Mental Health Matters

August 12^th 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.

References

1. BBC. (2014). Mental health cuts affecting. Rerieved on 4^th 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 4^th 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.

Communication with Parents

Despite growing independence during adolescence, family relationships still play an important role in socialisation and support, and continue to function as a strong determinant of adolescents’ health and well-being (1, 2). The time spent with parents drops from early to late adolescence but parents continue to play a key role in adolescents’ development. This role may be even more important than in the early stage, but may change and become less visible (3).

Open communication with parents and parents’ support are important factors for successful development of mental and physical health in young people. A strong association has been found between parental support and improved level of mental health, emotional well-being and reduced levels of health risk behaviors (4).  Adolescents who feel connected to their families and whose parents are highly knowledgeable about their child’s activities are more likely to delay sexual initiation, have lower incidence of sexual risk behaviour and teenage pregnancy, report lower levels of cigarette, alcohol and marijuana use,  and are less likely to engage in  violence and other problem behaviour (5,6,7,8,9,10,11). In countries & communities where stronger family ties are present, adolescents have fewer behavioural and mental health problems, particularly young women (12).Parental communication functions as a protective health asset supporting to maintain high life satisfaction and positive body image through to late adolescence (13).

There are age and gender differences in how easy young people find it talking to mothers and fathers respectively: generally, both boys and girls report it to be easier talking to mothers than fathers, and younger adolescents find communication easier than do older ones (See figures 1 and 2 below).

Results from HBSC England 2009/10 (14) indicated that young people who reported having high quality of parental communication also have less health complaints like headaches and stomach aches, higher life satisfaction,  and rate their overall health as higher than those young people who reported having poorer quality parental communication. Overall parental communication functions as a protective health asset supporting to maintain high life satisfaction and health related quality of life.

Drawing on a qualitative project linked to the HBSC study, interesting insights have been found regarding young peoples’ expectations and attitudes towards parental communications. Although seeking independence, the desire and need for support and positive communication with their parents remained strong. Against commonly accepted views that during adolescence young people value peer relationship more and spend less time with their parents, it appears that family communication and parental communication are still very important and necessary for young teenagers of both genders. It appears though that at this stage, young people are seeking equal partners in parents and wish to have communication based on trust.

1. Levin, K. A., & Currie, C. (2010). Family structure, mother-child communication, father child communication, and adolescent life satisfaction. A cross-sectional multilevel analysis. Health Education, 110, 152-168. 
2. Velleman, R. D., Templeton, L. J., & Copello A. G. (2005). The role of the family in preventing and intervening with substance use and misuse: A comprehensive review of family interventions, with a focus on young people. Drug and Alcohol Review, 24, 93-109. 
3. Moretti, M.(2004) Adolescent-parent attachment: Bonds that support healthy development Paediatr.  Child Health. Oct 2004; 9(8): 551–555.
4. Moreno C, Sánchez-Queija I, Muñoz-Tinoco V, Gaspar de Matos M, Dallago L, ter Bogt T, Camacho I, Rivera F and the HBSC Peer Culture Focus Group (2009) Cross-national associations between parent and peer communication and psychological complaints. International Journal of Public Health, 54, S235-242.
5.  Resnick, M.D., Bearman P.S., Blum, R.W. (1997) Protecting adolescents from harm. The Journal of American Medical Association, 278:823–32.
6. Borowsky, I.W., Ireland, M., Resnick, M.D. (2002)Violence risk and protective factors among youth held back in school. Ambulatory Paediatrics, 2: 475–84.
7.  Fletcher AC, Steinberg L, Williams-Wheeler M. (2004) Parental influence on adolescent problem behaviour: revisiting Stattin and Kerr. Child Dev 2004; 75: 781–96.
8. Bonnie R. J., O’connell M.E., eds.(2004) Reducing underage drinking: a collective responsibility. Washington, DC: The National Academies Press;
9.  Crosby, R.A., DiClemente, R.J., Wingood, G.M., Lang, D.L., Harrington, K. (2003) Infrequent parental monitoring predicts sexually transmitted infections among low-income African American female adolescents. Arch Pediatr Adolesc Med,157: 169–73;.
10.  Barber, B.K., Stolz, H.E., Olsen, J.A. (2005)Parental support, psychological control, and behavioural control: assessing relevance across time, culture, and method, Monogr Soc Res Child Dev 2005; 70: 1–137.
11.   Sethi, D., Hughes, K., Bellis, M., Mitis, F., Racioppi, F.(2010) European report on preventing knife crime and violence among young people, Copenhagen: World Health Organization Regional Office for Europe.
12. Viner, R. M., Ozer, E.M., Denny,S. et al.(2012)Adolescence and the social determinants of health, The  Lancet, 379 (9826), 1641–1652.
13. Fenton C, Brooks F, Spencer NH, Morgan A (2009) Sustaining a positive body image in adolescence: an assets-based analysis. Health and Social Care in the Community, 18, 189-198.
14.  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.

 Ellen Klemera

Why walk to school?

The World Health Organization (WHO) recommends young people need at least 1 hour of moderate to vigorous physical activity per day. Physical activity is important for young people to keep healthy. It helps develop strong bones and muscles, maintain a healthy body weight and develop cardiovascular fitness. Regular physical activity has also been linked to a lower risk of heart disease, diabetes and cancer.  While there are many physical health benefits of keeping active, physical activity is also associated with positive emotional wellbeing. Research has demonstrated regular physical activity is linked to lower levels of anxiety, depression and stress as well as increased self-esteem. Moreover, research suggests that young people who are physically active are less likely to adopt health risk behaviours such as smoking tobacco and alcohol use. Despite the benefits of physical activity, the findings from the 2010/11 Health Behaviour in School-aged Children (HBSC) survey indicate the majority of young people in England are not meeting the WHO guidelines¹. Click here to see the latest HBSC national report.

Walking to school may be an easy way of integrating physical activity into young people’s lives. As part of National Walking Month, the charity Living Streets is running their annual Walk to School Week campaign from 19^th to 23^rd May. A number of studies have consistently demonstrated that walking to school can be an effective way of contributing to the recommendations set out by the WHO. A study carried out in England measured the physical activity of 2035 children aged 9 – 10 years; those who walked to school had higher levels of moderate to vigorous physical activity compared with those who travelled by car². Like physical activity generally, walking to school has been associated with many positive health outcomes. Lubans and colleagues³ reviewed the literature on active travel to school and health related fitness, and found an association between walking to school and a healthier body composition and cardiorespiratory fitness among young people. Similarly, a recent study⁴ in Portugal found young people who used active means when travelling to school were more likely to have a healthy waist circumference and cholesterol levels compared with those who used cars or public transport.

The physical health benefits of walking to school are often promoted in the bid to encourage more young people to adopt  active travel methods to  school, however walking to school also has a number of positive effects on young people’s social developmental. Interviews and focus groups with adults and young people have demonstrated walking to school is associated with increased independence and responsibility, social skills and road safety skills^5,6.  Children who walked to school demonstrated better spatial awareness and road sense; they were able to draw more detailed maps of their route to school which included pavements and pedestrian crossings⁶.

While there is no doubting the health and social benefits of walking to school, many children are unable to do so. In fact, active transport such as walking and cycling to school has become less common over recent years. In 1995/97, 53% of primary school children and 42% of secondary school children reported walking to school. By 2012, the numbers had decreased to 47% and 38% respectively. Consequently the number of students travelling to school by car has increased; from 38% to 44% for primary school students and 20% to 26% for secondary school students⁷. A number of researchers have explored the barriers preventing children and parents from walking to school, including family schedule, distance to school, weather and parental concerns about safety⁸.

Walking to school is associated with a number of positive physical and health social development outcomes however it is obvious certain barriers do prevent young people from walking to school every day. The Walk Once a Week (WoW) and Park and Stride scheme promoted by Living Streets may be ideal ways of incorporating walking to school into busy lives. Buckley and colleagues⁹ found active travel awareness days had positive effects on young people’s choice of travel, with parents noticed the awareness days increased their child’s motivation to walk to school. Let’s hope this Walk to School Week can have similar impacts in the UK…fingers crossed the sun keeps shining! 

1. Brooks, F., Magnusson, J., Klemera, E., Spencer, N. & Morgan, A. (2011). “HBSC England National Report: Health Behaviour in School-aged Children (HBSC): World Health Organization collaborative cross national study.”
2. Owen, C. G., Nightingale, C. M., Rudnicka, A. R., van Sluijs, E. M. F., Ekelund, U. et al. (2012) Travel to school and physical activity levels in 9–10 year-old UK children of different ethnic origin: Child Heart and Health Study in England (CHASE). PLoS ONE, 7(2), e30932
3. Lubans, D. R., Boreham, C. A., Kelly, P., Foster, C. E. (2001). The relationship between active travel to school and health-related fitness in children and adolescents: a systematic review. International Journal of Behavioral Nutrition and Physical Activity, 8(5)
4.   Pizarro, A. N., Ribeiro, J. C., Marques, E. A., Mota, J. & Santos, M. P. (2013). Is walking to school associated with improved metabolic health? International Journal of Behavioral Nutrition and Physical Activity, 10(12)
5. Tooley, R., Bickerstaff, K. & Shaw, S. (nd) Beyond public health: benefits of walking on children’s social development.
6. Living Streets (2008). Backseat Children: How our Car Dependent Culture Compromises Safety on our Streets.
7. Department for Transport (2013). Statistical Release - National Travel Survey 2012.
8.  Stewart, O., Moudon, A. V. & Claybrooke, C. (2012). Common ground: Eight factors that influence walking and biking to school.  Transport Policy, 24, 240-248. 
9. Buckley, A., Lowry, M. B., Brown, H. & Barton, B. (2013). Evaluating safe routes to school events that designate days for walking and bicycling. Transport Policy, 30, 294-300.

Kayleigh Chester

Youth Engagement at the HBSC Conference

Youth engagement was a key element of the recent Health Behaviour in School-aged Children (HBSC) conference. Youth delegates from England, Scotland, Wales, Ireland and Canada attended the conference in St Andrews between 18^th and 21^st June. Six youth delegates from England travelled up to Scotland; Maddie, Holly and Kathryn from Bedford Modern School and Claudia, Aminah and Sophie from Hitchin Girls School.

On the first day of the conference the youth delegates co-presented a scientific paper on the topic of bullying with Professor Fiona Brooks (University of Hertfordshire), Professor John Freeman (Queen’s University, Canada) and the Canadian youth delegates. The girls also attended a number of seminars, in which they actively encouraged and contributed to the debate through well informed questions and comments. On the second day the youth delegates presented their perspectives on health to the whole conference of 250 delegates; the England team focused primarily on the topics of body image and family communication. After their presentation they invited questions from the audience, which they proceeded to answer with a great sense of insight and awareness. Throughout the second day, the girls also interviewed a number of the conference delegates on their views surrounding youth engagement within research.  They talked to delegates from across Europe and Canada, including representatives from The Scottish Government, The World Health Organisation and NICE England. 

Above: Presenting to the conference delegates on the topic of body image.

The youth delegates were excellent ambassadors for young people, and the views they expressed were both insightful and applicable to the Health Behaviour in School-aged Children (HBSC) study. The young people’s participation within the conference highlighted the importance and benefit of including young people within the study. Candace Currie, the International Co-ordinator of HBSC, said, “It was great to witness the power of youth participation. I was really impressed with the potential for a different kind of dialogue and engagement with young people as stakeholders in research.”

 

Above: Our fantastic youth delegates from England!

For more information about youth engagement within HBSC England check out our other blog posts: "Involving the people that matter: A day with our young researchers" and "Youth Participation".

 

Kayleigh Chester

 

 

 

 

 

Are the youth of today really as lazy as the media suggest?

(This is a guest post by Joe Wilson who is currently doing an internship with HBSC England)

The last national report for HBSC England shows that only about a third of 11 year old boys, and less than a fifth of 11 year old girls, meet the recommended levels of physical activity. Participation in physical activity decreases with age, so by the time they hit 15 years of age even fewer young people meet the recommended target of at least one hour per day (Brooks et al. 2011). It seems to be common knowledge that children and adolescents are considered to be lazy by media outlets and wider society in general. An example of this can be quoted from Broers (2010) who suggests that young people are ‘probably lazier than ever before’. They go on to say that ‘teens do struggle with pulling themselves off the couch, just as much as they did 20 years ago. But in today’s world there is much more keeping them sitting’. This article will look at the way in which the media portrays young people of today in terms of their declining exercise rates and will look to offer reasons as to why this is the case.

Whilst doing a scan of the immediate media outlets, it is evident to see a clear pattern of negativity towards young people in terms of their exercise rates and general laziness. CBC News (2011) suggests that in Canada, only 7% of young people aged between 6 and 19 participated in enough exercise to be able to see the health benefits. This goes to show that exercise rates have been decreasing in recent years and media agencies have been picking up on such statistics in order to label the youth of today as ‘lazy’. The Washington Times (2008) is another example of a media agency claiming that young people of today have become lazy. It suggests that perhaps young people become lazy as they become older: 90% of children aged 9 in the USA get at least a couple of hours of exercise each day, which is a huge contrast to teenagers aged 15 in the same nation where less than a third get the same amount of exercise each day.

The Daily Mail (2004) points the blame of falling exercise rates of adolescents towards the parents. It suggests that most parents do not care if their child gets the required amount of exercise. It goes on to say that four out of five parents claimed that they were unconcerned about their children being inactive. Woodhouse (2012) adds to this by saying that parents need to be stricter with their children when it comes to exercise, and not let excuses such as the weather result in letting children play video games rather than going outside to play.

However, Singhateh (2013) disagrees with the media labelling young people as being lazy and instead cites the reason for the falling rate of youth exercise is in fact the lack of opportunities available for young people to get involved with sport. Lowry et al. (2005) also agree with this suggesting that a lack of sporting opportunities within the schooling system is to blame for the low exercise rates within children and adolescents. Fox (2012) also extends on this claiming that even Prince Harry believed that there are not enough opportunities for young people to participate in sport. At the 2012 London Olympic Games, there was a clear lack of state school educated winners in Team GB. This goes to show that perhaps the government is not doing enough to fund and encourage the participation of sport at school. BBC News (2008) found out that in a poll of 3,700 teenagers, 72% would prefer to visit the gym, play football or attend a youth club than hang around at home. However, 4 out of 5 of which claimed that there were not enough for them to do and participate in their local community.

According to statistics, perhaps the media are right in saying that young people are lazy. However, I believe it is much deeper than this and maybe perhaps it is lazy parenting and lack of opportunities to become active that has led to this labelling of young people today. Perhaps more needs to be done to solve this problem of lazy children and adolescents today rather than the continuous barrage of complaints about them.

Joe Wilson

2nd year Human Geography student, University of Hull

References

BBC News (2008). Poll dispels 'lazy teenager' myth. [online] Available at: http://news.bbc.co.uk/1/hi/uk/7698201.stm [Accessed: 11 Jul 2013].

Broers, S (2010). Why are teens so lazy today?. [online] Available at: http://www.examiner.com/article/why-are-teens-so-lazy-today [Accessed: 11 Jul 2013].

Brooks, F and Magnusson, J et al. (2011). HBSC England National Report. Findings from the 2010 HBSC study for England. Hatfield: University of Hertfordshire.

CBC News (2011). Canadian youth woefully inactive. [online] Available at: http://www.cbc.ca/news/health/story/2011/01/19/fitness-canadians-health.html [Accessed: 11 Jul 2013].

Daily Mail (2004). Parents 'do not care' about lazy children. [online] Available at: http://www.dailymail.co.uk/health/article-326145/Parents-care-lazy-children.html[Accessed: 11 Jul 2013].

Fox, E (2012). Prince Harry hits out at 'lack of opportunities' in sport for young people | UK | News | Daily Express. [online] Available at: http://www.express.co.uk/news/uk/337043/Prince-Harry-hits-out-at-lack-of-opportunities-in-sport-for-young-people [Accessed: 11 Jul 2013].

Lowry, R  et al. (2005). Young People: Physical Health, Exercise and Recreation. [e-book].

Singhateh, M (2013). Young People Are Not Lazy. [online] Available at: http://www.foroyaa.gm/the-future-generation/13526-young-people-are-not-lazy [Accessed: 11 Jul 2013].

The Washingtion Times (2008). Youth grow lazy as they get older. [online] Available at: http://www.washingtontimes.com/news/2008/jul/16/youth-grow-lazy-as-they-get-older/?page=all [Accessed: 11 Jul 2013].

Woodhouse, C (2012). Fat’s your lot. [online] Available at: http://www.thesun.co.uk/sol/homepage/news/politics/4443257/Parents-are-offered-help-to-prevent-rain-sodden-summer-making-kids-fat-and-lazy.html [Accessed: 11 Jul 2013].

HBSC England Accepts Award!

Above: The HBSC England team (minus Antony). 

On Friday the 21st of June, the HBSC England team attended the University of Hertfordshire Vice Chancellor's award ceremony to pick up their 'Highly Commended' award in the category Excellence in Research.

The award for Excellence in Research is "awarded to a member of staff or team who have undertaken innovative or creative research which supports engagement with business, the professions and partner organisations through one of more of the following: undertaking and exploiting new research, creating new knowledge that is disseminated, transferred, applied and impactful, knowledge exchange and technology transfer, achieving international standing in key research areas, shaping policy agendas".

 

Above: The HBSC England team (minus Ellen & Antony) with the award! 

Adolescent health concerns: Not all sex, drugs and reckless risk taking.

Often when young people’s health feature in the media, the focus is on ‘problem-behaviour’ issues like alcohol consumption, smoking, teenage pregnancy, or poor diet and lack of physical exercise. Adolescents on the whole are perceived as being physically healthy and mostly at risk from behaviours that they themselves control, and which may be perceived as a normative part of being a young person. Teenagers are stereotypically portrayed as risk takers, and the potentially negative outcomes of their behaviour has led to a strong focus on reducing risk taking as a priority for young people’s health initiatives. In 2010 the UK government published the White Paper ‘Healthy lives, healthy people’¹, which recognises the distinct needs of different age groups and the necessity for approaches that are tailored to best meet individual circumstances. It reinforces the importance of people being ‘in charge’ of their own health, and of access to appropriate information and genuine dialogue with health care professionals. However, the concerns listed specifically in relation to adolescents are very much focused on the stereotypical issues listed above, with little or no mention of other types of health concerns.

There is no denying that involvement in risk behaviours can at times result in significant and detrimental consequences for young people, both in terms of health and more generally for academic achievement and maintenance of positive relationships. However, just focusing on the problem behaviours of adolescence may lead to other concerns being marginalised or ignored altogether. The latest National Report for HBSC England² shows that in 2009/ 10, 7% of boys and 10% of girls aged 11-15 years reported smoking at least sometimes; a sharp decrease since 2002 when 15% of boys and 21% of girls said they smoked at least sometimes. When it comes to drinking alcohol, at age 11, 4% of boys and 2% of girls say they drink alcohol every week; the figures for 15 year olds are 32% of boys and 23% of girls who report weekly alcohol consumption. Again, these figures have reduced dramatically since 2002 – for some age groups they have more than halved. We know from other statistics that teenage conceptions are at their lowest rate since 1969³. Meanwhile, the latest HBSC England report also show that many young people suffer from a range of physical health concerns. Headaches are the most prevalent, with 33% of all young people aged 11-15 years saying that they experience headaches every week. Among 15 year old girls, weekly headaches are reported by almost half (48%). Around a fifth (22%) of 11-15 year olds say they suffer from weekly stomach aches, and 14% from weekly back aches. More than half of young people aged 11-15 years (51% of boys and 62% of girls) suffer at least one physical symptom weekly (HBSC England unpublished data). Furthermore, unlike many of the risk behaviours, reported incidences of physical symptoms like headaches are increasing among young people.

Our findings that headaches are the most commonly reported physical symptom by young people is backed up by other research.⁴ Frequent somatic symptoms have been identified by children themselves to be related to the school environment (pressure of studying, noisy classrooms)⁵, and insecurity or conflict within the family.⁶ Other research has confirmed the association between somatic complaints and school-related stress⁷ and several studies have found the presence of functional symptoms to correlate negatively with young people’s quality of life.^8-10 Complaints like headaches and stomach-aches may have physical causes, which need to be investigated, or may be symptoms of other problems and stress. It is important not to dismiss young people presenting with such complaints as malingering, but to understand that regardless of the origins these symptoms can be indicative of serious problems and, consequently, lead to negative outcomes. Children and young people presenting in health care settings are also far more likely to discuss physical health symptoms than they are to discuss risk behaviours, meaning that such concerns may be more amenable to intervention.

Seeing adolescent health mainly from the perspective of problematic risk taking could result in overlooking the physical health complaints experienced by this age group; this tendency is already evident in both national and international policy. Meanwhile, we suggest that physical health complaints are far more frequently occurring among adolescents than are risk behaviours, that they are on the increase and can have a significantly negative impact on young people’s lives, and therefore deserve greater attention and respect than is currently the case.

Josefine Magnusson

References

1. Department of Health (2010) Healthy lives, healthy people. Department of Health
2. Brooks, F., Magnusson, J., Klemera, E., Spencer, N., and Morgan, A. (2011) HBSC England National Report:Findings from the 2010 HBSC study for England. University of Hertfordshire
3. Office for National Statistics (2013) Conceptions in England and Wales, 2011. Statistical Bulletin, Office for National Statistics
4. Shannon, R.A., Bergren, M.D., and Matthews, A. (2010) Frequent Visitors: Somatization in School-Age Children and Implications forSchool Nurses. The Journal of School Nursing, 26:169-182
5. Hjern, A., Alfven, G., and Östberg, V. (2008) School stressors, psychological complaints and psychosomatic pain. Acta Paediatrica, 97 (1): 112-117
6. Odegaard, G., Lindbladh, E., and Hovelius, B. (2003) Children who suffer from headaches – A narrativeof insecurity in school and family. British Journal of General Practice, 53 (488): 210-213
7. Henriksen, R.E., and Murberg, T.A. (2009) Shyness as a risk factor for somatic complaints amongNorwegian adolescents. School Psychology International, 30 (2): 148-162
8. Langeveld, J.H., Koot, H.M., and Passchier, J. (1997) Headache Intensity and Quality of Life inAdolescents. How are Changes in Headache Intensity in Adolescents Related toChanges in Experienced Quality of Life? Headache: The Journal of Head and Face Pain, 37 (1): 37-42
9. Youssef, N.N., Murphy, T.G., Langseder, A.L. and Rosh, J.R. (2006) Quality of life forchildren with functional abdominal pain: A comparison study of patients’ andparents’ perceptions. Pediatrics, 117 (1): 54-59
10. Hunfeld, A.M., Perquin, C.W., Duivenvoorden, H.J.,  Hazebroek-Kampschreur, A.J.M., Passchier, J., van Suijlekom-Smit, L.W.A., and van der Wouden, J.C. (2001) Chronic pain andits impact on quality of life in adolescents and their families. Journal of Pediatric Psychology, 26 (3): 145-153