The last few decades have seen increasing rates of mental health disorders among children and young people. But while children and young people’s mental health is currently high on the public agenda, many of these mental health conditions remain unrecognised and untreated.
The NHS conducted a Mental Health Survey for Children and Young People in 2017, interviewing 3,667 children and young people, which was followed up in 2021. The follow-up survey found that 39.2% of 6 to 16 year olds had experienced a decrease in their mental health since 2017, while approximately 52% of 17 to 23 year olds also reported a decrease. Within these last four years, a number of factors appear to have impacted these figures, including the continued rise and prominence of social media platforms, family life, and, of course, the Coronavirus (COVID-19) pandemic.
Impact of the pandemic
The beginning of the pandemic marked the closure of all schools, colleges and universities. Not only were young people faced with the anxiety and stress associated with living through a global pandemic, particularly for those who are immunocompromised or have family members who are, but these closures also cut off access to resources for mental health problems. A survey by YoungMinds in January 2021 found that among over 2000 participants who were under the age of 25 in the UK with a history of mental illness, 75% agreed that they were finding the current lockdown harder to cope with than the previous ones, and 67% believed that the pandemic will have a long-term negative effect on their mental health.
Peer support groups and face to face services such as counselling that could be accessed through school were closed, or made accessible through the internet or over the phone. While this does offer some kind of continued support, it is not a form of support that works for everyone and many young people were left feeling unsupported. The YoungMinds report emphasised that any future provision must recognise the value of face to face interaction alongside virtual and digital forms of support.
Alongside issues with access to support, school closures also disrupted routines, which for many people of all ages with mental health problems can be particularly important as a coping mechanism. It has been suggested that being unable to attend school or university in person, or part-time jobs, can lead to a relapse in symptoms where young people relied on these routines. Refusing to undertake typical daily activities such as showering, getting out of bed and eating sufficient meals are some of the effects seen amongst these young people – all which can exacerbate feelings of depression or loneliness.
Role of families
Families have been found to play a vital part in helping young people who are suffering from mental health issues. This has only become more apparent with the impact of COVID-19 lockdowns, where young people would most likely be living with their family – whether that be parents, siblings or other relatives or caregivers. Lockdown guidelines that mandated staying at home would leave these young people spending more time with their families, and the closure of other services outwith the home, meant these young people’s households often became their main support system. The NHS follow-up survey found that both family connectedness and family functioning were associated with mental disorder, highlighting the importance of supporting families to enable them to support young people’s mental health.
The Local Government Association has recently published a guide on a “whole household approach” to young people’s mental health, stressing the importance of educating families on how to support their young people. This is highlighted as particularly important when they transition from child services to adult services as many teenagers and young people struggle with the lack of support offered when they are legally considered adults.
Another big issue affecting young people’s mental health is the use of social media. While there are many reported benefits of social media, particularly in relation to connecting with others, there are also growing concerns about its effects on wellbeing and the pandemic has undoubtedly exacerbated this. The NHS survey found that, in 2021, half (50.7%) of 11-16 year olds agreed that they spent more time on social media than they meant to and 16.7% using social media agreed that the number of likes, comments and shares they received had an impact on their mood. Those with a probable mental disorder were particularly likely to spend more time on social media than they intended, and girls seem to be more affected that boys.
The survey found that 21.1% of girls reported that likes, comments and shares from social media affected their mood, compared to 12.1% of boys. It also found that double the number of girls than boys spent more time on social media than they meant to. Other research has also highlighted the disproportionate impact on young girls. One study found that constant social media use predicted lower wellbeing in girls only and that these mental health harms may be due to a combination of cyberbullying, and a lack of sleep or exercise. This was not found in the teenage boys interviewed.
When addressing mental health problems, it is clear that a ‘one size fits all’ approach does not work. As highlighted in the research, mental health problems can present themselves in a range of ways, and depend on a number of variables. People from different socio-economic and cultural backgrounds, or those with additional needs, often face more stigma and can find it more difficult to express their problems or access the correct support for their specific needs.
There have been suggestions for more targeted support for young people and the issues they may be facing, including more investment in schools and social services. Particularly for adolescents who are transitioning to adulthood, it is important to provide continuous support. As highlighted in the NHS Mental Health Survey, more adolescents and young adults (17 to 23 year olds) mentioned a decrease in their mental health than younger people (6 to 16 year olds). Children and Young People’s Mental Health Services (CYPMHS) notes that the transition from child to adult mental health services tends to begin around three to six months before the individual turns 18, although there can be flexibility. Perhaps even greater flexibility is required, particularly as we assess the damage left by the pandemic. It is argued that engaging adolescents in the provision of mental health services and a shift towards early intervention and prevention will also be important as we look to build new solutions.
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