The Power of Youth-Informed Change: How Young People are Bringing Hope to the Mental Health Crisis
By Tamara Golosarsky, Zacharias Foti, and Katelyn Spicer
This submission is part of a series by McGill students who were in the Fall 2024 course, Fundamentals of Global Health.
The Mental Health Crisis
When living in a state of polycrisis, it is difficult to keep a level-headed outlook on daily life, especially for children, adolescents and young adults. Every day, we are witnesses to constant conflict, political strife, a burning planet, vast corruption, pandemics, and more. What’s worse is that this constant bombardment of information is right at our fingertips: through technology, our phones, and social media. Thus, it is no surprise that crises of mental health are on the rise, especially in pediatric and young adult populations.
The World Health Organization (WHO) defines mental health as “a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community” (2022a). Globally, “an estimated 1 in 7 children and adolescents aged 10 to 19 are affected by mental health conditions, with anxiety, depression, and behavioral disorders among the most common.” (WHO, 2024b). Furthermore, even with this high prevalence of mental health disorders, care and treatment is largely inaccessible to adolescents and young adults due to low service availability, unaffordable costs, and stigma (WHO, 2024b). For example, a study assessing access to mental health services among children with anxiety and depression within the United States found that even in children who had been formally diagnosed with a mental disorder and were living within a “high-income” Global North country such as the United States, factors such as “household educational level, the child meeting criteria for having a medical home, and insurance coverage for mental or behavioral health needs were significant predictors of perceived access to mental health care services” (Mahmood et al., 2024, p. 1541). Thus, it can be seen that there is a notable lack of accessibility to much needed mental health services among children and adolescents, further exacerbating an already raging mental health crisis.
The lack and unaffordability of services is further compounded by social determinants, such as poverty, violence, inequality and environmental deprivation, especially for children living in conflict zones and areas of political instability and environmental degradation (WHO, 2022a). For example, children that come from low-income households have their mental health affected at three distinct levels: individual, relational and institutional (Hodgkinson et al., 2017). As poverty progresses, not only is mental health sculpted by the individual effects on the physical body––such as increased blood pressure, increased cortisol levels, and stressor-based changes in DNA methylation through distinct epigenetic changes––but it is further shaped by the community-based impacts of poverty such as poor housing, limited resources, inadequate schools, and high crime and violence (Hodgkinson et al., 2017). This results in a three-pronged aggravation of pre-existing mental health challenges in children and adolescents who have no control over their living situation and thus the social determinants that surround them, further exacerbating conditions such as non-communicable diseases (NCDs).
What can be done? A Bottom-Up Approach to Change
As a result of the detrimental effects of social determinants of health and the lack of adequate access to proper mental health care, many advocate that to provide effective care, we must support younger populations earlier in their lives. This can be achieved either through direct treatment of mental illness or through education about the importance of mental health. As “one-third of mental health conditions emerg[e] before the age of 14 and half before the age of 18, early action is essential to enable children and young people to thrive and realize their full potential”, states WHO (2024b). Many recommendations have advocated for this “earlier rather than later” approach. This approach can be implemented using a bottom-up model of change, starting with the mental health clinician and ending with community-based integration of care.
Individual: The Clinician
Due to the stigma surrounding mental health treatment, children and adolescents may be hesitant to seek care earlier in life. In order to increase their comfort and inclination toward treatment, mental health clinicians should: 1) have a friendly and non-judgmental demeanor, making a clinical visit less daunting; 2) protect and provide the patient space during screening and visitation; 3) respect and treat the patient as an equal; and 4) respond directly to the needs and wants of the patient in their treatment (Stubbing & Gibson, 2022).
Mid-level: Local Treatment
After clinician behavioral modification, the next bottom-up approach to earlier prevention involves changes in treatment structure. Mental health care and assessment must be integrated with physical checkups, especially earlier in the child’s or adolescent’s life. Through this integration, successful screening can be implemented, allowing for identification and treatment of potential mental illness earlier (Canadian Pediatric Society, 2023). This strengthens the child's physical and mental health, effectively protecting them from worsening mental health symptoms.
High-level: Community-based Care
Lastly, to achieve change at the highest level, community-based care must be established. This means locally available mental health support through primary care providers and allied health. This model allows not only for earlier mental health service access, but also for quicker access due to the proximity of services (WHO, 2024b). Furthermore, creating community-based care facilitates trust between the child and the provider, as it will likely be someone whom they are already familiar with. This creates a stronger support network and protects the child from further mental health challenges.
Thus, not only can the system be modified, but we can work towards modifying mental health treatment at an individual level, starting from the practitioner and working our way up. This allows for a more equitable, accessible, and effective system that can work to end the mental health crisis.
Bottom-up framework to guide improvement in child and adolescent mental health based on review of current literature.
Stopping to Ask the Student
However, with all of these guidelines and recommendations, has anyone ever stopped to ask: what do young people think of this issue? How would they go about solving a crisis in which a disproportionate number of them suffer? Thus, we asked our peers: how can young people, as one of the most vulnerable demographics, provide hope in improving the global mental health crisis? Responses among our peers revealed striking similarities, highlighting shared concerns and perspectives among the youth.
One theme that frequently came up in our discussions was the importance of exercise for mental health. The connection between mental health and physical activity is no longer in doubt; it is a proven, evidence-based approach to mental health promotion. In addition to its significance for individual resilience, young voices throughout the interviews emphasized the relevance of movement as a way to address global mental health inequities and build communal strength.
Physical exercise not only offers a reactive solution, but also a preventive one, lowering the prevalence of mental health conditions. Jeremi Sfeir highlighted how exercise helps him reset his mind: “Recently, I discovered swimming as a hobby, and I have been going 4-5 times a week and I realized my stress levels during my chaotic days have gone down quite a bit.” Raising awareness about the benefits of exercise for future generations provides hope for the state of mental health worldwide.
Another important environment for encouraging physical exercise is the workplace. “In offices, we can encourage companies to install and have a dedicated space like a gym, allowing their employees to decompress during lunch break," Sfeir continued. These areas have the power to change workplaces into encouraging spaces where productivity and mental health flourish. As a result, physical activity should be given top priority by international organizations as a fundamental element of mental health programs. Megan Ringler promoted programs to increase public awareness of the positive effects of exercise on mental health. She emphasized the need for a global push to incorporate physical activity into public health strategies, pointing out, “I think there could be some campaigns that promote exercise as a way to manage stress.” Young people are ultimately leading us toward a culture that prioritizes movement and exercise over idleness, which benefits both physical and mental health.
At the same time, Emily Foxman, along with many peers, emphasizes the importance of seeking professional help during a crisis: ”If the situation requires it, I can refer my friends to crisis resources like the McGill Nightline or Peer Support Centre. I have other friends who work at these services, and I know that they are really beneficial for McGill students.” This is incredibly promising for our generation, as the growing de-stigmatization of seeking therapy and other forms of professional support can encourage individuals to get help without shame, ultimately enabling more people to confidently reach out when they are struggling.
Foxman further emphasized the value of building relationships within local communities. She noted, “There is evidence that this type of community-based care works really well and can be implemented basically anywhere. Whether that’s outdoor spaces, libraries, or cafés, having a safe place to talk and receive support is important.” Increasing community active listening fosters hope for working together to enhance mental health. People can also come together through planned activities like wellness programs, creative workshops, or group talks, which can lessen loneliness and build support networks. Establishing programs for animal-assisted therapy is one example of a helpful therapeutic intervention. Nathalie Abouchar highlighted the therapeutic advantages of working with animals, saying, “I have been to dog therapy, and I think that animal therapy should be a common resource offered to many around the world to help others, which can also provide opportunities for people to meet new people that are willing to share their personal experiences.” Initiatives like this can promote emotional bonds, lessen stress, and ease anxiety, all of which improve mental health.
As one anonymous student put it, “Maybe the only thing to add at a community level is that we need to be better at connecting with those around us. The world has made it too easy to be alone.” As an individualistic society in Canada, we have been conditioned to focus on self-preservation, which becomes detrimental to our mental health. In contrast, collectivistic countries such as China demonstrate that in tightly knit cultures, the protective effect of collectivism is evident (Dong et al., 2022). Peers like Ringler and Foxman offer optimism, as both shared in their interviews that they've noticed the abundant small acts of support peers are offering each other, which have made a significant difference. Ultimately, this suggests that our youth may be leading us into a more collectivistic culture where community-based support is prioritized.
Moreover, in order to address systemic gaps and advance mental health as a human right, global solutions are required, even as community initiatives remain vital. “Promoting the needs of the body for good rest and nutrition is very important to make sure the mind is capable of working,” said Jimmy Greige, calling for measures to address fundamental hurdles like sleep and nutrition. These measures must be tailored to different parts of the world. In underprivileged areas of the globe, such as refugee camps, perhaps "earplugs, eye masks, and even investment in good bedding" are examples of actions we might take. These investments could have a significant impact on helping these individuals with their most basic requirements. Canada-specific examples include "put[ing] taxes on items at the grocery store that are highly processed which can guide decision making towards the less processed food," which can help people make healthier dietary choices. All of these instances of changes in funding or policy offer encouragement for the future of mental health worldwide.
Finally, Foxman hinted at the duality of the role of social media in youth mental health: “Technology can play, and has been playing, a huge part in both improving and worsening the mental health of our generation.” In one regard, social media can become a weapon that erodes self-esteem by amplifying anxiety due to unrealistic ‘highlight reel’ lives, fostering toxic comparison habits. Conversely, social media can help to destigmatize mental health conditions, shed light on helpful resources such as online therapy, and deliver support networks to manage crises without leaving the comfort of your home. This is encouraging for our generation, as improvements in accessibility of mental health resources diminish the challenges, such as cost and location, faced by those who experience structural barriers to care (Stringer, 2024). For instance, online therapy is a much more accessible and affordable option for those struggling to access traditional mental health care.
Key factors supporting youth mental health according to Montreal students.
Conclusion
A ray of hope for mental health is offered by young voices, which encourage community connection, physical activity, and structural change. They provide workable, scalable solutions by creating inclusive environments, emphasizing relaxation and nutrition, and tackling injustices worldwide. Their emphasis on accepting collaborative care, incorporating cultural adaptability, and de-stigmatizing mental health is a positive turn toward a more compassionate society. When combined, these steps open the door to a better, more promising future for mental health.
References
Canadian Pediatric Society. (2023). Promoting optimal mental health outcomes for children and youth. https://cps.ca/en/documents/position/promoting-optimal-mental-health-outcomes-for-chil dren-and-youth.
Dong, D., Feng, Y., & Qiao, Z. (2022). Understanding cultural factors in mental health during the COVID-19 pandemic: When collectivism meets a tight culture. Current Psychology, 42(30), 26772–26782. https://doi.org/10.1007/s12144-022-03780-x.
Hodgkinson, S., Godoy, L., Beers, L. S., & Lewin, A. (2017). Improving mental health access for low-income children and families in the Primary Care Setting. Pediatrics, 139(1). https://doi.org/10.1542/peds.2015-1175.
Mahmood, A., Kedia, S., Arshad, H., Mou, X., & Dillon, P. J. (2024). Disparities in access to mental health services among children diagnosed with anxiety and depression in the United States. Community Mental Health Journal, 60(8), 1532–1546. https://doi.org/10.1007/s10597-024-01305-3.
Stringer, H. (2024). Mental health care is in high demand. psychologists are leveraging tech and peers to meet the need. Monitor on Psychology, 55(1), 60. Retrieved from https://www.apa.org/monitor/2024/01/trends-pathways-access-mental-health-care.
Stubbing, J., & Gibson, K. (2022). What young people want from clinicians: Youth-informed clinical practice in mental health care. Youth, 2(4), 538–555. https://doi.org/10.3390/youth2040039.
World Health Organization. (2022a). Mental health. https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-respo nse.
World Health Organization. (2024b). WHO and UNICEF release guidance to improve access to mental health care for children and young people. https://www.who.int/news/item/09-10-2024-who-and-unicef-launch-guidance-to-improve-access-to-mental-health-care-for-children-and-young-people.
Tamara Golosarsky (left) is a third-year undergraduate at McGill University, pursuing a Bachelor of Science in Anatomy and Cell Biology with a minor in Social Studies of Medicine. Her research experience spans biomedical sciences, clinical development, and medical writing, with contributions at institutions such as Alexion Pharmaceuticals, Takeda Pharmaceuticals, and McGill’s Sleiman Lab. With a strong interest in global health, she is dedicated to examining the intersection of medical research, health policy, and patient care.
Zacharias Foti (centre) is a second-year undergraduate at McGill University, pursuing a Bachelor of Science in Anatomy and Cell biology. He is passionate about world health and is especially interested in mental health, particularly among the elderly. His commitment to elder care is demonstrated by volunteering at the Park Extension CLSC, long-term care facilities, and Notre-Dame Hospital emergency department. As the VP of Hospital Affairs for the McGill Children's Health Alliance of Montreal (MCHAM), Zacharias supports programs to improve pediatric healthcare. His interests in aging populations, healthcare accessibility, and patient advocacy are all things he aims to incorporate into a future medical career.
Katelyn Spicer (right) is a fourth-year undergraduate at McGill University, pursuing a Bachelor of Science in Anatomy and Cell Biology. A dedicated advocate for women’s health, she has gained clinical research experience at the MUHC DOvEEgene clinic, which focuses on early detection of ovarian and endometrial cancer. She is also passionate about improving pediatric care, serving as co-president of the McGill Children’s Health Alliance of Montreal to fundraise for the Montreal Children’s Hospital. She hopes to integrate her interests in biomedical science, patient advocacy, and health policy into a future career dedicated to advancing women’s health research and geriatric care.