The national crisis of child mental health

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At least one in ten children in the UK have a diagnosable mental illness, and the numbers are only rising. But what are the reasons behind this explosion in children with serious mental health problems?

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The mass media have suddenly got it. As Every Child Journal and School Leadership Today have been proclaiming for a while, the crisis of the nation’s mental health is spiralling out of control. Tragically, it has taken a couple of young suicides to really focus the media’s collective mind on the explosion in unmet need for child mental health support.

The figures are really shocking. In the last four years, the admissions to A&E of young people with problems related to mental health have more than doubled to nearly 18,000. They are mostly young girls admitted for cutting or burning themselves, or for anorexia. The last official survey of the problem in 2004 showed that one in ten children below 18 had a diagnosable mental illness. That’s bad enough, but in the last three years alone, there has been a reported 110 per cent increase in the number of children and teenagers seeking help for eating disorders such as anorexia; and in the last two, an estimated 70 per cent increase in self-harmMore children are considering suicide than ever before, and nearly 80,000 children and young people suffer from severe depression.

At a policy level, the causes are clear. Child mental health has been an easy option for cuts, and early intervention for problems manifesting themselves in GP surgeries or schools has all but disappeared. Children have to deteriorate to the point where they are seriously ill or ‘make a credible suicide attempt’ for any real services to be triggered. The number of hospital beds for children with serious mental health is so low that Young Minds reports growing numbers of children being held in police cells or in adult psychiatric wards. Schools are not blameless – their focus has always been on behaviour rather than the underlying causes, which can normally be traced back to some anxiety at school or with home life.

But the really fundamental questions – Why us? Why now? – are proving more elusive to definitively pin down.

The UK has long had the reputation of being a ‘child-unfriendly’ nation, obsessed with pushing children into formal learning and testing years earlier than our continental neighbours. This is undoubtedly a factor, and it has grown much worse with the new National Curriculum. But EU-commissioned studies are reporting the same levels of concern about child mental health as we are. As indeed are the United States, Australia and Japan.

Social media has figured highly among academic and popular commentators, because of the pressures it puts on children to conform to unreachable social stereotypes and the constant need to keep up with ‘friends’. Social media bullying is really an extension of this new, more extensive power of the group, which when online, needn’t be just a traditional friendship group. The media is, however, always wheeled out as a cause for violence, social misdemeanours and decay, and by and large, research has found that it is more a reflection of problems than a cause, and a factor that really only affects individuals that are already vulnerable.

The most convincing argument to explain the negative impact of social media is that it has broken down some of the barriers – and defences – that individuals used to have against social pressure. Old notions of privacy that once erected a wall between the self and social exposure have gone. It’s much harder now for young children to opt out of conversations or social situations – they follow them into their bedrooms and the inner recesses of their being. The home is just another former barrier or safety zone that has been breached by the internet and media at large.

The idea that the home is no longer a safety zone where you can recharge your resilience before you go back out into the bruising and controlling world of school is an interesting one. It ties into the statistic that the biggest group of children with a diagnosable mental illness come from single-parent families or care, and the second biggest is from families where both parents are out of work and there is a high degree of stress. This group of children, particularly the teens, are even more dependent on their peer groups and the social media channels that give them constant access to them. It’s a double whammy – they yield up in their dependency a lot of power to the group, and at the same time, have not been given the skills and concepts of resilience that are traditionally given to children by their parents and home environment.

The failure to equip children with self-respect and resilience might, however, extend far beyond these obviously vulnerable groups. There is a strange cultural dynamic around the child in the West where child-centredness has led to an obsessively over-caring and managerial style of parenting. The Americans simply call it smother love and they attach to it significant blame for children failing to acquire adequate resilience skills through ordinary life experience. On the other hand, working or insecure parents are failing to bestow values and skills that can shield children from a superficial but highly competitive consumerism.

Certainly, the home no longer seems able to protect children from the two gender crises that are now afflicting our children – for boys, the crisis of masculinity and for girls, the crisis of expectation. There are fewer places of safety left for more and more children.

One group of statistics summarises the unsettled world of children in our age, a world in which they are forced to grow up quicker than ever before, but without any of the traditional structures to help them: while in some areas of the country, up to 65 per cent of children live in households with no fathers, some 90 per cent of children over the age of 12 have possession of a mobile phone, with 65 per cent of these owning a smartphone.

Image: Koichi Saito