Early onset mental illness is becoming more prevalent

By Alpana Mohta, MD, DNB, FEADV, FIADVL, IFAAD | Fact-checked by Barbara Bekiesz
Published November 7, 2023

Key Takeaways

  • The onset of many mental health disorders occurs during the first 2 decades of life, and approximately half of all individuals will experience a mental disorder by the age of 75.

  • Mental health problems cause personal suffering, impose significant economic burdens, reduce quality of life, and adversely affect physical health.

  • Preventive psychiatry, which includes early intervention and lifestyle modifications, can play a vital role in preventing and managing mental health disorders in your patients.

Mental health issues are widespread within the United States. As of 2021, the National Institute of Mental Health (NIMH) estimated that 57.8 million adults, nearly one in five individuals, grappled with mental health disorders. Approximately 14.1 million adults suffer from severe mental illnesses like schizophrenia or bipolar disorder.[] 

These disorders not only cause significant suffering but also impose substantial financial burdens. What’s more—early onset of mental disorders is becoming increasingly prevalent.

In 2023, researchers publishing in JAMA discovered a significant increase in emergency room visits for mental health issues among youth—going from 7.7% in 2011 to 13.1% in 2020.[]

The state of mental health in America

In contrast to most other non-communicable ailments, the onset of many mental disorders occurs during the initial 2 decades of life. According to NIMH statistics, the rate of mental health disorders is 33.7% among adults aged 18–25; for those aged 26–49 it is 28.1%; and for individuals aged 50 and above, it is as low as 15.0%.

Adults who identify as two or more races show the highest prevalence at 34.9%, while American Indian/Alaskan Native adults follow closely behind at 26.6%. Conversely, Asian adults have the lowest prevalence at 16.4%.

Findings reported in Lancet Psychiatry suggest that, when reaching 75, roughly one out of every two individuals will experience at least one mental disorder.[] Anxiety and mood disorders tend to be higher among females. In contrast, externalizing disorders like ADHD, impulse control, and substance abuse exhibit a higher incidence in male respondents. 

The 2023 Lancet report also found that around 50% of those who develop a mental disorder before age 75 experienced their first episode by age 20 for females and 19 for males. 

Beyond the conventional childhood-onset disorders such as ADHD and social phobia, common mental illnesses, including generalized anxiety disorder, substance abuse, major depressive disorder, and panic disorder, often manifest before early adulthood. 

A broader spectrum of issues

Rising mental health issues in the general population pose a significant detriment to public health for several reasons.

Economic Burden

Mental health issues lead to substantial financial costs, including healthcare expenditures, reduced workplace productivity, and increased disability claims. 

In 2020, the United States federal government allocated a whopping $280 billion to treat mental health conditions.[] Despite the considerable economic impact, mental health seems to receive less attention regarding healthcare investments and funding than other medical conditions, such as cancers and cardiovascular disorders.[]

As mental health issues increase, healthcare facilities may struggle to meet the demand for services. This can result in longer treatment waiting times and reduced care access.

Reduced quality of life

Poor mental health can diminish an individual's overall quality of life. This includes a decreased ability to engage in social relationships, pursue education and employment opportunities, and enjoy a fulfilling life.

Physical health impacts

Mental illness often co-occurs with physical health issues. For instance, depression can raise the risk of developing heart problems, stroke, and diabetes. Likewise, having long-term health problems can make it more likely for mental illness to occur.[] Research has also consistently found that mental health issues contribute to a higher risk of suicide, which remains a significant public health concern.[] 

Stigma and discrimination

The stigma linked with mental health problems can discourage individuals from seeking help, leading to delayed or inadequate treatment. Discrimination against those with mental health issues can also affect their social integration and well-being. Mental health issues also intersect with other public health challenges, such as substance abuse, homelessness, and poverty. 

Recognizing mental health issues in patients

HCPs play a crucial role in identifying and supporting patients with mental health concerns. Here are some key signs to watch for:

  • Behavioral changes: Withdrawal from social activities, mood swings, or irritability; pay attention if patients express feelings of hopelessness, anhedonia, or suicidal thoughts

  • Sleep disturbances: Insomnia or excessive sleeping patterns

  • Appetite changes: Significant weight fluctuations or changes in eating habits

  • Substance abuse: An increase in alcohol or drug use can be a sign of mental health concerns

  • Concentration issues: Patients may struggle with decision-making and memory

  • Hygiene changes: A decline in personal grooming and hygiene

  • Unexplained aches and pains: Chronic pain without a clear medical cause; complaints of headaches or stomaches

  • Psychosis symptoms: Hallucinations, delusions, or disorganized thinking could indicate severe mental health conditions

Preventive psychiatry: The way forward?

Preventative psychiatry is a research-proven way to prevent the onset of mental health disorders, which HCPs can address in their clinical practice, regardless of specialty.[] 

Preventive psychiatry seeks to proactively address mental health issues by averting their onset or mitigating their effects if they have already started. It includes primary prevention for at-risk individuals, secondary prevention to detect problems in their early stages, and tertiary prevention to limit harm. 

Contemporary strategies like exercising, meditating, and dietary interventions also have a part to play. New tech-minded approaches, such as online and mobile-based therapies, have also proven to be effective. 

What this means for you

We need better mental health treatment and policies to fix the rising issues of mental health disorders across all age groups. Understanding the onset patterns aid in delivering timely treatments to specific demographics, such as preventative approaches and early intervention for adolescents grappling with mental disorders. Research endeavors should prioritize exploring risk factors associated with distinct mental disorders during critical life phases. 

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