Trends in mental health problems among young people and the presence of youth clinics in Sweden: An ecological controlled interrupted time series analysis using the Health on Equal Terms surveys (2004 to 2021)

Main Article Content

Miguel San Sebastián
Osvaldo Fonseca-Rodríguez
Isabel Goicolea

Abstract

Introduction: In Sweden, youth clinics (YCs) address, among other things, issues related to the mental well-being among young people. However, YCs´ impact on their mental health have not been assessed. This study aimed to: i) analyse trends in mental health outcomes (stress, anxiety and psychological distress) among young people in Sweden according to the municipal availability of YCs; and ii) assess the impact on mental health outcomes of the presence of YCs with a first-line mental health (FLMH) assignment and YCs without this assignment, as compared to municipalities without YCs.


Methods: An ecological controlled interrupted time series design was applied. Annual data over 18 years (2004-2021) on self-reported stress, anxiety and psychological distress of individuals aged 16-25 were used. Thus, the mental health outcome trends in municipalities with YCs and those without YCs were compared. The prevalence ratio and their 95% confidence intervals were estimated.


Results: In total, 17,174 young people aged 16–25 participated in the study. A decrease in the reporting of stress, anxiety and psychological distress was observed from 2004 to 2010, followed by an increase in all three outcomes during the period 2011–2021. Trends were not statistically significant different in municipalities with or without YCs (even among YCs with the FLMH assignment).


Conclusion: The prevalence of mental ill-health has been increasing among young people in Sweden since 2011. While YCs play an important role in the prevention of mental illness, their impact on these trends could not be determined. We recommend that structural factors such as education and the labour market for youth, which are outside the scope of YCs, should be addressed to curb these trends.

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1.
San Sebastián M, Fonseca-Rodríguez O, Goicolea I. Trends in mental health problems among young people and the presence of youth clinics in Sweden: An ecological controlled interrupted time series analysis using the Health on Equal Terms surveys (2004 to 2021) . J Community Syst Health [Internet]. 2024 Oct. 1 [cited 2024 Oct. 3];1(1). Available from: https://journals.ub.umu.se/index.php/jcsh/article/view/1035
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Original research

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