There is a lack of epidemiological research on the mental health of young adults in Ireland.

To determine prevalence of psychiatric disorders in a cohort of young Irish adults.

The Challenging Times study was a landmark study of the prevalence of psychiatric disorders in adolescents in North Dublin, Ireland: 212 school children aged 12-15 years were recruited through schools and interviewed using the K-SADS semi-structured diagnostic instrument. This cohort was traced again at age 19-24 years (mean age 20.8 years) and interviewed using SCID I & II. Main outcome measures were current and lifetime Axis I and Axis II psychiatric disorders.

Follow-up rate was 80%. Using a weighted population prevalence analysis 19.8% of the cohort had a current mental disorder, 56.0% had a lifetime mental disorder of whom 28.4% had mood disorders, 27.1% had anxiety disorders, 22.7% had substance use disorders; 25.4% had lifetime multi-morbidity. Cluster A personality disorders were found in 2.3%. Lifetime prevalence of binge-drinking was 75.0%, cannabis use 65% and 17% of young adults had fulfilled criteria for an alcohol use disorder at sometime in their life. Lifetime prevalence of suicidal thoughts/behaviour was 21.1%.

Lifetime prevalence of psychiatric disorder and substance use were high in this sample of young Irish adults. Mental Health service provision for this age group is a priority. Larger studies of nationally representative samples are needed to inform service development.

The aim of this study is to examine the risk and protective factors associated with anxiety and depression in a representative sample of Irish adolescents.

Data used in this study were drawn from a subset of the My World Survey (MWS). The MWS-Second Level (MWS-SL) subset consists of a randomised sample of 72 schools, with a final sample of 6085 students. Outcome measures were depression and anxiety. Risk and protective factors included measures within the socio-demographic, psychosocial and risk-taking domains.

One in three adolescents experienced elevated levels of depression and anxiety. Age, gender, maternal education, family composition, parental mental health as well as the experience of racism and bereavement were associated with elevated distress. Psychosocial factors associated with depression and anxiety included optimism, personal competence, life-satisfaction, self-esteem, anger, body dissatisfaction, family competence, maternal and paternal criticism, experiencing the break-up of a romantic relationship, school and peer connectedness as well as the availability of one good adult. Finally, engaging in substance misuse was found to increase the likelihood of anxiety and depression.

Since factors protecting and putting adolescents at risk of anxiety and depression exist at every level of the adolescent’s ecological system, the study supports a community-based approach to youth mental health.

Self-report data from 2716 adolescents aged 15–17 years old in Irish schools were analysed to consider the association between psycho-social factors and the presence of adolescent substance and alcohol abuse, with an emphasis on family circumstances.

Data were collected using the ‘Lifestyle and Coping Questionnaire’ which includes questions about lifestyle, coping, problems, alcohol and drug use, deliberate self-harm, depression, anxiety, impulsivity and self-esteem. Two additional questions were added to the standard questionnaire regarding parental substance misuse.

Adolescent substance abuse was more common in boys; parental substance misuse increased the risk of adolescent abuse of alcohol and drugs; the increased risk was marginally higher if the parental substance abuse was maternal rather than paternal; the increased risk was higher if the parental substance abuse affected both rather than one of the parents, especially regarding adolescent drug abuse; the magnitude of the increased risk was similar for boys and girls. Parental substance misuse increased the risk of adolescent substance abuse even after adjusting for other family problems and the adolescent’s psychological characteristics.

This study indicates that parental substance misuse affects the development of both alcohol and drug misuse in adolescent children independent of other family problems and the psychological characteristics of the adolescent. A wider perspective is needed, including societal and family issues, especially parental behaviour, when attempting to reduce risk of adolescent addiction. The impact on children of parental substance misuse also needs consideration in clinical contexts.

Social context has a major influence on the detection and treatment of youth mental and substance use disorders in socioeconomically disadvantaged urban areas, particularly where gang culture, community violence, normalisation of drug use and repetitive maladaptive family structures prevail. This paper aims to examine how social context influences the development, identification and treatment of youth mental and substance use disorders in socioeconomically disadvantaged urban areas from the perspectives of health care workers.

Semi-structured interviews were conducted with health care workers (n=37) from clinical settings including: primary care, secondary care and community agencies and analysed thematically using Bronfenbrenner’s Ecological Theory to guide analysis.

Health care workers’ engagement with young people was influenced by the multilevel ecological systems within the individual’s social context which included: the young person’s immediate environment/‘microsystem’ (e.g., family relationships), personal relationships in the ‘mesosystem’ (e.g., peer and school relationships), external factors in the young person’s local area context/‘exosystem’ (e.g., drug culture and criminality) and wider societal aspects in the ‘macrosystem’ (e.g., mental health policy, health care inequalities and stigma).

In socioeconomically disadvantaged urban areas, social context, specifically the micro-, meso-, exo-, and macro-system impact both on the young person’s experience of mental health or substance use problems and services, which endeavour to address these problems. Interventions that effectively identify and treat these problems should reflect the additional challenges posed by such settings.

Mental health literacy is increasingly referenced as a goal of mental health policy. However, the current definition of this concept has a relatively narrow focus on mental disorders. The objectives of this study were to explore mental health literacy through the use of vignettes and to begin to articulate a broader definition.

Six groups of young people (n=42) aged between 16 and 25 years old responded to open-ended questions about vignettes depicting fictional characters with diagnosable mental health problems. The responses were analysed using Foucault’s governmentality theory.

The responses to the vignettes highlighted a range of determinants of our mental health. The young people suggested informal mental health-promoting techniques and highlighted the importance of talking. Ambiguity was reported in relation to the types of knowledge that are important in responding to mental health need. Finally, the responses were reflective of young people who are empathetic and view mental health from the perspective of our shared humanity, rather than as a marginal issue.

As mental health literacy is increasingly becoming a goal of mental health policy, it is timely that a shared understanding of this important concept is articulated. The current definition of mental health literacy is narrow in its focus on the recognition of mental disorders. A more broad-based definition of mental health literacy should be adopted by policy makers, reflecting the full range of determinants of mental health and recognising the importance of mental wellbeing.

Irish adolescents have one of the highest rates of suicide and self-harm in the European Union. Although primary care has been identified as an opportune environment in which to detect and treat mental health problems in adolescents, lack of training among primary care professionals (PCPs) is a barrier to optimum identification and treatment. We describe the development and evaluation of an educational intervention on youth mental health and substance misuse for PCPs.

Thirty general practitioners and other PCPs working in the Mid-West region participated in an educational session on youth-friendly consultations, and identification and treatment of mental ill-health and substance use. Learning objectives were addressed through a presentation, video demonstration, small group discussions, role play, question-and-answer sessions with clinical experts, and an information pack. Following the session, participants completed an evaluation form assessing knowledge gain and usefulness of different components of the session.

A total of 71% of participants were involved in the provision of care to young people and 55% had no previous training in youth mental health or substance abuse. Participants rated knowledge gains as highest with regard to understanding the importance of early intervention, and primary care, in youth mental health. The components rated as most useful were case studies/small group discussion, the ‘question-and-answer session’ with clinical experts, and peer interaction.

The educational session outlined in this pilot was feasible and acceptable and may represent an effective way to train professionals to help tackle the current crisis in youth mental health.

Study of illness characteristics and symptoms in a young population with psychosis can assist for understanding of their needs, and can inform service planning strategies. The aims of the current study were to describe illness characteristics and symptoms of a first episode psychosis (FEP) sample aged 25 years and under, and compare with a sample aged over 25 years.

Interviews were conducted for 437 individuals aged 16–65 years presenting with suspected psychosis between 2005 and 2012 in a defined catchment area (population of 390 000) using the Structured Clinical Interview for DSM IV to determine the presence of a psychosis diagnosis. Individuals with confirmed psychosis were assessed using standardised instruments to determine illness characteristics at first presentation.

Among the 25 years, and under FEP sample, 23.9% had their first onset of symptoms (prodromal or psychotic) before 18 years of age. After controlling for confounders, the sample aged 25 years and under had a significantly shorter log transformed duration of untreated psychosis (p=0.002), more negative symptoms (p=0.045) and greater frequency of comorbid cannabis abuse diagnosis (p=0.027).

Symptom onset in a youth FEP sample frequently occurs before age 18 years. Certain illness characteristics differed across the age categories, such as greater negative symptoms and cannabis abuse in the youth sample. Overall, the findings support the provision of adequate strategies for management of negative symptom deficits and substance abuse across all ages in FEP.

Increasing rates of young people not in education, employment or training (NEETs) are a cause of concern both in Ireland and internationally, but little longitudinal research has examined the link between psychiatric disorder in young people and NEET status.

The Challenging Times (CT) Study is a longitudinal, population-based study of psychopathology among 212 young Irish people. Clinical interviews were performed at two time points: 12–15 years and 19–24 years.

NEET status in young adulthood was associated with a sevenfold increased risk of current suicidal ideation. This result was independent of prior adolescent mental disorder. NEET young people had a fourfold increased odds of being diagnosed with a mental disorder in childhood or early adolescence compared with their economically active peers. NEET young people were at an almost threefold increased risk of any mental health disorder a twofold increased risk of anxiety disorder and threefold increased odds of suicide attempts over their lifetime compared with economically active peers.

NEET young people are at increased risk for mental disorder and suicidal ideation. The association is bidirectional, as prior mental disorder in adolescence appeared to account for much of the association between NEET status and current mental health problems. However, economic inactivity conveys an increased risk for suicidal ideation over and above that due to prior disorder. Our findings provide a compelling economic and societal argument for early intervention and treatment of mental disorder and the importance of vocational interventions for reducing suicide risk in young adults.