SINGAPORE – A recent study on youth mental health has found a gap in parents’ understanding of such issues – only about one in 10 parents observed signs of distress in their children, but one in three adolescents reported such symptoms.

Findings from the Youth Epidemiology and Resilience study of 3,336 respondents aged 10 to 18, led by Associate Professor John Wong from the Yong Loo Lin School of Medicine at National University of Singapore (NUS Medicine), were presented at a symposium on Wednesday.

This is the first nationwide study of adolescents’ mental health and resilience. Data was collected from 2020 to 2022. The study, which also looked at identity development and media activity, found that one in three respondents reported internalising symptoms like depression and anxiety. These refer to what the individuals felt.

About one in six said they experienced externalising mental health symptoms, or external behaviour such as hyperactivity, rule-breaking and aggression. 

Overall, one in 10 respondents met the criteria for at least one mental health disorder.

Prof Wong, director of the NUS Mind Science Centre, which is under NUS Medicine, said there is a need to look out for adolescents in distress. “We don’t want to wait until mental health symptoms become a disorder. We want teens, parents and educators to help them recognise (symptoms) early and get professional help,” he said.

He worked on the project with investigators from NUS Medicine’s Department of Psychological Medicine, the NUS Mind Science Centre, the Institute of Mental Health and Erasmus University Medical Centre in the Netherlands, in collaboration with the Ministry of Education (MOE).

The study grant was jointly awarded by the Tote Board and a seed grant from the NUS Mind Science Centre.

The role of resilience

Teens aged 14 to 16 have reported experiencing more mental health symptoms, said Prof Wong. Adolescents from single-parent households also had more problems than those from dual-parent families.

Using a clinical assessment tool, the study found that 12 per cent of the respondents met the full criteria for having at least one disorder, including depressive and anxiety disorders.

Those with good mental health scores fared well in resilience, based on an evaluation of 10 different aspects of resilience, such as perseverance and positive self-image, using a locally developed tool called the Singapore Youth Resilience Scale.

Resilience scores dipped for respondents aged 15 and 16, while 18-year-olds did significantly better, perhaps because they had grown in maturity by then, said Prof Wong. Boys reported higher resilience than girls across all 10 domains.

Four aspects of resilience, in particular, contributed to better mental well-being: positive self-image or optimism, personal control, relationships and social support, as well as emotional regulation.

Prof Wong said the data will be useful for clinicians, educators and youth themselves to better understand their strengths and weaknesses, and tailor interventions accordingly.

Bridging the parental gap

The study found that parents were less likely to identify mental health symptoms in their children. They also consistently underestimated the time their children spent on devices.

But not all media usage may be negative: Socialising and listening to music online had positive effects on adolescents’ mental health, according to the study, indicating that they may turn to such avenues for emotional regulation and self-therapy.

With the findings indicating that many parents do not really know their children very well, Prof Wong said this is a timely call for parents to develop a relationship with their children when they are young so that when they enter the puberty years, they will have channels of communication, conversation and understanding.

Current efforts

In a joint statement on Wednesday, the MOE, the Ministry of Social and Family Development and the Ministry of Health said research like the NUS study contributes to overall efforts to better support youth mental health.

The Government set up the Interagency Taskforce on Mental Health and Well-being in July 2021 to coordinate efforts. It has made recommendations, including a tiered care model of mental health services for youth with varying levels of needs and a “toolbox” for parents with resources on supporting children’s mental well-being.

Speaking at Wednesday’s event, Ms Sun Xueling, Minister of State for Social and Family Development, said: “Each domain (of resilience) is a challenge to us as practitioners; as teachers, counsellors and social service agencies, what kind of community programmes can we develop on the ground to help build resilience in our youth?”

She added: “Growing up is a very exciting stage of life – there are endless possibilities of who we can be... But at the same time, this process can be challenging for our youth. They face many stressors in life, from expectations in their work and studies to relationships with family members and friends.

“Whatever happens at this stage of their lives has a very long-term impact on who they will become subsequently as they reach adulthood.”