In recent years, the global struggle with mental health issues has become increasingly visible, yet accessing the necessary support remains a challenge for many. In Japan, where suicide is the leading cause of death for young people, researchers from the University of Tokyo conducted a comprehensive six-year study aimed at unraveling the intricate factors affecting adolescent mental health.
The study, published in The Lancet Regional Health—Western Pacific, involved surveying 2,344 adolescents and their caregivers, utilizing computer-based deep learning to analyze the results. The researchers identified five distinct categories into which the adolescents could be grouped based on their mental health trajectories.
Alarmingly, nearly 40% fell into groups experiencing some problems, with close to 10% facing mental health issues that had gone unnoticed by their caregivers. This subgroup was found to be at the highest risk of self-harm and suicidal ideation. Recognizing and understanding the factors contributing to suicide risk is crucial for effective preventive efforts and early intervention.Â
Japan, in particular, has seen a concerning rise in youth suicides, with 514 deaths recorded among youths and children aged 18 and younger last year – the highest number since records began in 1978. Suicide is now the leading cause of death for individuals aged 15 to 34, as reported by Japan’s Ministry of Health, Labor, and Welfare.
While adult suicide rates have generally been declining, the reverse trend has been observed among adolescents, with officials speculating that school-related issues, challenging personal and family relationships, and the lingering impacts of the pandemic may contribute to the alarming number of deaths.Â
The World Health Organization (WHO) recognizes suicide as a significant global public health concern, emphasizing its preventability through evidence-based interventions and addressing factors contributing to poor mental health. In Japan, researchers from the University of Tokyo and the Tokyo Metropolitan Institute of Medical Science have delved into data on various adolescent problems, considering both self and caregiver assessments to identify those at suicide-related risk.Â
Daiki Nagaoka, a doctoral student in the Department of Neuropsychiatry at the University of Tokyo and a hospital psychiatrist, highlighted a critical finding: adolescents considered to have no problems by their caregivers exhibited the highest suicide-related risk. This emphasizes the importance of societal involvement in recognizing and supporting adolescents who face difficulties in seeking help and whose distress often goes unnoticed.Â
The six-year study involved surveys of adolescents and their caregivers in Tokyo, with participants completing self-report questionnaires on psychological and behavioural problems, feelings about family and school life, and factors such as maternal health during pregnancy, involvement in bullying, and caregivers’ psychological states. The study commenced when the children were 10 years old, with follow-ups at ages 12, 14, and 16, involving 3,171 adolescents and 2,344 pairs of adolescents and caregivers.Â
Utilizing deep learning, a computer program that mimics the brain’s learning process, researchers could analyze the extensive data to identify patterns in responses. This allowed for the classification of adolescents into five groups – unaffected, internalizing, discrepant, externalizing, and severe – based on the trajectories of psychological and behavioural problems.Â
The largest group, comprising 60.5% of the adolescents, was labeled “unaffected” by suicidal behavior. The remaining 40% displayed negative effects, with the “discrepant” group (9.9%) identified as having the highest risk of self-harm and suicidal thoughts. This group experienced depressive symptoms and “psychotic-like experiences,” which had not been recognized by caregivers.Â
The researchers found that predicting inclusion in the “discrepant” group was possible based on whether the child avoided seeking help for depression and whether their caregiver had a mental health problem. The caregiver’s mental state was identified as a factor impacting the adolescent’s mental health through both genetic factors and parenting environment, emphasizing the importance of caregiver attention to an adolescent’s difficulties.Â
Despite the study’s limitations, it successfully identified risk factors that could predict the groups adolescents might fall into. Nagaoka acknowledged the need for a better understanding of adolescents’ psychopathological problems, which are diverse and dynamic, and for establishing supportive systems and structures in society to address the challenges faced by numerous adolescents who hesitate to seek help.Â
This six-year study sheds light on the complex landscape of adolescent mental health in Japan, emphasizing the critical role of societal awareness and support. The findings underscore the urgency of implementing preventive measures and early interventions to address the alarming rise in youth suicides and promote the overall well-being of adolescents.Â
Journal Reference Â
Identify adolescents’ help-seeking intention on suicide through self- and caregiver’s assessments of psychobehavioral problems: deep clustering of the Tokyo TEEN Cohort study., The Lancet Regional Health—Western Pacific (2023). DOI: 10.1016/j.lanwpc.2023.100979. Â
