Early Treatment Helps Later Employment and Social Engagement

When a teenager receives a diagnosis for a mental health, behavioral, or addiction disorder, there are several compelling reasons for their parents to seek professional treatment and support to help them address the disorder.

First, our 21^st century understanding of mental health disorders teaches us that they’re more like physical disorders than we thought during the latter half of the 20^th century. They respond well to integrated, holistic, evidence-based treatment. Integrated and holistic means that in addition to medication, lifestyle changes – like healthy eating, exercise, good sleep, and stress management – are an important part of any recovery regimen.

That’s as true for chronic physical ailments as it is for mental health issues. Any doctor today treating diabetes, hypertension, or a heart condition will require lifestyle changes in addition to medication. But that’s not our real point. Our real point here is that if you get an injury or illness, you go to the doctor. Now we know that if you develop a mental health or addiction disorder, you go to the doctor: evidence says it’s the best way to heal.

Second, parents seek professional treatment and support for their teen because they see them in pain. Parental instinct drives them to ease that pain and relieve any suffering or hardship they experience, because on one level, parents always see their kids – even when they’re teens – as their children they need to protect. Treatment helps teens with psychiatric disorders reduce the pain and suffering caused by the symptoms of their disorder: that’s documented fact – and a compelling reason to seek treatment.

Now we’ve identified a third compelling reason for parent to seek professional support for their teen with a psychiatric disorder: delaying or not getting treatment can lead to social exclusion and unemployment when they’re young adults.

Long Range Studies Shows Consequences of Early Psychiatric Diagnoses

Three studies published over the past several years examined the effect of adolescent stress, adolescent psychiatric disorders, and adolescent addiction disorders on social engagement during early adulthood. In the context of this discussion, social engagement refers to a range of activities common to early adulthood. These studies define social engagement as participation in education past high school, active employment, or participation in a training program designed to lead to gainful employment.

Let’s take a look at the first study: Adolescent Psychological Distress, Unemployment, and The Great Recession: Evidence From The National Longitudinal Study Of Youth 1997. This study, published in 2016, analyzed survey results from 7,125 individuals. Participants completed surveys twice: in 2000, during adolescence, and in 2011, during early adulthood.

Here’s what researchers found.

High Levels of Psychological Distress During Adolescence

Compared to adolescents without high levels of psychological distress, adolescents with high levels of psychological distress were:

• 32% more likely to be unemployed
• 26% more likely to be out of the workforce altogether
• 28% more likely to report at least three months (11 weeks or more) of unemployment per year

Now let’s look the second, more recent article, published in 2019. Adolescent Mental Health and Unemployment Over the Lifespan: Population Evidence from Sweden examined records on close to a million Swedish male adolescents, drawing on birth data collected between 1969 and 1989 and employment data from 1992-2012.

Here’s what they found.

Mental Health and Addiction During Adolescence

• Adolescents with any psychiatric condition reported:
  • 10 more days of unemployment per year, compared to those without any psychiatric disorder
• Adolescents with alcohol use disorder (AUD) reported:
  • 16 more days of unemployment per year, compared to those without AUD
• Adolescents with a substance use disorder (SUD) reported:
  • 17 more days of unemployment per year, compared to those without SUD
• Adolescents with:
  • Personality disorders reported 10 more days of unemployment per year
  • Anxiety disorders reported 9 more days of unemployment per year
  • Depressive disorders reported 9 more days of unemployment per year

We can see a clear trend: adolescent mental health issues can lead to significant increases in adult unemployment, which mental health experts consider a feature of social exclusion. The evidence for early treatment is powerful – but that’s not all we have.

Let’s look at the most recent study, published in 2021. Psychiatric Disorders Diagnosed in Adolescence and Subsequent Long-Term Exclusion from Education, Employment or Training: Longitudinal National Birth Cohort Study used records on 55,273 individuals diagnosed with a mental health disorder during adolescence (1998-2007). They compared these diagnostic records with employment and education records related to the same individuals during early adulthood (2008-2015). For the purposes of this study, social exclusion is represented by the phrase Not in Education, Employment, or Training (NEET).

Here’s what they found.

Adolescent Psychiatric Diagnoses and Early Adult NEET

• Substance misuse: 15% increased likelihood of early adult NEET
  • Substance misuse + Incomplete Secondary Education (upper high school/vocational school): 23.9% increased likelihood of early adult NEET
• Psychosis: 5% increased likelihood
  • Psychosis + Incomplete Secondary Education: 48.4% increased likelihood
• Bipolar disorder: 18.8% increased likelihood
  • Bipolar disorder + Incomplete Secondary Education: 28.0 % increased likelihood
• Depressive disorders: 12.2% increased likelihood
  • Depressive disorder + Incomplete Secondary Education: 20.8 % increased likelihood
• Anxiety disorders: 11.8% increased likelihood
  • Anxiety disorders + Incomplete Secondary Education: 20.8 % increased likelihood
• Eating disorders: 6.8% increased likelihood
  • Eating disorders + Incomplete Secondary Education: 19.8% increased likelihood
• Personality disorders: 29.2% increased likelihood
  • Personality disorders + Incomplete Secondary Education: 37.1% increased likelihood
• Learning disabilities: 12.4% increased likelihood
  • Learning disabilities + Incomplete Secondary Education: 24.4% increased likelihood
• Autism spectrum disorder: 44.0% increased likelihood
  • Autism spectrum disorder + Incomplete Secondary Education: 70.6% increased likelihood
• Attention-deficit hyperactivity disorder (ADHD): 3% increased likelihood
  • Attention-deficit hyperactivity disorder + Incomplete Secondary Education: 22.7% increased likelihood
• Conduct disorder: 15.7% increased likelihood
  • Conduct disorder + Incomplete Secondary Education: 20.6% increased likelihood

That’s a lot of information to digest at once.

It’s important information for parents of teens with a psychiatric diagnosis to understand, though. We encourage parents to pay special attention to that last data set and increase their awareness about the impact of education on early adult social engagement.

We’ll elaborate on that now.

Mental Health, Education, Work, and Social Life: They’re All Connected

One thing that often happens when a teen has a significant psychiatric disorder is that it impairs their ability to go to school. And if they do go to school, it can have a significant negative impact on their grades, behavior, and social fluency. This, in turn, can lead to dropping out of high school, not considering college, and living with all the knock-on consequences associated with a lifetime of exclusion from jobs that require a high school diploma or college degree.

Here’s where treatment becomes a critical phase in their lives.

An adolescent who receives appropriate, evidence-based treatment can learn to manage the symptoms of their disorder. After treatment, many can return to home life, school life, and social life – and succeed in all three areas.

Evidence shows that treatment is effective for the following disorders common in adolescence:

• Depression (MDD)
• Bipolar Disorder (BD)
• Generalized Anxiety Disorder (GAD)
• Social Anxiety Disorder (Social Phobia)
• Panic Disorder (PD)
• Post-Traumatic Stress Disorder (PTSD)
• Oppositional Defiant Disorder (ODD)
• Disruptive Mood Dysregulation Disorder (DMDD)
• Alcohol Use Disorder (AUD)
• Substance Use Disorder (SUD)

When we cross-reference that list with the list from the Finnish study on NEET, we see a great deal of overlap. That tells us that teens with psychiatric disorders need treatment in order to avoid exclusion from education, work, and job training as adults.

Treatment Works: The Sooner the Better

Of course, any teen with a psychiatric disorder needs treatment to help them in the here and now, as well. They want to learn to manage the symptoms of their psychiatric disorder to ease their emotional pain. They want to learn the coping skills necessary to manage their disorder so they can return to life as usual. Teens want to heal so they can return to being teens. Which, in this case, means a returning to high school, hopefully finishing high school, then potentially going to college or vocational school and entering the workforce.

Without treatment, the likelihood of doing those three things – finishing high school, going to college/vocational school, and/or entering the workforce – decreases significantly. The data shows that an individual with a psychiatric disorder who does not finish high school or vocational school is at a disadvantage in many areas of life. They’re at risk of social exclusion as an adult, which can increase their senso if isolation, which itself can exacerbate the symptoms of any psychiatric disorder, including addiction.

In that way, the negative consequences of avoiding treatment compound over time, and become more disruptive with each passing year. That’s why we encourage parents of teens with any mental health or psychiatric issue to seek support for their teen. The consequences of not seeking treatment can last decades, and in some cases, avoiding treatment can create a lifetime of unnecessary difficulty. Seeking and engaging in treatment, however, can do the opposite: it can help a teenager lay the foundation of a fulfilling life lived on their terms, rather than those dictated by the problems created by their disorder.

Finding Help: Resources

If you’re seeking treatment for your teen, please navigate to our page How to Find the Best Treatment Programs for Teens and download our helpful handbook, A Parent’s Guide to Mental Health Treatment for Teens.

In addition, the American Academy of Child and Adolescent Psychiatry (AACAP) is an excellent resource for locating licensed and qualified psychiatrists, therapists, and counselors in your area. Both the National Institute of Mental Health (NIMH) and the National Alliance on Mental Illness also provide and high-quality online resources, ready and waiting for you right now.