Mental well-being of children and young people in EU/EEA countries is poor and declining. Between 2018 and 2022, the rate of multiple health complaints in adolescents increased, especially amongst girls, and the prevalence of anxiety and depression amongst under 20‑year‑olds increased by about 20%. Alarmingly, suicide is the second leading cause of death among young people aged 15‑29 in EU countries.
Mental ill-health affects educational outcomes. On average across EU countries, students indicating mental distress are 25% more likely to have repeated a grade, although causality may run in both directions. Furthermore, the mental disorders that emerge in childhood and adolescence tend to persist throughout life.
Many EU/EEA countries have national strategies and action plans on mental health in place, but levels of policy implementation vary, and all countries have significant policy gaps. Top priority areas for action include the primary care sector as well as school-based and workplace interventions, with only 10‑25% of countries that have fully implemented relevant policies in these sectors. During the pandemic, an estimated half of Europeans aged 18‑29 had unmet needs for mental health care.
The OECD has identified and assessed 11 candidate best practices that can help countries bridge the current policy gaps and improve the mental health of children and young adults. These can be grouped into three main categories:
School-based programmes, such as Zippy’s Friends and This is Me, can reduce difficult behaviour by 4‑9%, and social isolation by 15%. Icehearts improved social behaviour and reduced the number of adolescents not in employment, education, or training by nearly 50%.
Proactive mental health support can be delivered by mental health professionals, but also by teachers, school staff, and young people with peer-based programmes. Prompt and free access to psychological therapy, such as in the recent Belgian reform, can reduce prevalence of mental disorders by 10%. Peer-based programmes such as @Ease have reduced levels of mental distress by 19% and improved school participation by 60%.
Suicide prevention programmes such as Suicide Prevention Austria (SUPRA) and VigilanS, save lives by reducing suicide risks and improving follow-up after suicide attempts.
Common success factors among the identified candidate best practices include: i) access to low-threshold support is facilitated; ii) schools are used to ensure near-universal coverage of the target population; iii) mental health literacy is enhanced and the seeking of mental health support is destigmatised; and iv) action is tailored to the needs of children and young adults.
Scaling up and transferring best practices for promoting good mental health in children and young adults requires increasing the capacity of the mental health workforce and creating new roles. Additionally, this process will incur costs for the government, although the cost of failing to act is also high.
Better understanding of the drivers of declining youth mental health, and “what works” to create a healthy and safe digital environment for young people, is needed. The OECD is working to fill this knowledge gap, and will be drawing on expert insights from mental health professionals, teachers and parents, and young people themselves.