5 September 2018

We are at crisis point with child mental health – so don’t dismiss it as mere teen angst

The roots of this are complex and involve much more than the oft-cited villain, social media – or caffeine.

Last week, listeners to BBC Radio 4’s Today programme were afforded a telling insight into our society’s profound confusion over childhood mental health. On 29 August, research published by the Children’s Society revealed self-harming behaviour to be at epidemic levels among our young people – 22 per cent of female and 9 per cent of male 14-year-olds deliberately hurting themselves over the course of a year.

Presenter John Humphrys attracted much criticism on social media for the tone of his interviews on the subject that day, which were characterised by an air of baffled scepticism. His questions sought to normalise the data as mere adolescent angst: if self-harm is so commonplace then it must simply represent a modern variation on an age-old and natural phenomenon, the teenage struggle for selfhood.

This narrow interpretation takes no account of numerous other studies in recent years demonstrating substantial increases in other psychiatric conditions in childhood – eating disorders, anxiety, depression and body dysmorphia. More than 90 per cent of teachers report escalating rates and severity of psychological problems among their pupils. Greater openness about mental health may be leading to readier disclosure of problems, but this alone cannot account for the prevalence of psychological morbidity we are seeing. There is a genuine crisis in childhood mental health.

The subsequent Today programme featured public health minister Steve Brine announcing a putative ban on the sale of so-called energy drinks to under-18s. He was subjected to a sustained grilling by Humphrys’s co-presenter Mishal Husain, who seemed incensed by the idea and tried to trivialise it by comparing it to the state telling a 17-year-old whether or not they can drink a cup of coffee. Brine kept cool under fire and calmly reiterated the point: there is widespread agreement in health and education that massive doses of caffeine cause harm to still-developing teenage brains. A sales ban is as appropriate as that on tobacco and alcohol.

Humphrys and Husain unwittingly exemplified society’s problem. We are reluctant to believe that our current culture may be systemically injurious, and our libertarian instincts bridle at proposals to restrict, however modestly, the freedom to do as we choose. But the surge in numerous different psychiatric conditions in the young has nothing to do with some sudden generational flakiness. Our culture has become unsustainably stressful: as a result, our children are showing unprecedented levels of distress.

The roots of this are complex and involve much more than the oft-cited villain, social media – or caffeine. The education system’s transformation into a grinding exam-mill plays a part, as does the extension of testing into early years schooling. The trend towards individualism and the ever-widening wealth inequality set in train during the Thatcher years, coupled with the erosion of social cohesion, have created a highly competitive, threatening and unfair environment. Then there are the spectres of debt, and job and housing insecurity. Even welcome changes such as acceptance of sexual and gender differences, and the decline of religious dogma as a governing force in people’s lives, create as their flip side a shifting, evanescent quality to self-identity. The constraints against which adolescents have always rebelled and defined themselves are now likely to fall over when pushed. Insecurity is woven into life.

I don’t pretend to be offering a comprehensive summary. We need a royal commission to examine what we have collectively done to childhood. This should look at home and abroad, to learn lessons from other comparably developed societies – most obviously those in Scandinavia – who are doing so much better by their young. The conclusions should inform policy across government. If we can reshape our society to be fit for future generations to live in, adult mental health will undoubtedly improve in tandem.