Emotional and behavioral problems among adolescents

Adolescence is the transitional stage of development between childhood and adulthood, representing the period of time during which a person experiences a variety of biological and emotional changes. Hall denoted this period as “Storm and Stress” and states “conflict at this developmental stage is normal”. During this period, adolescents suffer from various forms of problems/dysfunctions and conflicts, which ultimately impair normal psychosocial development aggravating psychosocial dysfunction and that is why adolescent population is considered to be risk population for psychosocial problems^. Globally, 1 out of 10 (20%) adolescents encounter at least one behavioral problem. Half of lifetime mental disorders begin before the age of 14 years, and 75% begin by the age of 24 years.Studies completed in Canada and USA have shown that mental health among the adolescent population is a public health issue. In developing countries, such as Nepal and other south-Asian countries, scenario of mental health and its care system is worse than compared to developed countries. Similarly, there is also a lack of mental health-related evidence in Nepalese context; available evidence from hospital settings does not represent the situation accurately, and this situation highlights lack of serious effort on adolescent health. In the Indian context, 14–40% of adolescent students are assumed to have mental health problems.

According to the 'Mental Health Status of Adolescents in South-East Asia: Evidence for Action', a report published by WHO in April 2017, 5.8% population of India was in the age group of 13-15. The report suggested that about 25 % adolescents in India reported being depressed for 2 weeks or more.  Among all adolescents, 8% reported being in anxiety, 8% felt lonely most of the times or always and 10% had no friends and 11% adolescents admitted to substance abuse. The report also suggested that bullying in school and by peers increased the mental health issues and substance abuse and active parental involvement reduced the mental health issues while Conduct or behavior problems include problems related to repeated violation of other’s rights, aggressiveness, hyperkinetic impulsive behavior, and missing classes or running away from school.  A study conducted in five developing countries suggest that 10.5 % of adolescent suffer from mental health problems, with significant proportion being conduct problems. Likewise, 20.8 % of children in Brazil, 11.7-13.7 % of school-age children in Sri Lanka, 34-36 % of children in Pakistan, and 30 % of children in India suffer conduct or behavioral problems.

A systematic analysis study for global burden of diseases in 2013 reported that Among various age groups, adolescents and young adults (10-29 yr.) probably suffer the most, contributing to the highest proportion of disability-adjusted life years among various age groups The burden associated with common mental disorders (depressive and anxiety disorders) rises abruptly in childhood (1-10 yr.) and peaks in adolescence and early to middle age (10-29 yr.). The burden associated with less common but chronic disorders, such as schizophrenia and bipolar disorder, although higher in early adulthood  the study also report that Educational pressures, constantly reinforced by the family and the society, have been seen in the background of many suicides in young people in India while Consistent and engaging parental style, being in fulltime education, zero tolerance for bullying at school, involvement in community activities, religious observance, low levels of conflict in the family and social support have been recognized as the protective factors against suicides and mental disorder.