by University of Tokyo

Adolescents who fell into the "discrepant" category raised the most concern. In the past, young people who hadn't clearly or consistently shown symptoms of mental health problems had sometimes been overlooked, as discrepancies between informants' experiences lead to those problems being underestimated. However, the researchers highlight that monitoring for such discrepancies is very important to help identify adolescents at high risk. Credit: 2023 Nicola Burghall (design elements from Pablo Stanley/Canva)

The personal yet global struggle with mental health may be more visible now than ever before. Yet many people still find it difficult to access the support they need.

In Japan, suicide is sadly the leading cause of death for young people. Researchers, including from the University of Tokyo, have carried out a six-year study to better understand the myriad factors which can impact adolescent mental health. After surveying 2,344 adolescents and their caregivers, and using computer-based deep learning to process the results, they were able to identify five categories into which the young people could be grouped.

Nearly 40% of those involved were classified as groups with some problems. Of these, almost 10% lived with mental health problems that had not been identified by their caregivers. This group was most at risk of self-harm and suicidal ideation. Identifying the factors that may lead young people to suicide and who is most at risk is key to supporting preventive efforts and early intervention.

Last year in Japan, 514 youths and children aged 18 and younger tragically lost their lives to suicide. This was the highest number for this age group since records began in 1978. Suicide is the leading cause of death for people aged 15 to 34 years old, according to data from Japan's Ministry of Health, Labor and Welfare. While adult suicide rates have been generally declining over the past 10 to 15 years, the reverse has been noted for adolescents. Officials speculate that school-related issues, difficult personal and family relationships, and lingering impacts of the pandemic may have contributed to the high number of deaths.

The World Health Organization (WHO) identifies suicide as a major global public health concern, but also says it is preventable through evidence-based interventions and by addressing factors that can lead to poor mental health. Researchers from the University of Tokyo and the Tokyo Metropolitan Institute of Medical Science are analyzing data on various problems in adolescence which were assessed both by self and caregivers, resulting in identification of young people who may be at suicide-related risk.

"We recently found that adolescents who were considered to have no problems by their caregivers actually had the highest suicide-related risk," said Daiki Nagaoka, a doctoral student in the Department of Neuropsychiatry at the University of Tokyo and a hospital psychiatrist. "So it is important that society as a whole, rather than solely relying on caregivers, takes an active role in recognizing and supporting adolescents who have difficulty in seeking help and whose distress is often overlooked."

The team surveyed adolescents and their caregivers in Tokyo over a period of six years. The participants completed self-report questionnaires, answering questions on psychological and behavioral problems such as depression, anxiety, self-harm and inattention, as well as their feelings about family and school life. The team also made note of factors such as maternal health during pregnancy, involvement in bullying and the caregivers' psychological states.

More information: 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

If you or someone you know is struggling, free help and support is available. For a list of helplines around the world, please visit: www.suicide.org/international-suicide-hotlines.html

Befrienders International provides confidential support to people in emotional distress or crisis: https://www.befrienders.org

Provided by University of Tokyo