Towards a youth mental health paradigm: a perspective and roadmap

Peter J Uhlhaas; Christopher G Davey; Urvakhsh Meherwan Mehta; Jai Shah; John Torous; Nicholas B Allen; Shelli Avenevoli; Tolulope Bella-Awusah; Andrew Chanen; Eric Y H Chen; Christoph U Correll; Kim Q Do; Helen L Fisher; Sophia Frangou; Ian B Hickie; Matcheri S Keshavan; Kerstin Konrad; Francis S Lee; Cindy H Liu; Beatriz Luna; Patrick D McGorry; Andreas Meyer-Lindenberg; Merete Nordentoft; Dost Öngür; George C Patton; Tomáš Paus; Ulrich Reininghaus; Akira Sawa; Michael Schoenbaum; Gunter Schumann; Vinod H Srihari; Ezra Susser; Swapna K Verma; T Wilson Woo; Lawrence H Yang; Alison R Yung; Stephen J Wood

doi:10.1038/s41380-023-02202-z

Towards a youth mental health paradigm: a perspective and roadmap

Mol Psychiatry. 2023 Aug;28(8):3171-3181. doi: 10.1038/s41380-023-02202-z. Epub 2023 Aug 14.

Authors

Peter J Uhlhaas^{1

2}, Christopher G Davey³, Urvakhsh Meherwan Mehta⁴, Jai Shah⁵, John Torous⁶, Nicholas B Allen⁷, Shelli Avenevoli⁸, Tolulope Bella-Awusah⁹, Andrew Chanen^{10

11}, Eric Y H Chen¹², Christoph U Correll^{13

14

15}, Kim Q Do¹⁶, Helen L Fisher^{17

18}, Sophia Frangou¹⁹, Ian B Hickie²⁰, Matcheri S Keshavan²¹, Kerstin Konrad^{22

23}, Francis S Lee²⁴, Cindy H Liu²⁵, Beatriz Luna²⁶, Patrick D McGorry^{10

11}, Andreas Meyer-Lindenberg²⁷, Merete Nordentoft²⁸, Dost Öngür²⁹, George C Patton³⁰, Tomáš Paus^{31

32}, Ulrich Reininghaus^{33

34}, Akira Sawa³⁵, Michael Schoenbaum³⁶, Gunter Schumann^{37

38}, Vinod H Srihari^{39

40}, Ezra Susser^{41

42}, Swapna K Verma^{43

44}, T Wilson Woo^{45

46

47}, Lawrence H Yang^{48

49}, Alison R Yung^{50

51}, Stephen J Wood^{10

11}

Affiliations

¹ Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK. peter.uhlhaas@charite.de.
² Department of Child and Adolescent Psychiatry, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany. peter.uhlhaas@charite.de.
³ Department of Psychiatry, The University of Melbourne, Carlton, VIC, Australia.
⁴ Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India.
⁵ Department of Psychiatry, McGill University, Montreal, QC, Canada.
⁶ Division of Digital Psychiatry and Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
⁷ Department of Psychology, University of Oregon, Eugene, OR, USA.
⁸ Office of the Director, National Institute of Mental Health, Bethesda, MD, USA.
⁹ Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria.
¹⁰ Orygen: National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.
¹¹ Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia.
¹² Department of Psychiatry, University of Hong Kong, Hong Kong, China.
¹³ Department of Child and Adolescent Psychiatry, Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
¹⁴ Departments of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hostra/Northwell, Hempstead, NY, USA.
¹⁵ Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA.
¹⁶ Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland.
¹⁷ Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
¹⁸ ESRC Centre for Society and Mental Health, King's College London, London, UK.
¹⁹ Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada.
²⁰ Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia.
²¹ Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
²² Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, RWTH, Aachen, Germany.
²³ JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, Research Center Jülich, Jülich, Germany.
²⁴ Department of Psychiatry, Weill Cornell Cornell Medicall College, New York, NY, USA.
²⁵ Departments of Pediatrics and Psychiatry, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA.
²⁶ Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
²⁷ Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
²⁸ CORE-Copenhagen Research Centre for Mental Health, Mental Health Center Copenhagen, University of Copenhagen, Faculty of Health and Medical Sciences, Department of Clinical Medicine, Hellerup, Denmark.
²⁹ McLean Hospital/Harvard Medical School, Belmont, MA, USA.
³⁰ Centre for Adolescent Health, Murdoch Children's Research Institute, University of Melbourne, Parkville, VIC, Australia.
³¹ Departments of Psychiatry and Neuroscience, Faculty of Medicine and Centre Hospitalier Universitaire Sainte Justine, University of Montreal, Montreal, QC, Canada.
³² Department of Psychology and Psychiatry, University of Toronto, Toronto, ON, Canada.
³³ Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany.
³⁴ Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
³⁵ The John Hopkins Schizophrenia Center, Johns Hopkins University, Baltimore, MD, USA.
³⁶ Division of Service and Intervention Research, National Institute of Mental Health, Bethesda, MD, USA.
³⁷ Centre for Population Neuroscience and Stratified Medicine, ISTBI, Fudan University, Shanghai, China.
³⁸ Department of Psychiatry and Neuroscience, Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
³⁹ Department of Psychiatry, Yale University, New Haven, CT, USA.
⁴⁰ Program for Specialized Treatment Early in Psychosis (STEP), New Haven, VIC, USA.
⁴¹ Departments of Epidemiology and Psychiatry, Columbia University, New York, NY, USA.
⁴² New York State Psychiatric Institute, New York, NY, USA.
⁴³ Department of Psychosis, Institute of Mental Health, Buangkok, Singapore.
⁴⁴ Duke-NUS Medical School, Singapore, Singapore.
⁴⁵ Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA.
⁴⁶ Laboratory for Cellular Neuropathology, McLean Hospital, Belmont, MA, USA.
⁴⁷ Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
⁴⁸ Department of Social and Behavioral Sciences, New York University, New York, NY, USA.
⁴⁹ Department of Epidemiology, Columbia University, New York, NY, USA.
⁵⁰ School of Medicine, Faculty of Health, Deakin University, Melbourne, VIC, Australia.
⁵¹ Department of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.

Abstract

Most mental disorders have a typical onset between 12 and 25 years of age, highlighting the importance of this period for the pathogenesis, diagnosis, and treatment of mental ill-health. This perspective addresses interactions between risk and protective factors and brain development as key pillars accounting for the emergence of psychopathology in youth. Moreover, we propose that novel approaches towards early diagnosis and interventions are required that reflect the evolution of emerging psychopathology, the importance of novel service models, and knowledge exchange between science and practitioners. Taken together, we propose a transformative early intervention paradigm for research and clinical care that could significantly enhance mental health in young people and initiate a shift towards the prevention of severe mental disorders.

Publication types

Review

MeSH terms

Adolescent
Humans
Mental Disorders* / diagnosis
Mental Disorders* / therapy
Mental Health*
Psychopathology

Grants and funding

UL1 TR001863/TR/NCATS NIH HHS/United States