Support is a plus: past clients of ORYGEN Youth
Health who are now active members of the
ORYGEN youth participation program Platform.

Fifteen year old Caitlin is a happy, well-adjusted teenager. She spends up to three days a week training at the gym, has won several academic awards and is studying subjects beyond her level. “I love the gym, I find it addictive,” she says. “I couldn’t live without it or my friends.”

Georgia is 14 and loves dancing. She practises ballet up to eight hours a week. Her only free day out of her busy schedule is Sunday. “If I’m feeling down I stretch harder. I find I push myself because I know I will feel better,” she says.

Both girls have supportive family environments and supportive friends who share their drive to succeed.

At 15, Caitlin has been able to negotiate any concerns in her life, such as what subjects to choose in year 10, by talking to her parents, friends and teachers.

And Georgia says, “My parents have provided me with everything I have needed – they have paid for everything and got me to classes, whatever it was I wanted to do.”

Although not foolproof, research shows a supportive home environment is definitely a plus during the turbulent times of biological and emotional change in adolescence.

The girls say they have both been around others who party hard, smoke and use alcohol.

“I know plenty of kids who do get wasted,’’ says Caitlin. “My friends and I just don’t feel the need to, I suppose.”

Not all teenagers have these extended support networks and degree of self esteem. Research indicates that adolescence has been overlooked as an extremely vulnerable time – which can have huge repercussions on mental health into adulthood.

University of Melbourne Professor George Patton (Paediatrics/Centre for Adolescent Health) says adolescence has taken on more significance than ever before.

“There was a time when teens went from puberty to established pathways such as marriage, within a few years,” he says.

“In the pre-industrial era, the gap between completion of puberty and marriage and parenting was between just a few years. This is just not the case in modern society. Adolescence is now persisting until mid 20s or even 30s.

“The gap between puberty and parenting or marriage can now be more than 20 years. There is no guided pathway any more. Negotiating in areas such as sex, relationships, employment and education is more complex. And the influence of the media and youth cultures is also much more pronounced.”

Professor Patton says that factors such as increased time spent in education, increased affluence, more contraceptive choices have also played a role in changing adolescence and presenting a new set of developmental challenges.

According to a special adolescent health series of the prestigious international journal The Lancet (of which four out of 10 authors were from the University of Melbourne) today’s generation of teens is one of the largest in history.

The journal cites almost half of the world’s population being younger than 25 and facing much more complex challenges to their health than their parents did.

According to The Lancet, hazardous alcohol use now accounts for 86 per cent of the 8.6 million substance-related deaths of 15–29 years old people globally and that many of the world’s youth are living with HIV/AIDS or suffering depression.

It has become of increasing concern to researchers that there is a lack of epidemiological research into this period of life.

University of Melbourne researcher Dr Dan Lubman (Psychiatry/ORYGEN Research Centre) says it was once thought that adolescence was merely a transitional period – there was limited understanding of the magnitude of cognitive, emotional and social development at this stage.

“Evidence now shows that while adolescence represents a period of growth and opportunity, it also represents a time of increased risk, particularly for mental health and substance use disorders,” he says.

“Research shows that 75 per cent of mental health and substance use problems among adults begin before the age of 25.”

Dr Lubman says that early thought considered the brain reached its adult size, without much room for further change, by the age of five.

More current research reveals that a key period of brain development occurs during adolescence, and that brain developmental processes continue into the mid 20s.

Lubman says the changes which occur in the brain during this time involve pruning away sub-optimal brain connections, particularly in brain regions involved in thinking, reasoning and controlling emotions.

“These processes represent a great opportunity for growth, facilitating development of skills necessary for independent living,” he says.

“But it also represents a period of great vulnerability, particularly if there are major external stressors, such as family conflict, lack of support, abuse, or drug misuse.”

Research conducted by Dr Lubman and colleague Dr Murat Yucel, of the University’s Melbourne Neuropsychiatry Centre, suggests that adolescents are particularly vulnerable to the effects of substance abuse on the brain.

Their research reveals that early onset of cannabis use is associated with later psychopathology, including depression and psychosis.

Adolescents are also able to drink more alcohol before feeling sedated or unsteady, which is in line with high rates of binge drinking in youth.

“Such external factors may affect the normal development of the adolescent brain,” Dr Yucel says. “Abnormal brain maturation may be central to understanding the development of disorders later in life.”

Dr Yucel says early intervention could make a difference. “Coming from a background in brain research and neuropsychiatry, I have seen more and more scientific evidence mounting to suggest that if we can get in early and provide much needed education, treatment and external ­resources to affected individuals and their families, we will have a better chance of stopping, or at least delaying, young people going down pathways that lead to the dire long-term outcomes.”

According to Professor Alasdair Vance (Paediatrics/Royal Children’s Hospital) between 10 and 20 per cent of young people will experience a major mental health problem that requires intervention.

Professor Vance says one in 10 of those will go on to need both psychological and social treatment supported by medication.

Chris, 19, has had an adolescence marred with abuse, depression and drug abuse.

He left home at 16 to escape violence at the hands of his elder brother and his increasingly alcoholic father.

He now lives in transitional housing accommodation in Sunshine and is waiting for a place in the public system.

Chris is a participant in the Platform program at ORYGEN Youth Health dedicated to rehabilitating young people suffering mental disorders as a result of drug use.

“There were a lot of difficulties at home,” he says. “I was constantly being blamed for everything. I was never allowed to go and do anything other than go to school. I used to hide in my room.”

Chris started using drugs as a means of escape. He drank heavily for several months before ultimately dropping out of school at the end of year 10.

Between the ages of 16 and 18 he smoked marijuana daily and used heroin and speed heavily for another six months.

“I’ve never had a goal for any specific thing,’’ says Chris. “I just take life as it comes. I find if you have a dream and it doesn’t happen, you can feel like crap. I am just taking it one step at a time.”

Concerned about his own erratic behaviour, not being able to concentrate, falling asleep at school and his grades slipping, Chris spoke to a school coordinator who then referred him onto ORYGEN Youth Health.

Youth participation worker at ORYGEN, Bella Burns, says Chris has improved since coming to the service but there is a limited amount of assistance available for him.

“Unfortunately the treatment we provide is limited to 18 months. There is a real need to extend this type of support to kids in Chris’ situation. For teens to go into the adult mental health system is just not an option. Due to Chris’ background, life may always be a challenge for him.”

Professor Vance says this is a recurring problem for the community. “How many more young people are we going to watch suffer?” he asks.

“We need not just more research into the area, we need our clinicians and educational institutions to access the latest research to help them to deal with problems at the coal face.

“Young people suffer a real stigma within the media. We are constantly ‘shocked’ by their behaviour. It is time to actually understand what is going on and do something about it.”