Approximately one in every four young adults – persons between the ages of 18 and 24 – in developed countries worldwide meets criteria for a mental disorder with severe impairment across the lifetime, with the two most prevalent disorders being depression (12.8%) and anxiety (28.2%).  Seventy-five percent of mental health problems, such as depression and anxiety, emerge during young adulthood, and yet this age group is the least likely to seek help when suffering from a mental disorder or distress.

In combination with the chronic nature of anxiety and depression, the early onset of these disorders also increases their negative impact, significantly impairing education, work, and social lives, while increasing rates of self-harm and suicide in this age group. The highest rate of suicide occurs in the 20-24 year old age group.

Help-seeking is a term referring to coping mechanisms and health-related behavior.  It is one thing to recognize a problem as something one can no longer manage, but it is quite another to take the deeply personal step of asking for help, and there can be myriad factors that interfere with the help-seeking process.

Particularly for young adults, autonomy and social networks shape behavior, with seeking help complicated by wanting to feel normal, emotional immaturity, and the perception that help-seeking will be viewed negatively.  Seeking help is not a simple decision, and the development of interventions to encourage young adults to seek help early is critical.

During high school, adolescents use familiar relationships with family and friends as informal sources of help for personal and emotional problems, rather than more formal sources such as the family doctor or a mental health professional.  Around the time of graduation, young men and women increase in their tendency to seek help from friends.  This is developmentally appropriate as young adults become responsible for their own actions and rely more on themselves and their peer groups regarding personal decisions.  However, peers often cannot provide the necessary support.  Studies have shown that troubled youth form relationships with troubled peers to feel a sense of normalcy or belonging.

Social Psychologist Stanley Schachter at Columbia University found that college students who were in a high anxiety condition chose to sit with students who were in the same situation as them.  If students believed that others could not provide them with any means of social comparison there would be no desire to join them.  People may feel threatened by others who are better off and, as a result, choose to avoid them and instead seek out similar others.  Schachter concluded, “misery loves miserable company.”  However, sharing problems with peers can reinforce each other’s level of distress, result in poor problem solving and coping strategies, and cause a longer delay in seeking formal help.

A further complication is the inability to recognize the severity of one’s own symptoms.  In the U.S., a minority (37%) of young adults with clinical levels of psychopathology perceive their problems as self-limiting, instead believing that their difficulties are not serious and will go away.  Young adults, who to some extent, lack emotional maturity and mental health literacy often fail to recognize that their problems warrant intervention.

Fear of the stigma that goes along with mental illness is another barrier.  Many still believe that mental disorders are due to weak personality, that they over-burden the family, and that professionals will respond poorly.  Anxieties about receiving professional help can be a major barrier.  Disclosing personal matters to a professional makes it feel more real, and many fear unsettling treatment sessions, and a loss of personal efficacy.  At their stage in life, young adults are establishing an increasingly independent identity.

When young people do seek professional help, they prefer seeing their family doctors or school-based counselors.  With this in mind, utilizing community support via the educational and health system is crucial in improving help-seeking.  Implementing early mental health awareness in the classroom can promote adolescents to become emotionally competent young adults, and improve their level of trust and sense of normalcy seeing a professional.

However students will only begin seeking help once a clear line of communication regarding mental health is established.  Teachers and family doctors are in key positions to recognize and teach young adults the indicators of mental distress, as they have steady contact and a rapport with their students or patients.  In addition, promotion of mental health literacy requires the availability of high quality information.  By educating teachers on the various dimensions of mental health, they can become more attuned in identifying signs of distress, and can provide an understanding of mental health for their students.  Health education should provide a language to express distress to others.  Nurturing this “voice” can also assist family doctors in recognizing mental distress.

Psychologists Jane Pirkis and Philip Burgess from the University of Melbourne estimated in 1998, that about 38% of Australians who committed suicide had contact with their family doctors within one month of death, underscoring what an important role family doctors can play in mental health and in intervention.

Finally, professional services need to be easy to access for young adults.  Headspace, Australia’s national youth mental health foundation was launched in 2006 with the goal of filling the gap in the mental health system that is not equipped to treat young adults with mental health issues.  From depression to exam stress, they describe themselves as providing services tailored to young people by taking into account the different challenges this specific age group may face.  Recognizing that some young adults withdraw from their usual social supports and may prefer to use the more anonymous phone help-line, Headspace made it easier to access help by providing eheadspace, a 24-hour online and telephone counseling service.

And launched this past October, “Create a Better Story” is an online campaign focused on the importance of sharing personal mental health and help-seeking stories. Using different media including news and magazine articles, blogs, Q & A style interviews and videos, young adults share their personal stories of struggle and seeking help, to encourage others to get help when needed.

Ultimately, to aid in young adults feeling safe and hopeful about seeking help, health care professionals must provide services both educationally and in the community that work in true partnership with young adults’ specific needs.

– Stephanie Rhys, Contributing Writer