We often believe children are resilient, that they aren’t affected too much by life events. And yet we see increasing mental health needs in children as young as four.
There is no doubt that our children and young people are facing serious and possibly increasing challenges to their mental health. There has, belatedly, been increased attention paid to the wellbeing of infants, children and adolescents in recent months, along with concern about the availability of services to support those who require additional treatment and care.
This is something the Association of Child Psychotherapists spoke out about in its report ‘Silent Catastrophe’. The most recent voice to join the chorus of concern is the former children’s commissioner for England, Sir Al Aynsley-Green, in his book The British Betrayal of Childhood. His particular message is that childhood is being ruined in the UK and the education system is largely to blame
Teachers and parents are trying to do their best for children and adolescents in an increasingly complex and demanding world. Being aware of the competitive job market, young people are encouraged to do their best in schools and universities. But this focus on the “vertical” – the pressure to climb high, to aim at individual success – comes at a cost.
Heading to the top means the “horizontal” focus suffers – developing empathy, being able to share and see others’ point of view, to have relationships that are sympathetic and collaborative. In addition, not recognising the pressure of all this frequently leads to poor mental health.
Child and Adolescent Psychotherapists find children and young people anxious about tests, parental expectation, about their own online image and who are completely unprepared for the anxiety and depression which may follow. Many young people, even those who seem well resourced, may feel “it won’t happen to me” and the most common symptom they report is “overthinking”; an inability to regulate careful reflection on a difficult situation.
Ella*, 15 years old, was a GCSE student who worked hard. She found herself overwhelmed with worries about whether she would get the A star grades she was hoping for but could not shake it off; her anxieties deepened and she began losing interest in friends, and her drama classes that she loved. Ella, the usually bright and successful teenager was feeling life was pointless. Her parents took her to the GP, concerned about her low mood, and sleep problems, but local child and adolescent mental health services (CAMHS) could not offer ongoing help for 4 months.
CAMHS are not resourced to be able to offer help to young people struggling with anxiety and stress over performance expectations alongside friendship troubles and parental illness or divorce. Their symptoms are not severe enough to meet current high thresholds for NHS help, and so they may go on to become adults following the same pressurised route, vulnerable to depression and anxiety. After the results, some of Ella’s high achieving friends wanted to know not just that they had A stars, but exactly how high their scores had been.
Cases like Ella’s are all too familiar, where young people are aiming high and the world shrinks to the results of exams. This, compounded by dealing with separating parents, for example, can severely affect adolescent mental health. Parents and carers, and teachers, also need more help to recognise the early warning signs of mental health problems such as irritability, loss of previous interests and sleep and eating pattern disruption.
Even in the early years the pressure to do well builds up in primary school with the repeated testing of children. Despite best efforts to minimise the impact of testing, we see children anxious of the process and fearful of results. There are suggestions that the government would like this to extend downwards to include assessment of nursery children too. Some youngsters are already sent to private tutors on Saturdays to prepare for primary school tests. The British Educational Research Association (BERA) has argued that the new assessment could make this coaching culture worse and is “ethically and methodologically questionable”.
Parents and carers need more support here too, often believing that children are resilient, and that they aren’t affected too much by life events. And yet we see increasing mental health needs in young primary aged children with teachers reporting that children as young as four are showing signs of mental health problems. Teachers alone, in addition to their enormous workload, cannot be the guardians of child mental health. There is need for increased funding of the expert professionals we already have, enabling them to support effective early intervention in schools, colleges and the community.
Everyone involved in the care and raising of children needs to be helped to understand their pressure points and to change the demands made on them, including the government. We need to focus as much on relationships as on results. This means increased awareness of what good mental health is, and working together across parents, schools and other agencies, to promote the growing up of children as well-rounded, happy human beings.
*Name has been changed to protect the person’s anonymity.
This piece by Rachel Melville-Thomas was originally seen on ‘Huffpost’, 31 October 2018.