There is a statistic often quoted by children’s mental health campaigners: 10% of children and young people (aged five to 16 years) have a clinically diagnosable mental health problem. It comes from a 2004 report from the Office for National Statistics (ONS) (pdf), but its methodology is questionable – the diagnoses were made using transcripts of ONS interviews, by clinicians who never met the children in question. But what’s really revealing is the researchers’ broad definition of a mental health problem.
More than half (5.8%) of those diagnosed with a condition (9.6%) had what are described as conduct disorders – antisocial behaviours, such as aggression or deceitfulness. More than a third (3.7%) had emotional disorders including anxiety and depression, but also phobias – for example, a fear of dogs. The remainder were judged either “hyperactive”, “impulsive” and “inattentive” (1.5%) or had less common conditions (1.3%) such as autism.
In other words, a large part of the children’s mental health problem in this country is antisocial behaviour. What would have once been put down to a child being naughty is today turned into a need, and grounds for potential psychological or even psychiatric intervention.
That’s not to deny that there’s a problem. According to a survey conducted by the Association of School and College Leaders (ASCL), more than half (55%) of schools report increased stress and anxiety among their pupils. Over the past five years, 40% have seen a large rise in cyberbullying; four out of five (79%) report more self harm and suicidal thoughts among students; more than half (53%) rate their local Child and Adolescent Mental Health Services (Camhs) as poor or very poor, and 80% want to see those services expanded. This is despite most schools already offering on-site support with for mental health problems.
Young people are typically waiting months and even years for treatment by their local Camhs. But instead of asking how we meet these needs, we need to ask what has given rise to them.
No distinction
As a society, we are encouraged to understand the challenges children face as mental health or emotional problems – no distinction is made between the two. Behavioural problems at nursery and teenage use of social media are spoken of in the same breath as eating disorders. The impression is that a big and growing problem exists and that these very different concerns are somehow related or on a continuum – and that the apparently unprecedentedly challenging world of today is to blame.
The ASCL interim general secretary, Malcolm Trobe, said earlier this year: “Children today face an extraordinary range of pressures.” These include “enormously high expectations, where new technologies present totally new challenges such as cyberbullying”.
Nihara Krause, a clinical psychologist and founder of teenage mental health charity Stem4, says that young people today experience “levels of competition and performance anxiety unknown to any generation”.
“The increase in mental ill-health among our young people is exacerbated by our trophy culture. Outside school, our body-obsessed, share-everything culture subjects them to a new form of scrutiny,” she says.
There is a real problem here, but perhaps it’s not that young people are increasingly mentally or emotionally unwell, or because the difficulties they face are uniquely challenging. Maybe the issue is that we’ve adopted this narrative of vulnerability, and affected the way young people understand themselves and what they are capable of.
Young people are picking up the message that they are defined by their vulnerabilities, and that they are unable to deal with with what in the past would have been regarded as unremarkable facts of life. But what does it do to children if they are told that they can’t cope, that they must seek professional help? It means children and families feel less able to draw on their own informal ways of working things out – not least because families themselves (and parents in particular) are often seen by the experts as part of the problem.
If we want to prevent the problems campaigners describe, we need to hold the line – as parents, as teachers, as adults. We need to teach things that bring children out of themselves. We should give them something to aspire to or embrace. We need to prepare them for adulthood, and let them know that a certain amount of stress and feeling down is just part of growing up.
When teachers become glorified therapists rather than educators – by trying to treat young people rather than instruct them, by massaging young minds rather than filling them up with the knowledge – they can unwittingly contribute to the problem. And worse, they are being distracted from the one thing that they are qualified to do and that will help the young flourish and grow into well-adjusted young adults: teach.
Dave Clements (@daveclementsltd) works in health and social care and is convenor of the Social Policy Forum. He will be speaking at the Battle of Ideas on 22 October on Young People and Mental Illness: A growing problem?