Mental health awareness may do more harm than good

In recent years there has been a huge obsession with children’s mental health. Frequently the public is told that youngsters are suffering from an epidemic of panic, depression and suicidal thoughts. Anxiety about anxiety has led to massive increases in the numbers of antidepressants handed out; almost one million were given to children between April 2015 and March 2018, with prescriptions rising most sharply in the under 12 age group.

Fear over children’s mental health is now so great that the government wants to make the topic compulsory across primary and secondary schools. It is no wonder that we have reached this point, given the amount of pressure policymakers have faced to address the ‘crisis’, as it is perceived. Famously, the Duchess of Cambridge spoke out about the importance of children being aware of their mental health, receiving great praise. Clearly, it is fashionable to think that youngsters must be clued up, as a matter of urgency, on their psychology.

In our society, there is a frequent belief that information is the way to deal with many issues, be it sex, or drugs, or something else. The assumption is that the more children know, the better. But there is something to be said for the saying ‘ignorance is bliss’. Throwing kids into mental health education may actually do more harm than good – because through trying to erase stigma we plant ideas instead.

One of the first issues with widespread initiatives is that they actually overestimate the amount of children with mental health issues. Research indicates that these illnesses are not epidemic at all – 1 in 10 children and young people suffer from mental health disorders. The press sometimes portrays these figures as extreme, but the sources can be misleading. A study by stem4, for instance, uses data from teacher estimates, with four in five saying that they’ve seen a child struggle from poor mental health. This evidence is arguably more indicative of a teachers’ own sensibilities than anything else.

Furthermore, mental health education relies on subtle classification abilities in children, which they may not have. There are grey areas in how we define our emotional wellbeing. If children are taught about anxiety and depression through the prism of mental health, this encourages them to pathologise these states – which are appropriate in certain contexts (exam season, for instance) and sometimes a sign of an adaptive response to an adverse situation. It will be hard for children to make distinctions between a disordered and normal feeling.

There are, of course, children who do have mental health issues. But the fact remains that they are in a minority, and should receive specialised care, in the way that someone with dyslexia, ADHD or autism might do. A whole class does not need training for the sake of one or two individuals, not least because informing children about mental health could be irresponsible in some circumstances. Suicide rates, for instance, go up the more suicides are reported in the press. Learning about mental health does not necessarily combat it, and may have completely the opposite effect.

Part of the reason mental health has become such a pressing educational issue is that the breadth of what can be diagnosed as disorderly continues to grow – with sex addiction recently named an affliction. There is a strange market for definitions; we live in a correctional culture which leads us to believe that anything uncomfortable must automatically be wrong and seen to by a doctor. Paranoia about mental health has parallels with body dysmorphia. Nowadays, we not only want to look perfect, but feel perfect too, influenced by social media stars – who project beauty as well as sanity and happiness. This has left many members of the public unable to tolerate negative emotions, worrying instead that something sinister is going on.

The mental health obsession, in particular with regards to children, is leading us down the US path – where there is widespread panic over psychological disorders. It is sad state of affairs: I have worked with kids in the States, many of whom were given elaborate diagnoses and medication. This rendered some of them anxious, dopey and withdrawn, and that’s before one contemplates the longer-term effects of psychotropic medication, which are still relatively unknown.

One of the better ways I believe policymakers can pre-empt future mental health conditions in children is by enhancing physical education. Across the West there are big issues with obesity and lack of exercise, which goes hand in hand with low mood. Exercise provides us with endorphins and can reduce anxiety and low mood.

Mental health is, of course, a deeply complex issue, and there are a large amount of variables that influence its prevalence, symptoms and longitude. In recent times we have all been disheartened and shocked by the loss of Sophie Gradon from Love Island, Kate Spade, the handbag designer, and Anthony Bourdain, the TV personality and chef, to suicide. These awful tales remind us of the weight of depression and other disorders, as well as how difficult these can be to spot. There is an urge to fix the problem as much as possible.

But it is not so easy as to suggest that awareness is the fix. Widespread initiatives in schools may actually do more harm than good by causing panic and suggesting to children that they may be unwell. Sometimes lack of knowledge is, conversely, the best educational route.

  • mrs Croc

    At last, a sensible article on mental health.

  • Rob Groves Fifth

    It’s the swing of the pendulum, it might seem over the top at the moment, but attitudes towards mental health need to change. Around a tenth of the population has life changing mental health issues, and everyone else tries to ignore it which increases the misery. If I’d had help in the 90s when I was in high school my life might have turned out quite differently, even mental health services weren’t helpful nevermind the school who did there best to ignore my problems. Is there a risk of some kids over medicalising their normal experiences? Perhaps, but society overall needs to change, and if the education is done right, talking about how stress, anxiety, low periods etc are normal then that issue needn’t be a big one.

  • Public policy should be evidence-based and outcome driven. A shame that this argument is lost amidst the polemic, particularly if the flippant tone of this article risks causing further distress to those trying to support a child or relative. Read our response here

    About ACAMH

    The Association for Child and Adolescent Mental Health (ACAMH) is a registered charity with over 60 years’ experience in promoting the advancement of evidence-based child and adolescent mental health. Our membership comprises a diverse group of clinicians, practitioners and world-leading child mental health researchers, working across an array of child and adolescent mental health domains. We aim to raise standards in the understanding and management of child mental health issues. We publish the Journal of Child Psychology & Psychiatry (JCPP), an internationally acclaimed and world-leading child & adolescent psychology and psychiatry journal, that brings together empirical research, clinical studies and reviews in order to advance how we understand and approach child and adolescent mental health. We also publish the Child & Adolescent Mental Health (CAMH) journal, a high quality, peer-review of child and adolescent mental health services research, which has articles for practitioners describing evidence-based clinical methods and clinically orientated research.

    • John Whyte

      You wouldn’t have an opportunity interest in increasing the size of the patient population, would you? A lot of what is going on now ties in exactly with what Szasz predicted over 50 years ago.

  • John Whyte

    Thank goodness for some sense. If we continue to confuse problems of living and adjustment to life with mental illness, we will be unable to cope with a generation of “professional patients”.

    Services are stretched by the worried well as it is.

  • Finally, someone realises the counter-productivity of awareness.
    Misinformed and easily influenced minds are not a good combo.

    For that one child that does in fact suffer from depression, how many others think they do because it fills a void, offers an excuse, seems to be a viable explanation, or some other reason?

    Not to say that that one child or the significance of being able to recognise and help those in need is to be dismissed, but the way in which this is to be achieved is surely not the current flood of information, opinions and changes in policies and curriculums.

    It is unfortunate how a likely good-willed intention to spread awareness and prevent the detrimental effects of mental illness has instead let it become a “popular” topic, idea, or condition… One that is romanticised and generalised to the point where in an attempt to reduce stigma, the resulting attention and acceptance has instead spiked curiosity and idealisation…