A barrage of reports lately provides powerful evidence that young people, including teenagers and children, are suffering an epidemic of mental illness.
A large-scale study of 30,000 pupils by the Department for Education for England, with thousands of teenagers aged 14 and 15 interviewed in-depth, showed a 10% rise in poor mental health over the last decade; depression or anxiety afflicted one in three teenage girls. The number of under-16s being admitted to hospital for self-harm shot up by an astonishing 52%. A recent survey in England found that one in four women between 16 and 24 had self-harmed, and one in eight now suffer from post-traumatic stress disorder. Anxiety, depression, phobias or obsessive compulsive disorder were found to affect 26% of women in this age group.
The focus of media attention has been on teenage girls, especially as regards pressures attributed to problems of self-esteem. But in the pre-teen years more than twice as many boys as girls under 11 were in contact with NHS mental health services in England at the end of June 2016, according to a survey of NHS trusts.
So what is going on? As heretics, we are not short of ideas as to why children and teenagers are less happy and thriving than they might be, but we also need our intuitions to be as well informed as possible. With that in mind I took myself off to London for a discussion forum at the Barbican Centre called “Young people and mental illness: a growing problem?”, part of a two-day Battle of Ideas debating event last month run by the Institute of Ideas.
The question mark in the title hints at scepticism – no surprise, really, as the forum was initiated by Social Policy Forum, whose About page says “social policy…is rarely discussed in its own terms. This is a problem because instead of policy makers trying to find ways to better meet people’s needs, they are more likely to be found promoting behavioural change or advocating intrusive interventions into people’s lives.” Ah, yes, intrusive interventions! Some of us here know a thing or two about those and have good reasons to suspect the hyped-up horror stories, moral panics and hidden agendas used to justify them.
In line with this insight, the event description said “Influential voices claim that children today face more pressures from social media than previous generations, adding up to a ‘toxic’ childhood. Critics are wary of drawing more children into a therapeutic relationship with the caring professions, arguing that this would undermine rather than foster resilience.”
Part of this scepticism expresses itself through a disinclination to accept that there really is a mental health crisis among the young. I heard it pointed out, for instance, that school bullying, often cited as a cause of anxiety, depression and suicidal feelings, is nothing new and is an inevitable part of growing up. Kids just have to learn to live with it, the non-interventionists say: it’s part of their social education, it’ll toughen them up and stand them in good stead for the slings and arrows of life’s later fortunes. What we have these days, it is suggested, is the Snowflake Generation: over-protected kids who turn up at university demanding Safe Places where they won’t have to face intellectual “bullies” who will make them feel “uncomfortable” by challenging the politically correct dogmas they have been spoon-fed for as long as they can remember.
Those of us who value free speech will of course warm to its robust defence. We will thus welcome an important distinction implicitly made above between being made merely uncomfortable or anxious on the one hand, and bullying that entails actual or seriously threatened physical violence on the other. They are connected phenomena but radically different in degree. Likewise, there is a big difference in mental health terms between clinically diagnosed conditions such a schizophrenia and severe autism, at the genuinely serious end of the scale, and milder conditions at the other, especially when they are self-diagnosed or only discovered as answers solicited in unscientific surveys of the cheap and cheerful (or gloomy!) sort. Lots of people these days, for instance, claim to be autistic because, unlike some forms of mental illness, it carries no stigma now and has even become quite fashionable. To be “on the spectrum”, with a hint of Asperger’s, is to imply that you or your child might be socially a bit awkward but probably it’s because you are a high-flying geek, or even a genius.
How, then, are we supposed to sort the wheat from the chaff? What mental health issues do young people really face and are they truly getting worse? We have moved on a lot since David Cooper coined the term anti-psychiatry half a century ago, as part of a radical challenge to the whole idea of mental illness that involved such big names as Jacques Lacan, Thomas Szasz and R. D. Laing. These days most experts accept that mental illness is a reality but there is still a huge area of debate as to where individual pathology ends and social issues begin, and how they interact. Even the word “experts” is problematic in any area of investigation where supposedly knowledgeable people cannot agree among themselves.
But at least the forum I attended was privileged to have on its speaker panel someone whose expertise in the field of mental health surveys is indisputable. This was Sir Simon Wessely, president of the Royal College of Psychiatrists. A specialist in epidemiological psychiatry, he was a leading contributor to the very large and prestigious Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey, published last month by NHS Digital.
An expert’s exert, so to say. A witty one, too, especially in a self-deprecating way. But it was in boastful mode that he started, joking that for those who might not know what an epidemiological psychiatrist does, it means that “I don’t get out of bed for less than a thousand people.” The serious point, of course, is that his big-league number-crunching is the only way to get at meaningful trends.
Summarising those trends, he said the general level of mental illness, contrary to what had caught the headlines, was much the same as 30-40 years ago. But the level of anxiety conditions in young women aged 16-24, had gone up from 19% in about 1990 to 26% in 2014, when the new survey was conducted. He was in no doubt that this was a real and significant change. The survey had not published data on those younger than 16, but he said he was aware a similar pattern pertained in girls below this age too. Young males, by contrast, had not become more anxious. Keep in mind the gender disparity; we will return to it.
For now, though, let’s stay with the big picture, and pan out to make it even bigger. Much bigger, sweeping across the whole of our history as a species, and across the entire planet, this time taking the perspective offered by psychologist Steven Pinker, himself an expert’s expert and also one of the world’s leading public intellectuals. Sir Simon may not get out of bed for under a thousand people, but Pinker’s datasets run to the millions and even billions, and his monumental 1026-page tome The Better Angels of Our Nature has a very relevant 38-page section on children and, in recent times, the emergence of the concept of children’s rights. It includes a lot of statistical data and discussion on what the experience of childhood and growing up has been like through history and across cultures, and, in the light of this big picture, how current cultural changes in the developed countries are affecting the young, including their psychological well being.
My worry when reading Pinker was that he seemed to be painting himself into a corner, interpreting his admittedly impressive data in a naïve way, leading to the fallacy of presentism, characterised by our present culture uncritically congratulating itself on having progressed beyond the barbarities of the past towards a near-perfect now, in which present trends merely need to be pushed forward a bit further in order to achieve a society as just and flourishing as possible. I suspected I would have to write him off as another Lloyd deMause (whose work he cites), whose historical work on childhood presents a bleak picture in which children have typically suffered ghastly cruelty and every kind of abuse, including sexual coercion and rape, for millennia and only now are things getting better.
But no, Pinker avoids the trap. So what is he saying? His Better Angels book is subtitled A History of Violence and Humanity, his mission being to explore the nature of conflict and violence and the means by which we might be able to achieve a more peaceful, cooperative and, by implication, saner future which will be better for everyone’s wellbeing, including their mental health. Exploring the recently-developed concept of children’s rights, alongside other “rights revolutions” (ethnic, women, gay, animal), Pinker begins by painting a largely deMausian scene, albeit viewed through the lens of evolutionary psychology rather than deMause’s Freudian approach. In particular, he invokes the insights of evolutionary biologist Robert Trivers into parent-offspring conflict to explain the tough time often given to children throughout history.
We have come a long way, he says, from the “little devil” theory of childhood, when it was felt that kids needed to be thrashed to beat out their innate depravity – colourfully portrayed by a German preacher of the 1520s who sermonised that children harboured wishes for “adultery, fornication, impure desires, lewdness, idol worship, belief in magic, hostility, quarrelling, passion, anger, strife, dissension, facetiousness, hatred, murder, drunkenness, gluttony” and, as Pinker joked, he was just getting started! Like deMause, Pinker sees the Enlightenment’s later invention of childhood “innocence” as mainly a good thing, because it ushered in several centuries in which kids have gradually been treated more kindly, with a much greater concern for their well-being and even, latterly, their rights, albeit largely in terms of the right to be protected against ill-treatment rather than a right to self-determination.
Now, here is where Pinker gets really interesting, because – backed by extensive data, remember, he doesn’t just speculate or make stuff up – he comes to recent times and draws two startling conclusions that go in different directions.
First the good news, which will certainly seem strange in view of the reports of mental health crisis I started off with. Pinker writes:
…over the past two decades the lives or children and adolescents improved in just about every way you can measure. They were less likely to run away, to get pregnant, to get into trouble with the law, and to kill themselves. England and Wales have also enjoyed a decline in violence against children…
And now the bad. The effort to protect children has begun to overshoot its target “and is veering into the realms of sacrament and taboo”. We can see where he is going, can’t we? Kids wrapped in cotton wool by anxious, risk-averse parents and kept prisoner in their homes. As he puts it: “Children are not allowed to be outside in the middle of the day (skin cancer), to play in the grass (deer ticks), to buy lemonade from a stand (bacteria on lemon peel), or to lick batter off spoons (salmonella from uncooked eggs).” Most of all, they cannot explore on their own or with pals thanks to Stranger Danger. Interestingly, Sir Simon Wessely also singled this out as a persistent source of anxiety in our times, which it is also reasonable to suspect as a major cause not just of anxiety but also of depression and conduct problems for cooped-up kids.
Now, back to the more detailed local picture we started with: How might the specific findings of the various mental health surveys in the UK be best explained? What do they suggest in terms of how a mentally healthier society might be achieved, especially from childhood through to the early adult years? It will have to be a two-parter this time, I’m afraid. There is no way I can cram a worthwhile response to these big questions into a sensibly-sized single blog.
What I can do, though, is give a brief taster of what is to come next time. I said above that I would return to the marked gender disparity in the figures: boys seem to have a tougher time in the pre-teen years, but after that it is the girls who are in trouble. I have a theory about that, and a fair bit of evidence to support it. I will also be drawing on some of the wisdom I encountered at various sessions in the Battle of Ideas, including not just the mental health one already touched upon but also discussions entitled “Are young people scared of sex?”, “Can neuroparenting save the family?” and “Feminism: in conversation with Camille Paglia”. I trust this leaves you feeling there is something to look forward to!
ABUSE INQUIRY GETS A LIFT
The Independent Inquiry into Child Sexual Abuse (IICSA) definitely needed a substantial lift after being dogged by one farcical disaster after another since its inception.
But someone took the message too literally, it seems, for now they have put an actual lift at the centre of the narrative: you know, one of those chunky, boxy things that takes people up and down in big buildings – a lift at the inquiry’s London headquarters, to be precise. It was named as a crime scene when the inquiry’s most senior lawyer was alleged to have sexually assaulted an inquiry worker within its confines.
The BBC’s Newsnight TV programme broke the story and the corporation’s online news reported that “Ben Emmerson QC was suspended in September over concerns about his conduct, but the suspension was lifted the next day when he resigned, allowing him to keep working for the inquiry for two months.” Nothing appears to have been reported to the police and, unsurprisingly, Emmerson insists nothing happened.
You know what? I don’t believe the “victim’s” story. It simply beggars belief that a guy of Emmerson’s standing, at the centre of an inquiry into sexual abuse of all things, would do anything so stupid, especially to such a person in such a place. This reeks of the victim-lobby’s non-stop manoeuvring to get their way. Publicly, they praised him when he was first suspended, but I wouldn’t put it past one or two of them – or more – to stab him in the back by concocting a yarn intended to make his position untenable but without necessarily having to make an allegation sworn on oath in court.
The “victims” would not have forgotten that Emmerson had the courage to face down at least one of their number. As Heretic TOC reported last year, he said that Sharon Evans, one of the victims’ lobby representatives on the enquiry panel, could not tell the difference between truth and error.