With Children's Mental Health Week upon us, it is beneficial to prepare for the future by reflecting on how things are at the moment; and how we got here. In recent years, the media has been awash with headlines and articles about the ever exacerbating state of children's mental health. However, let us take a look at the underlying information through three key facts.
1. As of July 2021, 20% of children aged 5 to 16 were identified as having a mental health problem. This is a dramatic increase from 11% in 2017.
This is a truly remarkable statistic. Although the state of children's mental health has been in the media a lot in recent years, it is numbers like these that make one wonder whether actually it should be covered more. These numbers truly are indicative of an epidemic. As such, it should probably be treated as such, with much greater mobilisation of resources and research.
An additional intricacy of the situation is that cultural shifts may also be increasing the level of reported mental health problems (beyond actual growth in prevalence). This is to be expected with both increase public awareness and media coverage of issues once ignored. We are also now approaching the middle of the millennial parent generation, who are undoubtably different to their parents in perceptions of the topic - and will be different to their children also.
One might rightly ask for spending to increase to confront this problem; with 14% of current local health spending being focused on mental health. However, increased spending is not enough - especially with a finite amount of capital resources, and the healthcare system struggling across all indications.
This is partly because mental health issues are more complex than most other health concerns. Mental health is more profoundly and inextricably linked to familial, cultural, personal, economic, societal, and educational parameters. Therefore there is no one solution to any of the problems, and funding must be directed to many public bodies and long term programmes to deliver positive and sustainable results.
Furthermore, and due to all of these contributing factors, mental health is incredibly idiosyncratic. Therefore intervention is more difficult and costly to implement and sustain.
Fundamentally, there is an epidemic on our hands that will have massive future implications. To sustain a viable public health response, we need new solutions that are: pre-emptive, personalised, affordable, available to all, and not biased towards any demographic.
20% of children aged 5 to 16 are identified as having a mental health problem.
2. Surveys suggest that of those young people with mental health needs, approximately 83% agree that the pandemic made it worse.
It is perhaps not surprising that years of fear, restrictions and isolation contributed to mental health problems. However, it is important to acknowledge the importance of the COVID-19 pandemic when interpreting the current situation. It was undeniably a huge influencing factor in the growth of children's mental health problems, and the future implications to psychological health of children, adolescents, and adults is unknown due to its unprecedented nature. That is not to say that we should be pessimistic about the impact, but simply aware of it, and of the fact that as a society we have limited data to work with for comparison. Therefore, we must consider the trends in mental health before, during, and since.
Having said that, although the rate of mental health problems was growing prior to the pandemic, and we have not seen a reduction in prevalence in 2022, but an increase. Therefore it seems that, much like with many cultural shifts (e.g. increase of remote working, uptake of digital healthcare solutions, growth of home-schooling, and adoption of e-commerce), it has simply accelerated a trend already in motion.
However, the difference between these aforementioned trends and mental health, is that although the pandemic moved the clock forward on the others, it introduced new confounding factors into children's mental health. Due to its rare occurrence, and the associated lack of data, we have limited understanding of the impact of the pandemic on the developing mind. We therefore need to remain astute of future issues that may arise and react to them rapidly, decisively and compassionately. It is not all doom and gloom however; we humans are resilient, and that should give us hope!
3. Boys aged between 6 and 10 years old are almost twice as likely to have an identified mental disorder than girls. However, as they grown up this pattern reverses and the opposite ratio is seen in 17 to 23 year olds.
Gender has always been a controversial topic when considering mental health, and untangling the complex interconnected web of genetics, environment, culture, and psychology is far beyond the remit of this check-in. What was initially fascinating (especially to a millennial like myself), was how the ratio changes over time.
Unfortunately, the high rate of mental health problems amongst adolescent women in the 00s was increasingly apparent, and probably one of the first waves of publicly acknowledged CAMHS crises. At the time however, there was little insight into mental health problems in pre-adolescent boys, and this has clearly skyrocketed over the past decade.
However, we should simply be aware of these trends, rather than letting them influence are preconceptions and expectations. This is not a simple topic, and it is likely that the variations in statistics over time are not a fundamental change in the prevalence of mental health problems but a change in cultural expectations and variations in biological development. For example, it may be that due to societal conditioning that young boys are on average more likely to express psychological concerns in a way that is more publicly apparent - and that this rapidly changes due to peer pressure and gender expectations in adolescence. Additionally, unfettered access to social media (the influence of which on mental health is increasingly documented) accelerates with digital autonomy - the average age of which is around this crossover point.
Fundamentally, we should treat all children as people with developing psyche's - all of whom can be affected. Instead of biasing our expectations, we should simply remain aware that there are multiple influences (some of which are gender related), that confound or change the expression and symptoms of problems that may arise.
Keep an eye out for upcoming articles that will delve more deeply into each of these topics, as well as look at statistics coming in from beyond the UK.
Mental health dashboard (2022) NHS England. Children and young people's mental health in 2022: What does the data tell us? (2022) Centre for Mental Health. Grimm, F. et al. Briefing: Improving children and young people's mental health services. Local data insights from England, Scotland and Wales (2022) The Health Foundation.