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Mental health of young adults (18-24) in Scotland

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This blog provides a brief overview of some of the mental health and wellbeing issues that may be particularly relevant to young people aged between 18 and 24 years old.

The mental health of Scotland’s young adults

Data from the Scottish Health Survey suggests that young adults in Scotland have a higher prevalence of some, although not all, mental health difficulties.  

The General Health Questionnaire 12 (GHQ-12) is a standard measure of mental distress and mental ill-health, consisting of 12 questions. A score of 4+ is indicative of a possible psychiatric disorder. In 2019, 23% of 16–24 year-olds surveyed reported a score of 4+, which compared to 19% in the age category with the second highest score (25-34).The 16-24 age group’s result was largely driven by the high scores of young women.

For 2018-19 combined, 25% of the 16-24 age group reported either ‘1 depression symptom’ or ‘2 or more depression symptoms’, with the percentage rising to 32% of women in this age group.

Forty two percent of the 16-24 age group reported one or more anxiety symptom. For women, this rose to 54%.

Nine percent of men and 22% of women aged between 16 and 24 years old reported that they had deliberately self-harmed.

The COVID-19 pandemic

In September 2020, the Scottish Government published a review of the evidence around the pandemic’s impact on equality in Scotland. It noted that negative mental health was influenced by the pandemic’s impact on education, employment, and finances. The fact that young people had a higher proportion of mental health issues compared to other age groups prior to 2020 was found to have been “exacerbated” by the pandemic.

Impact on employment

In 2020, the impact of the pandemic on young people’s employment and economic prospects was predicted to be especially negative compared to other age groups. This was due to younger employees being more likely to work in a sector ‘shut-down’ by COVID-19 restrictions and more likely to have lost work due to furloughing, job losses, and reductions in the number of hours worked. One forecast projected that youth unemployment would increase by 600,000 across the UK.

The Scottish Government’s report on evidence around the pandemic’s impact on equality also highlighted research that predicted a negative impact on those leaving education and training in 2020. Much of this research referenced the impact of the 2008 economic recession on those who left education in 2008-09, which resulted in a longer and more negative impact on employment prospects, levels of pay, and job quality for that cohort of leavers. 

Young people’s employment prospects began to improve from Spring 2021 and youth unemployment did not reach projected levels. However, the uncertainties created by the COVID-19 pandemic in 2020, in addition to changes in employment, still had a significant impact on mental health during the pandemic and possibly on future mental health and wellbeing.

Impact on students

Students remaining in education for the 2020-21 academic year were also impacted, with a survey by the National Union of Students (NUS) Scotland (November 2020) finding that 55% of students reported their mental health was worse compared to before the pandemic.

The Scottish Government’s Programme for Government 2018-19 committed to funding more than 80 additional counsellors in colleges and universities over a four-year period, supported by an investment of around £20 million. £3.6 million was provided for both the 2019-20 and 2020-21 academic years and £4.2 million was provided for the most recent (2021-22) academic year.

Jamie Hepburn MSP, the Minister for Higher Education and Further Education, Youth Employment and Training stated in February 2022 that the Scottish Government is on-track to meet its Programme for Government 2018-19 commitment.  

The Scottish Government also funds ‘Think Positive’ – a student mental health project managed by NUS Scotland that provides support for students experiencing poor mental health, promotes good wellbeing in colleges and universities, and helps to tackle stigma and discrimination. Action 9 of the Scottish Government’s Mental Health Strategy 2017-2027 had committed to supporting the “further development of ‘Think Positive’ to ensure consistent support for students across Scotland.”

‘Think Positive’ also commissioned research into student mental health and the support available in Scotland. NUS Scotland published the report in October 2020, which included a survey of 3,000 college and university students. 

The Programme for Government 2021-22 committed to developing a student mental health action plan. An update on work undertaken to progress the development of the plan was published in response to a written parliamentary question, although it is unclear when the plan will be published. In the response, Jamie Hepburn MSP stated that the Plan will “address waiting times, ensure equity of access to counsellors, and embed mental health and wellbeing into the curriculum.”

Community mental health services

Young adults aged between 18 and 24 can access the community mental wellbeing services developed for children and young people (5-24) as part of the Scottish Government’s Programme for Government 2018-19 commitments. Care experienced young people can access these services until they are 26. The SPICe briefing on children and young people’s mental health discusses the development of these services in greater detail.

Young adults do not have separate services and local authorities have been able to develop supports and services tailored to local needs. However, the ‘Community mental health and wellbeing supports and services: framework’, published in February 2021 to support the delivery of these services, does emphasise the need for local authorities to cover the “full age range” when developing services.

Transitioning to adult mental health services

Young adults aged 18+ in need of specialist treatment will be seen by Adult Mental Health Services. The Children and Adolescent Mental Health Services (CAMHS) National Service Specification now states that specialist CAMHS “are for children and young people age 0 – 18th birthday”.

Some young people aged 17 who are being treated by CAMHS may need to continue receiving support once they turn 18. For specialist services, this will mean transitioning from CAMHS to Adult Mental Health Services. SPICe published a briefing on the transitions of young people with service and care needs between child and adult services in Scotland, which included a section on mental health care transitions.

Part of Action 21 of the Mental Health Strategy 2017-2027 aims to improve the “quality of anticipatory care planning approaches” for those transitioning from CAMHS to Adult Mental Health Services.

Transition Care Plans (TCPs) were co-designed with young people and clinicians and were launched in August 2018.

As stated in the second progress report for the Mental Health Strategy, there is an expectation that TCPs will be used “as standard in every transition between CAMHS and adult services”.

Conclusion

Young people aged 18 to 24 have unique mental wellbeing concerns. Before 2020, results from the Scottish Health Survey suggested that the mental health of this age group was lower than for other adults. The COVID-19 pandemic has had a significant impact on youth employment, which has affected mental health in the short-term and may have created a negative legacy.

In addition to the impact of the pandemic on this age group in Scotland, other developments will include the implementation of community mental health and wellbeing services for this age group, better supporting transitions to adult mental health services, and completing the commitment of an additional 80 counsellors in colleges and universities across Scotland.

Cristina Marini, SPICe Trainee

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