Mental health conditions amongst young people have doubled in the past decade with researchers describing it as "a silent pandemic of psychological distress".
A commentary published today called Youth Mental Health in Aotearoa New Zealand: Greater Urgency Required, produced by Koi Tū: The Centre for Informed Futures at The University of Auckland, looked into the factors that impacted young people's mental health, and effective strategies for prevention and intervention.
It called for urgent action to better understand the rapid rise in issues among youth, and found nationally, poor mental health in our rangatahi had doubled in 10 years - a sharp rise - which was inequitable and only worsening.
The collection of psychologists and academics providing commentary on the matter included Sir Peter Gluckman, professor Richie Poulton and Rochelle Menzies.
"We don't understand what is going on because we are only now screaming there is a problem that has been ignored, that is the rapidly rising rate of compromise to young people's mental well being," Sir Peter Gluckman said.
Added impacts of Covid-19 on youth mental health was likely to be extensive and enduring.
The protection and promotion of mental wellbeing for youth was a matter of urgency, he said.
New Zealand also faced unique challenges around the mental health of young Māori and Pacific people, particularly for girls.
The research group wanted a new, fit-for-purpose baseline study of children and adolescents to understand the context and conditions underpinning the mental health of New Zealand's youth.
The commentary followed the Youth 19 survey of 7721 school students, aged 13-19 years, which painted a bleak picture. The survey was done by researchers including Dr Terry (Theresa) Fleming from the University's Faculty of Health and Associate Professor Terryann Clark from the University of Auckland.
Around 23 percent (29 percent of females and 17 percent of males) reported symptoms of depression, about twice the rate of 2012.
The Youth 19 study found 38 percent of Māori and 37 percent of Pacific females reported depression compared to 24 percent of Pākehā females, highlighting growing ethnic inequities in mental health.
Among rainbow and queer (LGBTQIA+) youth, about 57 percent reported experiencing symptoms of depression.
Overall 6 percent of those surveyed reported they had attempted suicide in the previous 12 months.
Recent reports revealed detrimental impacts of lockdowns on school-aged youth with potentially lifelong implications, and expert warnings around the heightened vulnerability of youth during the pandemic and beyond.
"During these times of unprecedented uncertainty and disruption, we need targeted efforts to promote greater well-being and brighter futures for our increasingly vulnerable youth population," Sir Peter said.
The World Health Organisation reports that 16 percent of the global burden of disease and injury for adolescents aged 10-19 years is attributable to mental morbidity, such as depression and anxiety. They estimate that 10-20 percent of adolescents worldwide will experience mental illness to some extent.
Further, a large portion of the 1.2 billion global youth population have symptoms that compromised their mental well-being, which when combined with the normal risk taking of adolescence increased their risks of injuries, self-harm and substance abuse.
For youth belonging to disadvantaged populations and marginalised communities, the risks of mental illness, addictions and suicide was much higher.
Ethnicity, poverty and sexual orientation are particularly critical determinants of mental health and wellbeing.
There was a need to build "psychological resistance, emotional control, improve early childhood and child rearing practices" to equip and strengthen the younger generation, Sir Peter said.
Causes of worsening youth mental health
So why have these rates risen so quickly?
The research highlights the need to consider "the digital milieu, and more removed issues such as early life experience, trauma, educational structures, and changing parenting, family and social contexts" when considering the causes of worsening mental health.
The most important issues for youth, identified by respondents were social media and technology, bleak futures, climate change, and risky choices. These findings were supported by international literature investigating the mental health of young persons aged 10-24 years.
The role of social media and the use of alcohol/drugs was also damaging.
"There is growing evidence that a complex interplay of contextual determinants, sociocultural and historic factors, and personal-behavioural mechanisms play a significant role in the higher risk of mental health morbidity and suicidality among young people," the research says.
There is also evidence that maternal mental health during pregnancy and directly after a child's birth is a major factor in affecting their offspring's self-control.
Research shows factors such as cultural identity, resilience, and self-regulation as protective for youth mental wellbeing.
But, "no one factor is causal and many of these factors interact," the report said.
Protecting and promoting youth mental health
The study found determinants which are highly fluid and not well understood become increasingly complex when intergenerational trauma, marginalisation and disadvantage is at play in the lives of indigenous and other minority groups, as is the case for many Māori and Pacific young people.
Recognising obligations under Te Tiriti o Waitangi, protection and strengthening of mental well-being for rangatahi Māori needed to be prioritised to ensure equitable and sustainable improvements were made.
This is a "matter of urgency," and we need research to identify the risk and protective factors influencing youth mental health and to design effective solutions to sustainably improve mental well-being for young people, Sir Peter said.
Studies show New Zealand youth felt change was needed in improving youth mental well-being, including listening to youth, promoting connection and fun, updating education, and protecting their futures.
"It is critical to acknowledge the aspirations and diversity of youth in Aotearoa New Zealand," Sir Peter said.
Where to get help:
Need to Talk? Free call or text 1737 any time to speak to a trained counsellor, for any reason.
Lifeline: 0800 543 354 or text HELP to 4357
Suicide Crisis Helpline: 0508 828 865 / 0508 TAUTOKO (24/7). This is a service for people who may be thinking about suicide, or those who are concerned about family or friends.
Depression Helpline: 0800 111 757 (24/7) or text 4202
Samaritans: 0800 726 666 (24/7)
Youthline: 0800 376 633 (24/7) or free text 234 (8am-12am), or email firstname.lastname@example.org
What's Up: online chat (3pm-10pm) or 0800 WHATSUP / 0800 9428 787 helpline (12pm-10pm weekdays, 3pm-11pm weekends)
Kidsline (ages 5-18): 0800 543 754 (24/7)
Rural Support Trust Helpline: 0800 787 254
Healthline: 0800 611 116
Rainbow Youth: (09) 376 4155
If it is an emergency and you feel like you or someone else is at risk, call 111.