São Paulo will have mental disturbance prevention center for young people

Researchers intend to create a preventive mental health center for adolescents with greater likelihood of developing disturbances.

By Elton Alisson

Agência FAPESP – Studies have shown that mental disturbances, such as depression, schizophrenia and bipolar disorder, are most likely to appear during adolescence and currently affect the 10- to 24-year-old population more than any other chronic disease.

Due to this finding, countries like Australia and Canada have implemented mental health disturbance prevention centers specifically aimed at youth. Their goal is to diagnose teens who have or are exposed to risk factors leading to the development of addictions, depressive states and serious mental disorders, such as schizophrenia and bipolar affective disorder.

A group of researchers from the psychiatry departments at the Universidade Federal de São Paulo (Unifesp), the Universidade de São Paulo (USP) and the USP Ribeirão Preto Medical School (FMRP) intend to replicate the experiment in Brazil.

The goal is to create a model meeting center for teens in São Paulo who are likely to develop neurodevelopmental disturbances. Preventive mental health activities will be offered at the center.

The project was presented by Jair de Jesus Mari, professor in the Unifesp Department of Psychiatry and coordinator of the initiative, at a conference held on July 25 at the 64th Annual Meeting of the Brazilian Society for the Progress of Science (SBPC) in São Luís, Maranhão.

According to Jesus Mari, the objective is for the model center, currently referred to as Espaço Cuca Legal [Cool Head Space], to attract youths that have not yet developed mental disturbances so that they may be accompanied by a multidisciplinary team of professionals.

The researchers plan to offer social/educational activities such as reading workshops, theater, music and sports at the centers to attract adolescents, as is the case at the Headspace Centres created by Australia’s National Youth Mental Health Foundation that inspired the Brazilian project.

“We intend to guarantee early identification and intervention for young people with a greater propensity for developing serious mental disorders to inhibit or slow the development of psychotic outbreaks and change behavior related to known risk factors, like the use of marijuana," Jesus Mari told Agência FAPESP.

According to the researcher, it is estimated that between 50% and 75% of all mental disturbances begin during adolescence. However, the false impression that young people are healthy, aside from the stigma of mental illness, leads to slower diagnosis and initiation of treatment. This situation increases the severity of the mental disturbance and has repercussions throughout life.

“The studies conducted in Brazil and abroad show that if we are able to intervene earlier with this part of the population during this critical phase of development when mental disturbances emerge, it will be possible to reduce the probability that the young people will have psychotic disturbances in the future,” said Jesus Mari.

Some of the factors that are considered risks for the development of mental disturbances include the consumption of alcohol, drugs and tobacco as well as exposure to traumatic situations.

According to Jesus Mari, because there is lenience in Brazil regarding the consumption of alcohol among young people and experimentation with drugs and cigarettes is often seen as glamorous during this phase of life, it is necessary to create public policy to restrict young people’s access to psychoactive substances.

“The use of alcohol and drugs during adolescence is extremely damaging to cerebral development. Adolescence is the period during which the young person is defining his/her sexual identity and is dealing with questions about a professional future. The use of alcohol and drugs during this phase of life, especially if it is excessive, will interrupt the natural progress of cerebral development in the adolescent and cause damage that can be permanent,” he warned.

Preventive measures

Mental disturbance is currently classified as a disturbance in neurodevelopment that affects people during the adolescent phase, when the brain is reorganizing itself.

Consumption of alcohol, drugs and tobacco, exposure to bullying, physical and sexual violence, phobias, depression, anxiety and stress resulting from traumatic events increase the risk of developing cerebral reactions that may become more serious mental disturbances.

Given this scenario of worsening mental health among youth, in recent years, preventive efforts related to mental disturbances in adolescents have been widely discussed and recommended by specialists.

Some of the actions being conducted with adolescents at existing mental disturbance prevention centers in Australia and Canada are the propagation of healthy sexual behavior, the promotion of physical, sports and sociocultural activities and education about the risks of alcohol, drug and tobacco consumption during adolescence.

By working together with specialists from other areas, such as education and law, the specialists working in these centers intend to identify youths at an earlier age who have a greater likelihood of developing mental disturbances and who have difficulties adapting socially.

Among these youths are students who engage in bullying at school, who are candidates for demonstrating aggressive behavior and who have problems with the law as well as youths who are targets of physical or psychological violence at school and who may suffer from anxiety, depression and suicidal tendencies.

“The idea is to repeat this experiment at the model center in São Paulo to guarantee identification and early intervention in emergency cases where young people are more likely to develop serious mental disorders, like, for example, those who begin to use crack,” explained Jesus Mari.

“We can’t wait for these adolescents to become dependent before we intervene,” he said. The researchers intend to begin this model of mental disturbance prevention among youths in the Vila Maria region, located in the North Zone of São Paulo, which is home to some 300,000 inhabitants and where a training center has been created.

The idea is to divide the region into six areas with 50,000 inhabitants each. These areas will be mapped by health officials to identify the most urgent cases of youths who have broken the law, for example, and to direct them to the mental health center.

ESPCA on mental disturbances during adolescence

According to Jesus Mari, the prevention of mental disturbances during adolescence has been widely debated and is the subject of a number of studies published in scientific journals, such as The Lancet.

“This is because when intervention happens during the preliminary phase of mental disturbances, meaning before the first psychotic episode, it’s possible to reduce symptoms and the loss of social capacity caused by the development of a psychosis,” he said.

“Even when a person develops a psychosis, it’s possible to reduce the negative impact, which isn’t only cerebral but involves overall health,” said Jesus Mari.

“Today, we have very consistent data showing that if psychotic episodes aren’t treated, patients can suffer serious consequences, such as greater probability of developing cancer or autoimmune illnesses. And their life expectancies and productivity are reduced,” he explained. 

The importance of preventing mental disorders in adolescence will also be discussed during the Y-Mind School of Advanced Science for Prevention of Mental Disorders.

Promoted by Unifesp together with USP, the Universidade Federal do Rio Grande do Sul (UFRGS), Columbia University in the United States and King’s College in England, the event, which is part of the FAPESP São Paulo School of Advanced Science, will bring together some of the foremost specialists on mental disorders from Brazil and abroad.

One hundred post-graduate students will be selected to participate in the School: 25 from São Paulo State, 25 from the rest of Brazil, and 50 from overseas. The School will be held at the end of March 2013.

Information on the application process will be available at www.saudedamente.com.br.