Editor’s note: Dr. Jeff Derevensky is Professor Emeritus and former James McGill Professor in the Department of Educational and Counselling Psychology and Professor in the Department of Psychiatry at McGill University. He also serves as Director of the International Centre for Youth Gambling Problems and High-risk Behaviours. His research, treatment, and prevention work focuses on child and adolescent high-risk behaviors and has resulted in important social policy and governmental changes. This op-ed is part of our Special Series on Addiction Among Emerging Adults, which was funded by a research and consulting contract with DraftKings.
It seems as if every generation of adolescents and young adults perceives their lives to be more difficult than those of previous generations. There is little doubt that today’s teens and young adults face a host of challenges, many of which their parents never encountered. The digital age is in full bloom, readily available, and easily accessible. Artificial Intelligence (AI) threatens young adults’ ability to gain meaningful employment and has had a significant effect on learning (both positive and negative).
Typically, emerging adulthood, as a developmental period, ranges from late adolescence to early adulthood (ages 16-25). This life stage is marked by teens and young adults experiencing some unique mental health challenges as they transition to adulthood. It is a developmental period of significant growth and change, characterized by social transitions, identity development, intimacy, independence, and entry into the workforce. It is also a period of experimentation, uncertainty, and anxiety. A recent study by SAMHSA, examining emerging adults, found that a third of emerging adults (33.2%) experience some form of mental health disorder. They concluded that the pressures of societal expectations, the importance and impact of social media, and the quest for identity and independence exacerbate the challenges many emerging adults face. Financial difficulties resulting from student debt, excessive spending, engagement in online platforms and addictive behaviors, and increasingly high levels of unemployment have resulted in mental health problems. Add in the social isolation difficulties adolescents and emerging adults faced during the COVID pandemic, and it should not be unexpected that today’s young people have more mental health challenges than previous generations.
Stories of young celebrities suffering mental health illnesses through their 20’s are not new. Study after study reports emerging adults as a high-risk group for substance use disorders (SUDS: cannabis and other drugs, alcohol, binge drinking), depression, anxiety, suicidal ideation, addiction to pornography, video gaming, and gambling, all of which result in dysfunctional behaviors and difficulty transitioning to adulthood.
Today’s youth and young adults are glued to their smartphones, tablets, and laptops, experiencing excessive amounts of screen time to the detriment of in-person social activities and social communication. Interpersonal social communications have been relegated to text messaging or cooperative gaming. Clinical evidence indicates that removing smartphones from adolescents and emerging adults results in excessive anxiety, depression, aggressive and antisocial behaviors. It has become so problematic that many school boards now prohibit students from having their smartphones in class and some governments have tried to limit social media time for young people.
Today we live in a social world of YouTube, Facebook, TikTok, Instagram, and Snapchat. Video games have millions of subscribers and both the World Health Organization and the American Psychiatric Association have identified Internet Disorders and Internet Gaming Disorders as serious mental health concerns. While the American Psychiatric Association in the latest diagnostic manual recognized Internet Gaming Disorder as a condition warranting further investigation, the World Health Organization identified it as a behavioral disorder. As is typical in most addictive behaviors, these behaviors involve impaired control, prioritizing the behavior over other activities and continuing to engage in the behavior despite serious negative consequences.
For decades, mental health professionals have tried to address strategies and treatment approaches for substance use disorders. We have developed a wide range of treatment options for drug and alcohol rehabilitation (e.g., Cognitive Behavioral Therapy (CBT), Motivational Interviewing, and/or Contingency Management), some of which are also used for behavioral addictions. Treatment approaches include day treatment, individual therapy, group therapy, either as an outpatient or inpatient residential care. There is little doubt that today’s emerging adults remain at high risk for SUDs, with many jurisdictions legalizing cannabis use.
Today, we see a growing number of youth and emerging adults disenfranchised from society, turning to other excessive behaviors as a form of dissociation and psychological escape. This has resulted in a growing number of youth and young adults engaging in one or more behavioral disorders, Internet use disorders, gaming disorders, and gambling disorders. Similarly, because of their dependence on technology, they are prone to a number of behavioral disorders.
Although many potentially addictive behaviors, such as alcohol consumption, gambling, and, to a limited extent, video gaming, have age prohibitions, they are still socially acceptable and available to young people.
I am often called upon by the media, high school and college students using gambling as a school project to give an interview concerning youth and emerging adult gambling behavior. When speaking with students, I typically ask if they have any discussions around drug use. (Typical answer – Yes.) Have they had any discussions around alcohol abuse, binge drinking, and drinking and driving? (Typical answer – Yes.) Have they had any education about sexually transmitted diseases and the use of contraceptives? (Typical answer- Yes.) Then, I ask if they have had any discussions around social media use, digital technologies and gambling, and the typical answer is No. Clearly, there is a lack of preventive education when it comes to behavioral addictions. These behavioral addictions are accompanied by mental health problems.
At McGill University’s International Centre for Youth Gambling Problems and High-Risk Behaviors, we have been engaged in research, training of mental health professionals, treatment of youth and emerging adults with gambling problems, consultations with government and the industry, and the development of prevention tools. When our staff offers to provide gambling prevention workshops for students in high schools, we are often told: “Our students do not have a gambling problem, our health curriculum is full, and we don’t have time to add gambling into the curriculum.” Clearly, there is a lack of public awareness that young people can have a gambling disorder despite the significant amount of international research suggesting this age group has the highest prevalence of gambling problems. Adolescents and emerging adults with a gambling problem do not present in the same way as older adults. They typically have not lost a job, as many are still in school; they have not lost their families (the vast majority are single); they have accumulated debt but not to the same level as older adults; and they have not lost their homes, as most are in school and live at home or have their residence paid for by a parent.
There is a real need for the prevention of all forms of addictive behaviors. The good news is that we can gain entry into schools now because of the growing concern over social media and gaming problems. Young people, especially males, are greater risk takers. Sports gambling among young males has reached epidemic proportions. Couple the regulated licenses for online gambling with the opportunity to wager on prediction markets, it seems like the “perfect storm.”
Most young people do not voluntarily seek treatment from a mental health professional and yet manage to escape long-term addictive behaviors and their consequences. Some do so via web-based programs; others do so through ‘natural recovery.’ There is no doubt that appropriate early prevention and treatment during this developmental period can positively impact the lifetime trajectories of a young person’s mental health and well-being.
A general mental health curriculum addressing the commonalities and differences among addictive behaviors needs to be developed and implemented in our schools. While parents are frequently aware of SUDs, there is, in general, little recognition and awareness of behavioral disorders until a crisis develops.
Jeffrey L. Derevensky, Ph.D.
Professor Emeritus, School/Applied Child Psychology
Professor Emeritus, Psychiatry
Director, International Centre for Youth Gambling Problems and High-Risk Behaviors
McGill University