Riittakerttu KaltialaHeino

1
Mental disorders as a challenge for the
well-being of children and adolescents in the
Western world

• Riittakerttu Kaltiala-Heino, MD, DrMedSci
• Chief psychiatrist, Director
• Tampere University Hospital
• Department of Adolescent Psychiatry

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Mental health

• Cognitive, social and emotional ability to
  fulfil ones roles, set adequate goals, and enjoy
  this.
• To be able to work and love.

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Mental disorders are characterised by symptoms
in the area of

• Emotional balance, affects (depression, anxiety
  disorders)
• Behaviour (conduct disorders, impulse control
  problems)
• Social interaction (autism)
• Sense of reality (psychoses)

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Onset in childhood and adolescence

• Autism spectrum (lt1)
• ADHD (lt1)
• Anxiety disorders (5-10)
• Depression (5-10)
• Eating disorders (1-2)
• Conduct disorder (2-5)
• Substance use disorders (varies)

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Cornerstones of CA mental health

• Biological inherited characteristics such as
  temperament, cognitive abilities
• Psychological resilience, self-esteem, emotion
  regulation, internal behavioural control, reality
  testing
• Social parenting, peer group integration,
  school, role models
• Societal environment, services, attitudes

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Mental disorders are influenced by early stages
of life

• Antenatal period
• (Early) parenting
• Maltreatmet and abuse
• Peer group experiences
• School experiences, school environment
• Safety

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Mental disorders in CA have a negative impact on

• Social skills, social interaction, peer
  relationships, sexuality, intimate parntership
• Learning, educational carreer, work life
• Self-esteem, identity
• Behavioural control, juvenile delinquency,
  substance use
• Mortality (suicide, violent death, somatic
  illness)

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Arenas of mental health promotion and prevention
of CA mental disorders

• Family antenatal care, age-appropriate parenting
• School learning, social skills, self-esteem,
  anti-bullying work, interventions with risk
  groups
• Leisure time street life, safety,
  self-protecting skills, role models, peer
  influences
• Health care early identification early
  intervention, access, evidence based
  interventions
• Child welfare identification, trauma management,
  positive alternatives
• Society anti-stigma

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WHOs priority areas for action in the European
Region (relationship to mental health)

• Maternal and newborn health (attachment,
  development, maltreatment)
• Nutrition
• Communicable diseases (capacity to protect
  oneself)
• Injuries and violence (see below)
• Physical environment (alienation, violence)
• Adolescent health (incl. mental health health
  behaviours, risk-taking)
• Psychosocial development and mental health

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Violence and mental disorders in CA

• Wittnessing of and victimisation to violence as
  risk factors for mental disorders
• -post-traumatic stress disorder, anxiety
  disorders, depression, conduct disorder,
  personality disorders, course of psychosis
• Mental disorders as risk factors for violence
• Autism spectrum, ADHD, substance use disorders,
  conduct disorder, psychosis
• Suicide depression, psychosis

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Where could voluntary sector make a contribution?
Examples.

• Violence. Family violence, intimate parnteship
  violence, safe neighbourhoods, safe cities
• Parenting. Will and skill to age-appropriate
  parenting. Support to parenting. Networks.
• Schools. Anti-bullying programmes.
• Stigma. Fighting stigma related to mental
  disorders.