Tuesday, 12 August 2014

Mental Health Matters

August 12th sees International Youth Day 2014 promote young people’s mental health, using the slogan “Mental Health Matters”. The day is aimed at promoting awareness and tackling the stigma around mental health conditions, which can often leave young people feeling ashamed and unable to access the health services they require. However, the theme is also timely considering the recent scrutiny of young people’s mental health provisions in the UK 1,2.

When we use the term “mental health” people often assume it refers to mental health problems; however we all have mental health, just as we all have physical health. YoungMinds3 outlines six key features of mental health:
  • Capacity to form and maintain relationships
  • Continued psychological development
  • Age and intellect appropriate play and learning
  • Development of moral understanding
  • Ability to cope with some psychological distress
  • A sense of identity and self-worth

Like physical health, mental health can change throughout our lives. Childhood and adolescence is a particularly important period as it paves the way for future mental health; research suggests many mental health problems begin early in life4. Young people can develop a number of mental health problems, some of the more common include anxiety, depression, self-harm, eating disorders and attention deficit and hyperactivity disorder (ADHD)5. Mental health is just as important as physical health, and experiencing mental health problems can impact upon young people’s lives. School attendance and achievement, unemployment, engagement with health risk behaviours and difficulties maintaining relationships are all implications of poor mental health.

Recent data on young people’s mental health problems in the UK is limited. The most up-to-date research suggests 1 in 10 young people aged 5 – 16 years have a clinically diagnosed mental health problem; with older children aged 11-16 years more likely to have a diagnosis6. The findings suggest mental health problems are more common among boys than girls (13% vs 10%); boys were more likely to be diagnosed with conduct disorders while girls were more likely to be diagnosed with emotional disorders.

There are suggestions that the prevalence of mental health problems among young people is on the rise7. Preliminary findings from 2014 Health Behaviour in School-aged Children (HBSC) England study, recently reported in The Guardian, offer support for this notion as self-harm in teenagers appears to have nearly trebled in the last ten years. ChildLine8 offer anecdotal evidence for a decline in young people’s mental health also, with the helpline reporting 41% increase in calls about self-harm in the last year.

HBSC England does not measure clinically diagnosed mental health problems, but it does take account of the nuances of mental health. Our mental health cannot be categorised simply into good or bad, and it does not remain the same across time and situations. We all have experiences of poorer mental health, for example when we are feeling low, anxious or stressed during difficult periods in our lives. Mental health can be viewed on a spectrum, and HBSC England measures the subtleties of mental health in the context of young people’s social lives.  

Life satisfaction assesses how happy young people are with their current lives. It is measured using the Cantril Ladder, where respondents rank their happiness on a ladder from 0 (worst possible life) to 10 (best possible life). Data from HBSC England 20109 indicates 83% of young people reported positive life satisfaction. Figure 1 present’s life satisfaction by gender and age; girls show decreased life satisfaction with age and lower life satisfaction than boys at all ages.

Young people also reported how often they felt low. 49% of the young people surveyed reported rarely or never feeling low; figure 3 breaks this down by age and gender. Older girls were significantly less likely to report feeling low rarely or never.

These gender differences continue to be reflected in the proportion of young people who report feeling low at least once a week. Figure 3 shows girls were significantly more likely to report feeling low at least once a week than boys, and the likelihood increased with age for both boys and girls.

Research suggests 10% young people have a diagnosed mental health disorder6, but our 2010 findings indicate 28% of young people reported feeling low at least once a week (unpublished HBSC England 2010 data). While the measures used by HBSC England do not stretch to clinical diagnosis of emotional disorders like depression and anxiety, they do primarily gauge aspects of emotional health which probably accounts for the higher proportions observed among girls. It is difficult (and usually inappropriate) in a survey like HBSC to try and diagnose the conduct disorders that are more frequently experienced by boys. However, it is important to acknowledge the wide spectrum of mental health behaviours experienced by adolescents, and to recognise those who present poorer mental health despite not receiving a clinical diagnosis. Good care and support for these young people will matter both as a protective factor against developing more serious disorders later on, but also in ensuring optimal well-being in the here and now.

  1. BBC. (2014). Mental health cuts affecting. Rerieved on 4th August 2014, from http://www.bbc.co.uk/news/health-27942416
  2.  Guardian (2014). Children are suffering as mental health services fail to cope, say parents and teachers. Retrieved on 4th August 2014, from http://www.theguardian.com/education/2014/jul/29/chilld-and-adolescent-mental-health-service-failing-children
  3.  http://www.youngminds.org.uk
  4. Anthony, J.C. et al. (2007). Lifetime prevalence and age-of-onset distributions of mental disorders in the world health organization’s world mental health survey initiative. World Psychiatry, 6(3), 168-176.
  5.  Hagell, A., Coleman, J. & Brooks, F. (2013). Key Data on Adolescence 2013. London: Association for Young People’s Health
  6. Green, H., McGinnity, A., Meltzer, H., Ford, T. & Goodman, R. (2005). Mental Health of Children and Young People in Great Britain, 2004. London: ONS
  7.  Collishaw, S., Maughan, B., Goodman, R. & Pickles, A. (2004). Time trends in adolescent mental health. Journal of child psychology and psychiatry, 45(8), 1350-1362.
  8. ChildLine (2014). Can I tell you something? What’s affecting children in 2013.
  9.  Brooks, F., Magnusson, J., Klemera, E., Spencer, N. & Morgan, A. (2011). HBSC England National Report. Findings from the 2010 HBSC study for England. Hatfield: University of Hertfordshire.