While the Estonian state lacks complete statistics on mental illness in children, what existing data shows is that initial mental illness diagnoses in teenagers between the ages of 15-19 have become more frequent in recent years. An estimated total of 20,000-40,000 teenagers, or 10-20% of all teenagers, have been diagnosed with mental illness, and nearly 3,000 children take prescription antidepressants.
According to Käthlin Mikiver, chief specialist at the Ministry of Social Affairs' Public Health Department, initial diagnoses of mental and behavioural disorders have decreased somewhat, however the noticeable increase in mental illness in the 15-19 age group is concerning.
While just a few years ago, mental and behavioural disorders were diagnosed the most in the 5-9 age group, followed by the 10-14 age group, something changed around 2015-2016, and the number of initial diagnoses in the 15-19 age group began to rise sharply.
In 2016, a total of nearly 5,500 minors received a psychiatric diagnosis, 1,815 of whom were between the ages of 15-19, 1,618 of whom were between 10-14, 1,764 of whom were between 5-9 and 287 of whom were 1-4 years of age.
The most commonly occurring in children were behavioural and emotional disorders (28%), developmental disorders (27%), and neurotic, stress-related and somatoform disorders (19%), the last of which include for example depression, anxiety disorders, obsessive-compulsive disorders and neurological disorders.
"The increase may be due to the fact that as a result of increasing awareness, the number of people seeking help has increased," Mikiver offered, adding that this meant that more people dare seek help. "Indicators may have also increased due to the fact that children's access to services such as online counselling, children's and youth mental health centres and a network of offices has improved."
One in three teens suffering from depression
Among others, mood disorders, which include depression, bipolar disorder and mania, have become more prevalent, with nearly twice as many diagnoses in girls than in boys. In four years, the number of initial diagnoses of mood disorders has increased by a total of more than a quarter, but the frequency of initial diagnoses in the 15-19 age group has jumped by an entire third.
Depression is the one of the most common mental illnesses, which can manifest in children as learning disabilities and behavioural problems. Long-term depression can lead to self-harming behaviours up to and including suicidal ideation and suicide attempts.
According to the results of an international survey conducted in 2010, two percent of 14-15-year-old students studying in Tallinn schools indicated a strong desire to die or had already attempted suicide.
A total of approximately 10% of minors across all age groups suffer from depression, but the frequency increases significantly in the teen years. The results of a survey on Estonian schoolchildren's health behaviours indicate that nearly one third, or 30%, of students between the ages of 11-15 had experienced depressive episodes during the past year, including 37% of girls and 23% of boys.
"In the case of poor health and poor family relationships, students experienced sadness and depression nearly 30% more frequently than those who rated their health and family relationships as positive," Mikiver pointed out.
One third of youth have self-harmed
According to statistics, one third of Estonian youth have self-harmed at least once in their lives, with the behaviour more prevalent among girls.
Based on 2016 registered statistics, 366 children and young adults up to the age of 24 intentionally self-harmed, among them 47 children between the ages of 5-14. Incidents of self-harm were most common in Tallinn and Harju County (179), followed by Tartu and Tartu County (45) and Narva and Narva County (29).
The use of prescription antidepressants in the treatment of depression among children has increased somewhat by year as well.
The number of children between the ages of 10-19 to be prescribed antidepressants has increased from 2,347 in 2015 to 2,509 in 2016 and 2,977 in 2017.
Children in Estonia not immune to suicide
"When it comes to depression, it is very important to stress the fact that this is an illness and that this can be treated," Mikiver said. "Depression is a risk factor for suicide. Each year, we lose nearly 200 people to suicide — that is more than to traffic accidents and drowning combined.
According to National Institute for Health Development (NIHD) statistics, the number of suicides in the entire Estonian population increased 21.5% last year, from 186 to 226, among them six teenagers, the youngest of whom was below 14 years of age. In 2016, five teens between the ages of 15-19 died by suicide.
Up to 40,000 children in Estonia affected by mental illness
Many people suffering from depression do not seek help, due to which the Ministry of Social Affairs considers depression in the Estonian population to be underdiagnosed.
As a result, last year's 5,500 initial diagnoses of behavioural and mental disorders in children may only constitute a small part of a much bigger problem. As previously stated, the state lacks complete statistics on behavioural and mental disorders in the country's children.
An estimated total of 10-20% of all minors in Estonia, or 20,000-40,000 children and teenagers, suffer from depression and other mental illnesses.
According to the ministry, the easiest place to ask for help is at one's family doctor. Should any children find this difficult to do, a number of resources exist especially for children and teens.
A children's hotline can be reached at 116 111. Help can also be found at websites dedicated to providing info and support to those suffering from depression, including peaasi.ee, lahendus.net and enesetunne.ee, and mental health centres and offices exist especially for the assistance of children and teens.
Editor: Aili Vahtla