A 2020 report suggested that mental disorders are now probably affecting one in six children in the UK - part of a constant stream of negative news about young people's mental health. However, our review of the evidence suggests a more nuanced picture. Here's a summary of our evidence to the House of Commons Health and Social Care Committee:

The importance of clarifying what mental health means

The threshold for diagnosing mental health conditions has been lowered significantly in recent years. For example, ‘mental disorder’ has evolved from being a pre-requisite for sectioning under the Mental Health Act 1983 to a term which a 2020 report described as probably affecting one in six children in the UK. It is unlikely that one in six children in the UK are now at risk of being sectioned, more likely that the term is now being used much more loosely than originally envisaged.

 

We therefore recommend that the inquiry considers and clarifies the terms mental health, mental health problem, mental distress, mental health condition, mental illness and mental disorder - and who is therefore at serious risk and should be a priority for specialist support. 

 

The importance of the early years for long term mental health

To reduce diagnosed mental illness, action during the formative early years is important, as the brain undergoes particularly significant growth and development in its first two years.

The main risk factors here are well known. They include stress and trauma in early childhood (for example as a result of parental abuse, abandonment or neglect), or (for anorexia) parents who are low on care, high on control; the chances of parent-child bonding being reduced by post-natal depression or by substance abuse; and a lack of external support.

 

Given the significant influence of parenting on children’s mental health, in particular in the formative early years, we recommend targeted programmes to support ‘at risk’ mothers and mothers-to-be and provide examples of successful early years initiatives from the UK, Australia and the USA, for consideration.

 

Reduced resilience increases vulnerability to mental distress

Resilience is protective of mental health. However, children and young people in the twenty first century appear to exhibit less resilience and more ‘mental health problems’ than their counterparts during the upheavals of the Second World War.

Resilience is a combination of innate ability, a supportive environment and opportunities to experience and learn from challenge and failure. Social changes in recent decades have significantly reduced that third element for many young people – the opportunities to experience challenge and failure – which may help explain why levels of resilience now appear lower.

 

We recommend the inquiry considers what factors are reducing the resilience of children and young people and how these can be addressed; and what factors are encouraging their resilience and how these can be encouraged.

 

The unintended consequences of safeguarding for mental health

In recent decades there has been an increasing, well-intentioned desire to protect children and young people from harm, safeguarding them from risk. Unfortunately, as the children’s charity Barnardo’s reported as early as 2002, the more children have been protected from risk, the less resilient and prone to psychosocial disorders they have become.

While enhanced support and protection is an appropriate response where young people have experienced abuse and neglect in childhood, or have grown up in dysfunctional families, providing ever more support for children from caring, supportive families is proving counterproductive, reducing their resilience and increasing the risk of mental distress.

This safeguarding culture also leads to social pressure on parents to seek to protect their children from all possible risks, for fear of being branded a ‘bad parent’ if they don’t. 

In contrast, a recent study found no evidence of an increase in student mental health problems over the last ten years in the Netherlands. In the Dutch style of parenting the main concern is to raise their children to be independent and to learn from their own experiences. Whereas, in the UK, one Head Teacher we spoke with commented, ‘I’ve really noticed a change in parenting in recent years…They can be unwilling to let their children grow up.’

 

We recommend that the inquiry distinguish between the need to safeguard ‘at risk’ children and the need to encourage resilience among the majority of children and young people who are not ‘at risk.’

 

Four factors reducing resilience and predisposing to mental distress

Our research has identified four overlapping and mutually reinforcing factors:

  • A safeguarding, ‘spoon-feeding’ culture in schools – which is reducing opportunities to experience, learn from and cope with mental and physical challenges.
  • Over protective and over indulgent parenting (including a growth in ‘helicopter parenting’) – which research suggests increases levels of anxiety, stress and depression, while reducing self-efficacy and coping skills.
  • The lure of social media, which may be delaying adulthood by reducing time in the ‘real world’ while increasing the risk of mental health issues.
  • The unprecedented medicalization of normal feelings and emotions – which is leading young people to interpret as mental health problems a range of feelings and emotions previously viewed as normal responses to the developmental challenges traditionally faced as adolescence and early adulthood are navigated.

 

We recommend that: 

  • Schools are guided by the revised (2019) inspection framework, in particular as it relates to the extent to which, ‘the curriculum and the provider’s wider work support learners to develop their character – including their resilience, confidence and independence.’ 
  • The inquiry considers how autonomy supporting parenting can be encouraged, to limit the unintended harm potentially caused by over protective and over indulgent parenting. 
  • Social media platforms be reclassified as publishers, to ensure they take more responsibility for their content (including content relating to eating disorders and self-harm); and peer influence is used positively to help young people take a more realistic view of social media (e.g. training sixth formers to mentor younger pupils).
  • The inquiry considers how parents and schools can help young people recognise that their lives will not always be perfect, that they will encounter challenges and setbacks and so sometimes feel anxious, stressed and upset – but that this is normal, not a sign that they are experiencing mental health problems, and is an experience they can learn from.

 

Factors increasing resilience and reducing mental distress

Opportunities to experience life away from over protective schools and parents (and social media) and opportunities to experience ‘productive failure’ appear to increase resilience and coping skills and reduce reported mental health problems. Evidence here includes:

  • Research into the long-term effects on mental health of being a Guide or Scout, which concluded, ‘Participation in Guides or Scouts was associated with better mental health and narrower mental health inequalities.’
  • Research published by Leeds Becket University in 2019, which found that a single one-week Outdoor Adventure programme resulted in significant positive gains in the resilience of those participating.
  • The importance of encouraging students to consciously experience and learn from failure, in order to boost resilience, is now being recognised, from Ivy League Universities in the USA to independent schools in the UK and Australia.

 

We recommend that the inquiry explores how young people can be provided with more opportunities to experience life and challenges away from over-protective schools and parents, to develop their resilience and reduce their vulnerability to mental distress.

 

To find out more, read our evidence to the Health and Social Care Committee.

 April 2021