Mental health in young people: The time of their lives?
Just take a moment to think about your teenaged children, particularly girls, should you have them. Do they seem happy?
I'd love my boy to be less anxious, but Asperger's creates extra issues there, so I am definitely not expecting huge belly laughs on an hourly basis.
A recently published study into the state of mental health in England found quite alarming evidence that more young people are experiencing mental health problems than ever before, and particularly young women aged 16 to 24. This was a screening document and many of the respondents were undiagnosed and untreated. Sexual violence, childhood traumas and pressures from social media are being blamed for dramatic increases in the number of young women self-harming, having post-traumatic stress disorder (PTSD) or a chronic mental illness.
Psychological distress is now so common that one in four in that age group have harmed themselves at some point, according to the government-funded Adult Psychiatric Morbidity survey (1).
The number of women of that age who screened positive for PTSD had risen from 4.2% to 12.6% between 2007 and 2014, although the use of a more accurate screening tool in the new survey may explain some of that rise. When I first read the headline I was hugely sceptical. How can so many young women have PTSD?
I thought about the importance of resilience, how anxiety can make people more prone to see a blip as a disaster and how the authors were defining PTSD - obviously too loosely, open for interpretation. Unfortunately, I was wrong.
Reading through the document itself, they had been very precise in their definition and had stated specifically the criteria. Traumatic events were defined as experiences that either put a person, or someone close to them, at risk of serious harm or death, like a major natural disaster, a serious car accident, being raped, or a loved one dying by murder or suicide. About one in three adults in England report having experienced at least one such traumatic event.
How can so many young people have experienced this type of event? There we have a very unpleasant reflection of the society our children are growing up in; one that our political leaders should be examining closely. The dean of the Royal College of Psychiatrists said more research was needed to fully understand the rise in PTSD, but said rape or other sexual abuse were possible triggers. She said the rise in chronic mental illness among 16- to 24-year-old young women was clearly worrying, with social media a likely key contributor; 26% of women, and 9% of men aged 16 to 24 reported symptoms of common mental disorders in the week prior to the survey.
"This is the first age group that we have had coming of age with social media," Lovett said. "There are some studies that have found those who spend time on the internet or using social media are more likely to [experience] depression, but correlation doesn't imply causality."
The chief executive of the mental health charity Mind said untreated mental illness was still a huge problem. "It's still clear that nowhere near enough people are getting the support they need - in fact, more people than not are having no treatment at all," he said. About half of those who screened positive for PTSD were already receiving mental health treatment: 38.9% were taking medication and 24.0% were having psychological therapy. Child and adolescent mental health services (CAMHS) are usually resource poor and hugely over-burdened. A colleague describes a referral to the CAMHS locally as 'dropping a letter into a black hole.' There are some great 3rd party organisations who are trying to pick up the slack, but there still seems to be a growing gap.
The RCGP journal this week was devoted to mental health and describes children and young people's mental health services as the 'Cinderella of the Cinderella services', chronically underfunded and undervalued (2). We know that mental health problems in this group can have an effect on physical, social and educational development with effects lasting into adulthood. This group needs access to timely help, or we are truly storing up problems on a massive scale for generations to come.
We also know that young people find accessing healthcare difficult. How many of you have young people in your PPGs, or have practice news and information on social media? Something to consider maybe, and if you're feeling truly inspired, have a look at this beacon of good practice.
It is time to recognise that the kids are definitely not alright.
1) National Study of Health and Wellbeing: Adult Psychiatric Morbidity Survey (APMS); September 2016. https://www.statisticsauthority.gov.uk/monitoring-and-assessment/assessment/current-assessments/national-study-of-health-and-wellbeing-adult-psychiatric-morbidity-survey-apms/
2) Mughal F, England E. The mental health of young people; British Journal of General Practice. October 2016.