The current situation
The number of children who are struggling with their mental health is continuing to rise, with one in five young people now having a diagnosable mental health condition.
Like in adulthood, there are many types of mental health conditions that can impact children and adolescents with the most common of these falling within the sphere of anxiety and low mood. This could vary between mild worries about a particular issue (e.g. school) to diagnosable mental health conditions such as panic disorder, obsessive compulsive disorder, post-traumatic stress disorder, attachment difficulties or depression.
There are also other mental health conditions that are less common but do have their origins in adolescence such as psychosis, bipolar disorder or eating disorder.
The causes
Children and adolescents experience mental health problems for a lot of the same reasons that adults do ultimately. There may be biological or genetic vulnerabilities there, which make young people predisposed to a particular mental health condition. However, there are also lots of other psychosocial factors which are important and that contribute the development of mental health difficulties
Mental health conditions are rarely caused by one specific trigger or one identifiable factor. We do know that the more adverse childhood experiences that people go through, this increases the likelihood that someone will experience mental health difficulties. Experiences such as abuse, neglect, parental divorce, trauma, domestic violence, can all impact a young people’s sense of safety, stability and belonging, which can then in turn lead to mental health difficulties.
The way the world has changed and the prevalence of social media which, although is often helpful, can also have a negative side effect and actually confound people’s mental health difficulties. For example, in the past if young person experienced bullying in school they might be able to have some respite at home but now this bullying can often continue online or via social media meaning that there are fewer safe spaces.
We also need to remember the impact of the Covid-19 pandemic. It was hugely significant and young people were isolated for a large period of their development. As well as creating a huge sense of uncertainty at time of their lives where most adolescents are trying to solidify their identity and where they fit in in the world, this pandemic also meant that young people were isolated from their peers and in some cases stuck at home in situations where abuse / trauma was occurring.
What to look out for
The main thing to look out for would be any changes to how someone was before. If you’ve got a child or a young person who is usually a very outgoing and sociable person, and then all of a sudden becomes quite withdrawn and isolated and stops communicating with people, that could indicate that something’s going on. Equally, if you’ve got someone who’s naturally quite shy but starts becoming very extroverted, that could also be a sign they are struggling with something or something else might be going on. It’s important to pay attention to those subtle changes in behavior or everyday routine.
This could also extend to changes in someone’s eating habits or sleep patterns, as well as their willingness to go to school and engage in social activities. Perhaps there’ll be changes in their interpersonal relationships or stress levels.
It could be that those things are normal reactions to the everyday stressors of growing up and developing, but it could be indicative of something and should be paid attention to.
How to support
When people are struggling with their mental health, sometimes they don’t want to talk and will isolate themselves. The best thing that anyone can do is give the person the opportunity to talk when they’re ready to. However you often need to build that foundation of safety and trust in the relationship, because people will only talk about their mental health if they feel safe enough to be able do so.
It’s about taking the time to ask the questions as well and regularly check-in with questions such as ‘how are things going?’ If you demonstrate that you genuinely care, people will be more like to open up. Create the right environment by being non-confrontational, non-judgmental and actively listen. Just showing someone that you are there for them and giving them your full attention can make a big difference.
If you notice that things seem different, don’t be afraid to name it. Tell them what you are observing and ask genuine questions. Don’t assume.
There might be a temptation to try and go into problem solving mode and try and fix whatever is going on, and sometimes that might be appropriate. Often however it is having their internal thoughts and feelings validated that makes the most difference. Remember adolescence is a scary time by itself and it is scarier still when mental health difficulties are added to the melting pot. Validation and reassurance can go a long way.
Additionally, the biggest thing that people often struggle with as children and as adolescents, is understanding their own internal emotional world. We need to help them to understand their emotions and why they’re feeling the way they are, whether that be angry, sad, anxious or another emotion altogether. At different stages of a young person’s life, from being a baby, through to the toddler years, primary school and secondary school, there’s going to be different challenges and it’s about helping them figure out what their emotional responses are so that these emotions don’t then become too much or too scary. They’ll be more likely to cope with the stresses of day-to-day life if they have a good understanding of their own internal, emotional world.
As a parent or caregiver, try to tune into what the person’s feeling, help them understand it, help them be able to co-regulate and then they’re more likely to be able to regulate independently.
Advice for young people
If a young person is struggling with something, I would urge them to try and understand what had led to that and what the cause or triggers may be. It may be that they are then able to change something which then impacts how they feel for the better.
If there is someone in their lives they feel able to have that conversation with then consider reaching out to that person. It doesn’t always have to be a parent, it could be a family friend, a teacher or another trusted adult in their wider social network.
If they need a bit of extra support from a professional, this is absolutely nothing to be ashamed about and GPs or professionals from CAMHS are usually a good starting point. Childline for example offers confidential support for children and young people who are struggling with their mental health. Childine’s number is 0800 1111.
I want young people to understand that it’s okay to talk about mental health and difficulties. The main thing is to realise that whatever they’re going through, they are not alone. Of course it’s really scary to reach out and ask for support, but that help is out there once they find the courage to take that step.
What needs to change
There’s a lot that needs to change, particularly around the support which is available within the community. I’ve seen too often, examples where there’s been too little support or it has come too late.
Community services are stretched to capacity in terms of the level of support they can provide and the waiting times for young people to access help are often far too long. For someone who might not understand why they’re feeling the way they’re are, and that could be anything from anxiety, low mood to something like psychosis, or coping with trauma or an eating disorder, that can be incredibly harmful.
Without earlier intervention, we are not going to see a change and that needs to be on a societal level, from having mental health hubs in schools and an expansion of what community care looks like.
In terms of mental health treatment, there needs to be more talking therapies and more social prescribing in terms of social interventions that are going to help people such as tackling online bullying.
It is worth remembering that navigating childhood and adolescence is a difficult task for most of us anyway. Adolescence is a time when we start to grow up, develop, figure out our own identity, experiment, develop friendships, develop relationships, devise career plans, and ultimately become more and more independent. We need to do all we can, as a society, to ensure that those young people who cope with a mental health condition, on top of the everyday stress of adolescence, get the support they deserve.