Depression turns generation gap into a chasm

Dr Michael Sawyer is Associate Professor, Department of Psychiatry, Adelaide University, and one of the authors of The Mental Health of Young People in Australia.
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Wednesday, 28 February 2001

An Adelaide University study has revealed that a large number of adolescents in Australia perceive themselves to be depressed, but their parents seem unaware of their problems and may not seek help for them. These adolescents are prone to risk-taking behaviour and some may contemplate suicide. School-based services may be among the most effective for some of these students.

Adolescents and their parents quite often disagree. When opinions differ over fashion, music and television programs, there is no real cause for concern, but you can't say that about disease. Clinical depression in adolescents is an alarming illness, made much more so by the finding that adolescents and their parents often disagree about the extent of the problem; or even whether there is a problem at all.

Dr Michael Sawyer is in no such doubt about the problems posed by adolescent depression. "Adolescent depression is a major health problem," he said. Dr Sawyer, Associate Professor in the Department of Psychiatry at Adelaide University, is one of the authors of 'The Mental Health of Young People in Australia,' a report arising from the Child and Adolescent Component of the National Survey of Mental Health and Wellbeing, which was funded by the Commonwealth Government.

The report was released in October 2000, and contained much new information about the mental health problems that affect some 14% of Australian children and adolescents. Dr Sawyer described results in the area of adolescent depression at a national seminar, BLUEPRINT: a national response to depression, in Canberra from 28 Feb to 1 March 2001.

Structured interviews with those who care for adolescents (usually their parents) produced an estimate that 4.8% of adolescents suffer from clinical depression. That figure is consistent with other assessments, suggesting that in Australia nearly 61,000 adolescents between the ages of 13 and 17 suffer from depression.

But parent reports and adolescent reports produced different results. When adolescents themselves were surveyed, 12.1% of them claimed to suffer from depression, but the great majority (88%) of these adolescents were not identified as depressed by their parents.

The reverse was also true. Nearly three-quarters (74%) of adolescents whose parents reported them as having clinical depression did not report themselves as being depressed.

"Parent reports and adolescent reports largely identify different adolescents as being depressed," said Dr Sawyer, "Are they all depressed?" he asked. "Further research is needed to determine the importance of adolescent-only and parent-only reported cases."

The need for that research is urgent, not just to resolve the differing estimates of those who suffer from the illness, but because of the consequences of failing to identify them.

"These young people experience high rates of problems; increased health risk-behaviours such as substance abuse, increased suicidal behaviour and disruptive disorders," said Dr Sawyer.

Once depression is diagnosed, modern treatments for it can be very effective, and they are improving all the time, but none of that helps unless adolescents with problems are identified and receive assistance.

"Only 40% of adolescents identified by parents as depressed, had attended a professional service for help with their problems in the previous six months," said Dr Sawyer, "Only 18.5% of adolescents who reported themselves as depressed had attended a service for help," he added.

So if parents are not recognising their adolescent children's problems, and adolescents are not revealing them to their parents, where is that professional help to come from?

"A common source of help for these adolescents is school-based services," said Dr Sawyer. "Depressed adolescents were most likely to seek help from school counsellors. These counsellors play an important role in identifying adolescents with depression. They need to be available and well trained to help, and to facilitate referral for treatment," he said.

The national media seminar "BLUEPRINT: developing a national response to depression" is designed for media professionals and has been organised by "Beyondblue: The National Depression Initiative" chaired by the Hon Jeff Kennett.

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