A/HRC/32/32 IV. Promotion of emotional well-being and mental health A. Nature and prevalence of mental health problems in adolescence 67. Globally, it is estimated that approximately 20 per cent of 14-24 year olds experience a mental health condition each year.42 The transition from childhood to adulthood is a period of heightened vulnerability (half of all lifetime mental disorders appear by the age of 14 years) caused to a significant extent by the physical, psychological and emotional changes arising during this period. Research indicates that depression is the primary cause of illness and disability among adolescents and suicide is the third leading cause of death.43 68. Poor mental health can affect the health and development of adolescents more generally and is associated with many damaging health and social outcomes, such as substance use, the inability to form relationships, dropping out of school or academic underperformance and delinquent behaviours, together with increased likelihood of poverty and poorer employment opportunities. 44 69. The risk of experiencing mental ill-health is heightened by poverty and by adverse childhood events, including, for example, sexual and emotional abuse, bullying and parental loss. Adolescents in post-conflict or disaster settings or who are homeless and street-involved, orphaned, lesbian, gay, bisexual, transgender and intersex or involved with the juvenile justice system are also at greater risk. Adolescents in the juvenile justice system suffer substantially higher rates of mental health conditions than those in the general population, with an estimated 70 per cent having at least one diagnosable mental health condition.45 70. The international human rights framework establishes the clear duty of States to promote adolescents’ mental health and emotional well-being, provide appropriate mental health treatment and care and ensure that mental health laws fully recognize the rights of those with mental illness.46 Target 3.4 of the Sustainable Development Goals is to reduce by one third premature mortality from non-communicable diseases through prevention, treatment and the promotion of mental health and well-being. That target must be applied fully to adolescents. 71. Despite these obligations and commitments, there is a worrying lack of recognition or awareness of the nature and scale of mental health problems among adolescents in many countries. Evidence indicates that many adolescents consider emotional well-being to be the most important health problem they face and would like more access to quality mental health care.47 72. The nature of adolescents’ mental health needs differs from that of adults and requires targeted services. However, a national health system of well-functioning, effective 42 43 44 45 46 47 14 Vikram Patel, Benedetto Saraceno and Arthur Kleinman, “Beyond evidence: the moral case for international mental health”, American Journal of Psychiatry, vol. 163, No. 8 (2006), pp. 1312-1315; and UNICEF, The State of the World’s Children 2012: Children in an Urban World (2012). WHO, “Adolescents: health risks and solutions”, factsheet No. 345. United Nations, Mental Health Matters: Social Inclusion of Youth with Mental Health Conditions, (2014). Ibid. Convention on the Rights of the Child , arts. 24 (1) and (2) (b) and 6; Committee on Economic, Social and Cultural Rights general comment No. 14; and E/1995/22-E/C.12/1994/20. WHO, Health for the World’s Adolescents.