Risk-taking young people need better health services

(Medical Xpress)—Comprehensive health assessments and supports need to be more widely available for young people attending secondary schools in New Zealand, according to a new study.

While most secondary are healthy, the recent study has shown that 21 per cent of their peers are engaging in risky behaviours, are distressed, or have a combination of multiple risk factors.

A group of researchers led by Dr Simon Denny, a senior lecturer in Paediatrics at the University of Auckland, has just published the study* that shows the clustering of these adolescent among New Zealand secondary school students.

The study surveyed 9107 secondary school students and 315 alternative education students, providing a snapshot of population data of young people growing up in New Zealand , says Dr Denny.

"Youth services and particularly comprehensive health assessments are not widely available in secondary schools and are patchy and sporadically available at best", he says. "Government funding for these services is only mandated for decile 1 - 3 schools."

"The study shows that while most young people are doing fine, about 21 per cent of adolescents are distressed, suffering from issues and/or engaging in risk taking behaviour that often involves driving vehicles."

"Twenty-one per cent of young people are in need of some help and that is huge – it's too big for secondary health services, such as hospital outpatients or child and adolescent mental health services," says Dr Denny who is also a youth health clinician working in South Auckland.

"This research shows that mental health concerns and risky behaviour does not happen in isolation – they are happening together in clusters," he says. "This needs to be dealt with at a level."

Dr Denny says primary health care providers need to know that these behaviours among adolescents, (such as risk taking, depression, and sexual health), are occurring in clusters. The biggest killers of teenage young people in New Zealand are motor vehicle accidents and suicide.

"This study shows that most secondary school students are healthy and don't engage in risky behaviours or suffer from emotional health concerns, and that dispels the myth that most are distressed risk-takers in conflict with their parents", he says. "But a significant proportion of those students and a high proportion of alternative education students need comprehensive health assessments and intervention, especially among students in high-risk settings."

Until now, few studies investigating behaviour or emotional health concerns have looked at both mental health indicators and a wide range of problem behaviours, he says. The study questionnaire included questions on depression, attempted suicide, alcohol use, smoking cigarettes, marijuana use, motor vehicle risk behaviours, violent behaviours, unsafe sex and delinquency.

The study found that there were four main behavioural clusters among secondary school students; healthy, distressed, risky and multiple clusters.

In the 'healthy' group 78 per cent of students identified no health concerns and 22 per cent had only one health concern.

In the 'distressed' group, 86 per cent reported high levels of depressive symptoms and 48 per cent had made a suicide attempt in the past 12 months. Most of the group had multiple health concerns with 47 per cent having two health concerns and 52 per cent with three or more health concerns.

The 'risky' group had high rates of risk behaviours, but relatively low rates of emotional health concerns. For example 62 per cent were smoking cigarettes and 61 per cent reported one or more risky motor vehicle use behaviour in the past month. Only one per cent reported depression.

The 'multiple' group had high levels of both risk behaviours and concerns in areas such as cigarette smoking, risky use, and alcohol use problems, high levels of depression, and 36 per cent attempting suicide in the last 12 months. Ninety-eight per cent of students in this group were experiencing three or more health concerns.

Maori and Pacific students reported significant health disparities compared to New Zealand European students in the study, and were over represented in alternative education schools.

Previous research has already highlighted cultural alienation, socio-economic disadvantage and deprivation, institutional racism, poorer educational achievement and poorer access to health and social services among these groups of students.

"These issues require urgent action across multiple sectors, including health, education and social services to improve health and well-being outcomes for Maori and Pacific students," says Dr Denny.

More information: *The study by Denny et al, 'Clustering of adolescent health concerns: a latent class analysis of students in secondary schools and alternative education schools in New Zealand' was published in the Journal of Paediatrics and Child Health, first published online: 20 NOV 2013. Link to study DOI: 10.1111/jpc.12397

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