This chapter describes what young people reported about their mental health problems and
behaviours that are generally considered to put them at risk. While all young people aged 11 years or
older were asked to complete a self-report questionnaire, questions about smoking, alcohol and
other drugs and about sexual behaviours were only asked of young people aged 13 years and older.
12.1 Smoking
Overall one tenth (9.9%) of young people aged 13-17 years had smoked at least once a week at some
point in their lives and 7.2% had smoked in the last 30 days. Rates of smoking were higher in young
people with major depressive disorder and in young people with other mental disorders compared
with young people with no mental disorder. Some 29.9% of young people with major depressive
disorder identified from adolescent report had ever smoked and 24.4% had smoked in the last 30
days. These rates compared with 29.6% ever smoked and 24.1% smoked in the past 30 days among
young people with other mental disorders based on parent or carer report. The corresponding rates
were 5.9% ever smoked and 4.1% smoked in the last 30 days among young people with no mental
disorder (Table 12-1).
Table 12-1: Smoking among 13-17 year-olds by sex and mental health status
Sex Mental health status
Ever smoked at
least once a
week (%)
Smoked in last 30
days (%)
Males Major depressive disorder based on adolescent report 22.5 18.0
Major depressive disorder based on parent or carer report 20.6 20.6
Other disorder based on parent or carer report 21.9 12.9
No disorder 6.0 4.3
All males 8.6 6.2
Females Major depressive disorder based on adolescent report 32.7 26.7
Major depressive disorder based on parent or carer report 34.7 26.1
Other disorder based on parent or carer report 28.1 22.2
No disorder 5.8 3.8
All females 11.2 8.2
Persons Major depressive disorder based on adolescent report 29.9 24.4
Major depressive disorder based on parent or carer report 29.6 24.1
Other disorder based on parent or carer report 24.4 16.6
No disorder 5.9 4.1
All persons 9.9 7.2
112 The Mental Health of Children and Adolescents
12.2 Alcohol
Almost two in five (37.9%) young people 13-17 years had ever drunk alcohol, 18.1% had drunk alcohol
in the past 30 days and 12.5% had drunk more than 4 drinks in a row in the last 30 days. Rates were
essentially the same in males and females (Table 12-2).
Young people with major depressive disorder had higher rates of drinking alcohol. Some two thirds
(65.3%) of young people with major depressive disorder based on adolescent report had ever drunk
alcohol compared with one third (33.8%) of young people with no mental disorder. Some 34.3% of
young people with major depressive disorder based on adolescent report had drunk alcohol in the
last 30 days compared with half as many (15.4%) young people with no mental disorder, and
approximately one quarter (27.6%) of young people with major depressive disorder based on
adolescent report had drunk more than 4 drinks in a row in the last 30 days compared with one in ten
(10.1%) young people with no mental disorder. Higher rates of alcohol consumption were seen in
young people with other mental disorders than in young people with no disorder, but these rates
were less than in young people with major depressive disorder (Table 12-2).
Table 12-2: Alcohol consumption among 13-17 year-olds by sex and mental health status
Sex Mental health status
Ever drunk
alcohol (%)
Drunk alcohol in
last 30 days (%)
More than 4
drinks in a row in
last 30 days (%)
Males Major depressive disorder based on
adolescent report 65.2 25.0 19.3
Major depressive disorder based on
parent or carer report 51.0 19.2 18.3
Other disorder based on parent or
carer report 41.9 24.8 18.5
No disorder 35.0 16.6 11.3
All males 37.1 17.9 12.6
Females Major depressive disorder based on
adolescent report 65.3 37.8 30.7
Major depressive disorder based on
parent or carer report 66.3 36.3 27.2
Other disorder based on parent or
carer report 47.5 21.3 12.9
No disorder 32.4 13.9 8.9
All females 38.7 18.3 12.5
Persons Major depressive disorder based on
adolescent report 65.3 34.3 27.6
Major depressive disorder based on
parent or carer report 60.8 30.2 24.0
Other disorder based on parent or
carer report 44.1 23.4 16.2
No disorder 33.8 15.4 10.1
All persons 37.9 18.1 12.5
The Mental Health of Children and Adolescents 113
12.3 Cannabis and other drugs
Overall one in ten (11.6%) young people aged 13-17 years had ever used cannabis, and one in twenty
(5.0%) had used cannabis in the last 30 days. Some 4.5% of young people had ever used other drugs
and 1.6% had used other drugs in the last 30 days (e.g. prescription drugs for non-medical purposes,
ecstasy, amphetamines, cocaine). Rates of drug use were broadly similar between males and females.
Higher rates of drug use were seen in young people with major depressive disorder. Among young
people with major depressive disorder identified from adolescent report 28.8% had ever used
cannabis, and 13.1% had used cannabis in the last 30 days, while 16.1% had used other drugs, and
6.1% had used other drugs in the last 30 days. Among young people with other mental disorders
identified from parent or carer report, rates of drug use were higher compared with young people with
no mental disorder, but not as high as for young people with major depressive disorder. Among young
people with other mental disorders 18.9% had ever used cannabis, 8.6% had used cannabis in the last
30 days, 9.8% had used other drugs and 3.7% had used other drugs in the last 30 days (Table 12-3).
Low weight problem eating behaviour (where the young person was assessed as underweight on the
age-adjusted BMI scale and was practising weight controlling behaviours such as dieting, fasting,
vomiting or using laxatives or regularly exercising when they were supposed to be doing other things)
was identified in 1.1% of 11-17 year-olds. Differences between males and females and between
younger and older adolescents were not statistically significant (Table 12-6).
Binge eating and purging problem eating behaviour (where a young person of normal weight BMI or
higher was both binge eating and either vomiting or taking laxatives to control weight) was identified
in 1.3% of 11-17 year-olds. Differences between males and females and between younger and older
adolescents were not statistically significant (Table 12-6). Prevalence of the individual behaviours
used to define low weight problem eating behaviour and binge eating and purging problem eating
behaviour is shown in Supplementary Table S-68.
Taken together, 1.6% of males and 3.2% of females had either low weight or binge either and purging
problem eating behaviours. Among 11-15 year-olds proportions were similar for males and females.
However among 16-17 year-olds a higher proportion of females (4.9%) had either low weight or binge
either and purging problem eating behaviours than males (0.7%).
Not all young people identified with problem eating behaviours in these questions would be expected
to receive a formal diagnosis of an eating disorder under DSM-IV.
Sexual behaviours
Young people aged 13-17 years were asked several questions about their sexual activity. These
questions were sourced from the Youth Risk Behavior Surveillance System questionnaire developed by
the Centers for Disease Control and Prevention (CDC) in the United States. Overall, 14.9% of young
people aged 13-17 years had ever had sexual intercourse and 4.2% reported having had sexual
intercourse with 4 or more persons (Table 12-7).
The proportion of young people who had ever had sexual intercourse was higher in adolescents who
had mental disorders and highest in young people with major depressive disorder. Among young
people with major depressive disorder based on adolescent report, 38.0% had ever had sexual
intercourse, compared with 11.5% among young people with no mental disorder. Some 13.4% of
young people with major depressive disorder based on adolescent report had had sexual intercourse
with four or more persons during their life compared with 2.8% of young people with no mental disorder.
Two thirds of sexually active young people used a condom during last sexual intercourse (66.0%) and
two fifths (39.7%) used birth control pills. Around one in ten young people did not use any method to
prevent pregnancy or sexually transmitted infections during last sexual intercourse (11.5%). This was
higher for young people with mental disorders other than major depressive disorder (19.1%
compared with 9.6% among young people with no mental disorder).
Young people with major depressive disorder were more likely to have drunk alcohol or used drugs
before last sexual intercourse (27.8% based on adolescent report compared with 20.6% of young
people with no mental disorder). Almost 40% of young people with mental disorders other than major
depressive disorder drank alcohol or used drugs before last sexual intercourse (Table 12-8
Bullying
Bullying covered both face-to-face teasing, threatening, spreading rumours and physically hurting
another person, and cyber bullying when mobile phones and/or the internet were used to send
emails or messages, post comments or pictures, or pretend to be someone online with the aim of
hurting or threatening another person.
One quarter (24.3%) of young people aged 11-17 years had been bullied every few months or less
often in the previous year and another 10.0% had been bullied every few weeks or more often
(Table 12-9).
Slightly more younger adolescents experienced bullying, with 11.2% of 11-15 year-olds and 7.1% of
16-17 year-olds being bullied every few weeks or more often.
Three fifths of young people with major depressive disorder (62.8% based on self-report) had been
bullied in the previous year. This was twice the proportion among those with no disorder (30.2%). The
difference in proportions was greatest for those who were bullied more often, with 28.3% of 11-17
year-olds with major depressive disorder based on self-report having been bullied every few weeks or
more often in the previous 12 months. This proportion was over three times higher the proportion of
young people with no mental disorder (7.6%) (Table 12-9).
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