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Introduction to adolescent mental health
Introduction to adolescent mental health

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1 When does mental health become ill-health?

According to the World Health Organization, ‘Mental disorders comprise a broad range of problems, with different symptoms. However, they are generally characterized by some combination of abnormal thoughts, emotions, behaviour and relationships with others’ (WHO, n.d.).

There may be no clear dividing line between a situation where a young person is coping well with challenges, to a point where they struggle or become mentally unwell. As you can tell from the video you watched in the session introduction, problems with mental health can unfold gradually to a point where the young person and the people around them realise they have a serious problem. In the next activity, you’ll revisit the video and consider where to place these young people on the mental health spectrum.

You first saw this spectrum in Session 2 [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] . At the green ‘healthy’ end, there would be no particular cause for concern, except to ensure that the young person has the support and skills necessary to deal with everyday life. In the yellow ‘coping’ zone, the young person may be experiencing difficulties and need extra help to prevent any problems developing further. In the orange ‘struggling’ zone, the problems may become more visible and it is possible a diagnosis of a mental health problem will be made. An ‘unwell’ young person who has a very serious problem may need highly specialised help.

Activity 1: A spectrum of mental health

Timing: Allow about 20 minutes

Think about the mental health spectrum in Figure 2 and consider each of the case studies below of young people who are experiencing emotional challenges. As their stories progress, think about where they would be on the spectrum.

A diagram of an arrow, on the left it is green with the word ‘healthy’, then it changes to yellow with the word ‘coping’. Then it moves to red with the word ‘struggling’, then it moves to a dark red, with the word ‘unwell’.
Figure 2: Mental health spectrum (repeated from Session 2.)

Case 1: Jack

Jack had surgery and found it really difficult to play sport and go out with his friends, he found it really hard to cope with this. He became really sad and spoke to a teacher at school who tells him he needs to pick himself up and get on with it. But then as he continued to struggle to get to sleep, he then started to find it hard to get up in the morning and struggled to concentrate in lessons. He finally got help when he refused to go to class.

Case 2: Suzie

Suzie is shy and got bullied at school as a result. This really affected her self esteem and confidence. It also started her worrying when speaking in groups. This kicked off anxiety and she found it hard to enter particular classrooms where she knew the bullies were – she started missing these classes.

Case 3: Bob

Bob started questioning their gender identity from the age of 15. This became a big problem when they shared it with a friend who then broke their confidence and now the whole of their class know. They started to self harm and found they woke up in the middle of the night and could not get back to sleep. Their swim teacher noticed the marks on their arm were bleeding and reports it to her mum.


The spectrum can be a useful tool for understanding the varying nature of mental health. Although mental health problems are very particular and personal to the individual, their experience also takes place within the context of wider social and environmental influences. As you can see from these case studies, each of the young people moved through a range of emotions, and that recognising the difference and the point at which it was interfering with their life was crucial and reflected when the adults around them recognised there was a need for a solution.

Although mental health problems can sometimes make people feel trapped in cycles of unhelpful thoughts, feelings and behaviours, it is important to realise that with the right help solutions can be found. Going forward in this course, you’ll come across many examples of how family and friends as well as professionals can help young people.

Everyone has set-backs that can make them feel low, sad or anxious. However, we often know when all is not as it should be, and the next section considers when anxiety becomes a problem.