By Dr Nihara Krause, Consultant Clinical Psychologist and Founder of stem4
Finally, the mental health of children and young people is getting some of the attention it merits. This was confirmed by Theresa May’s commitment, made at the beginning of the year, to ‘transforming’ mental health services. The new focus on young people emphasised additional training of teachers, the development of stronger links between schools and adolescent services and a target for children to receive treatment in their local area by 2021.
All this is timely, since there has been substantial growth in the number of children in England receiving care for their mental health. Data covering 60% of mental health trusts (NHS Digital October 2016) revealed staggering figures: around a quarter of a million children were receiving mental health care in England. Some 12,000 boys and girls aged five and under were noted as receiving help, whilst 235,000 people under the age of 18 were receiving specialist care.
There is no doubt that children and young people are under increasing stress. This month, stem4, the teenage mental health charity, published the results of a survey of 500 12-16 year- olds. It revealed a number of anxieties, including exam worries (41%), work overload (31%), friendship concerns (28%), worries about peer acceptance (23%), lack of confidence (26%), concerns with body image (26%), low self-esteem (15%), and feelings of being overwhelmed (25%). Of course, anxiety may just be part and parcel of being an adolescent, but the increase in worries over exams and performance is more of a modern-day phenomenon.
One statistic however stood out for me: one in ten teenagers reported strong feelings of anxiety over current world affairs. This is an issue that often comes up in the work I do for stem4, in the course of which I have had contact with over 10,000 students through school workshops and conferences and in my clinical work. The world’s instability and unpredictability – whether manifest in terrorism, the Brexit vote or the Trump triumph – has left children and young people scared and bewildered. They are concerned about the decisions that adults around them take and the legacy they are going to be left.
Their sense of insecurity is no doubt further intensified by the rise in the number of parents suffering from mental ill health. One in four adults experience a mental ill health problem (National Centre for Social Research, 2015), while one in five mothers suffer from depression and anxiety during pregnancy or the first year after childbirth (Independent Mental Health Taskforce, 2016). It is estimated that nearly two million adults were in contact with specialist mental health services at some point in 2014/15, but that probably represents just 20% of the people who need help.
The chances are that between one-third and two-thirds of children whose parents have mental health problems will go on to experience difficulties themselves (ODPM 2004). This could be because the young person has to take on inappropriate levels of responsibility as they care for themselves or the household. Equally, it might result from the powerful emotions engendered by living with a parent who has a mental health issue; these include anger, guilt, embarrassment or self-blame, and put a young person at increased risk of difficulty in their relationships with friends, problems at school and vulnerability to harmful behaviours. Above all, poor mental health among parents leads to increased anxiety among children. As a clinician, I have worked with many children and young people whose parents have mental health problems. One of the things that frightens them most is their sense that the people who should be protecting them are vulnerable or fragile.
It’s not surprising that today’s children are increasingly experiencing problems with their mental health. They are fearful. They face challengingly high expectations when it comes to school work and friendships. Meanwhile, they look out on a world where their parents are vulnerable, their friends are troubled, and the geo-political situation is unpredictable and even terrorising.
If we are to stem the increase in mental ill health among young people, we need to find ways of making them feel safe. They need prompt access to effective interventions that can alleviate their internal turbulence. At the same time, we need to make provision for offering equally rapid support and effective intervention to their parents. At the level of society in general, we must find ways of reassuring young people that the decisions taken by their elders will take their safety into consideration, now and in the future.