Challenges in addressing youth mental health

The Lancet Psychiatry Commission on youth mental health1 is an impressive document. We agree that the worldwide rise in mental ill health in the young demands attention. The Commission discusses many possible causes of this rise, including loss of cultural connectedness, climate change, intergenerational inequality, displacement, and unregulated social media. These contributing factors are plausible, but whether the observed associations are causal in nature often remains unclear. It is therefore surprising that the Commission overlooks the factor for which most evidence is available. As rates of recreational drug use have risen, so too have rates of mental ill health in young people.