlie this are not clear.

Furthermore, Alexander Daros at the Campbell Family Mental Health Institute in Toronto, Canada, and colleagues present a meta-analysis based on 90 controlled studies that were randomized. They discovered that assisting adolescents to develop their emotional regulation skills that help regulate emotional responses to challenging situations, allows them to manage depression and anxiety seven. But, it's not certain if improved control in the control of emotional responses is the reason or the result of these changes.

Co-production is essential

It's rare -- but more and more, it is considered essentialresearchers conducting research on treatment and interventions are directly engaging adolescents who've suffered from mental illness. Young people must be included in every aspect of the research process, from conceptualizing the design of a study through conducting it, and then analysing the findings. This will yield more effective science and decrease the possibility of implementing ineffective or irrelevant actions.

Two of these young people are co-authors of a review by Karolin Krause from the Centre for Addiction and Mental Health in Toronto, Canada, and colleagues. The review examined the possibility that training in problem-solving can help alleviate symptoms of depression. The two youth partners together, established an advisory panel consisting of 12 youth advisers. Together they offered input into how the examination of research was conducted as well as on the interpretation and context of the results. It was concluded by the study that even though problem-solving instruction can aid to overcome personal struggles when it is combined with other therapies but it cannot in itself decrease the symptoms of depression.

The main message that comes out from these studies is that there isn't a "silver bullet" to prevent and treat depression and anxiety in young people. Rather treatment and prevention must be based on a variety of strategies that are tailored to the specific needs of each person and their particular the context. More evidence of high-quality is also required in the form of large-scale research with established procedures.

In conjunction along with UNICEF report, the research studies emphasize the transformative role funders are required to play and the reason why clinicians, researchers and the communities need to collaborate in more studies that involve youngsters as co-investigators. We can all be more effective in creating an improved, healthier and brighter future for the next generation of children facing greater issues as never before.