Another week of speaking to the depressed and anxious. Aren’t we all? Spending weeks in lockdown in their homes, our patients are gradually becoming increasingly mentally unwell.
We must all be particularly aware of the huge, long-standing burden of mental illness among the young. One in six children is now thought to be experiencing a probable mental health disorder, according to The Mental Health of Children and Young People in England 2020 report, published by NHS Digital.
Up to one in four young women were thought to have a mental disorder. For years, the numbers of children experiencing mental health difficulties has been on the rise.
All this distress, and all this sadness. What are we doing to help these young people? As a GP, I am all too familiar with the call: ‘My daughter is extremely anxious. She doesn’t sleep. She won’t go out. She doesn’t see any point in her life.’ ‘Have you contacted the school nurse or counsellor?’, I ask. ‘Why don’t you take a look at these helpful online resources? If you contact this number, they can arrange some talking therapy. If you really find yourself in crisis, ring this number for help…’ And on it goes.
Some time ago, I listened to a beautiful reflection by Michael Morpego on mental wellbeing in young people. You should listen to it. In fact, he says everything I’ll try to communicate in this blog, only far more eloquently. He talks of giving children happy childhood experiences, of providing them with a bank of memories to draw from, when they face difficult times. Childhoods spent playing outside, memories of collecting a warm egg from under a chicken, family togetherness, and freedom to roam.
Today, when we talk of mental illness in the young, we hear calls for more mental health services; more investment in talking therapies; shorter waiting times for CAMHS. But, when you look back on difficult times or traumatic experiences in your life, what was it that you called on? I believe my mental resilience has come from a happy childhood.
My ability to deal with fear was developed playing on a treacherous rope swing, skiing down a mountain, abseiling off a cliff. My ability to cope with social anxiety was developed by attending teenage sports holidays with a friend, away from my family or regular social network. My ability to keep myself in balance was developed through regular routines of sleep, meals, exercise, and schoolwork, repeated day in, day out for years on end, until it was my rhythm, and I’d miss it when it was absent.
My ability to cope with criticism was honed by cutting remarks from my siblings. My ability to cope with uncertainty was developed by travelling and working abroad in my university years. So many happy (yet sometimes challenging) experiences that have prepared me to cope with life.
As we deal with the after-effects of the lockdowns and school closures on young people, I believe we need to take a long, hard look at our mental health services, and the whole approach our society has taken to mental wellbeing. It’s clearly not been working.
Many young people who start engaging with mental health services in their teens continue to move in and out of CBT or psychiatry services throughout their adult lives. For young people, in particular, I believe one-on-one counselling might actually be counterproductive.
Rather than teaching the young person to look beyond themselves; to join a community; to engage with friends and family, we’ve been teaching them to turn to a professional, that this is the route to improving their mental health.
There’s only so much that mental health services can do to support our society’s mental wellbeing. We need to look at the causes of distress, rather than continue to apply sticking-plaster measures to address the issues.
We’ve lost community, togetherness, freedom to roam, and childhood innocence. Teenagers feel they need to look perfect for their Instagram Stories. They’re consumed by a fear of missing out, because they’re constantly reminded on social media what everyone else is doing. They spend hours alone in their bedrooms clicking buttons which make them sadder, less active, and lead to insomnia. They spend less time outdoors, and have fewer adventures and freedoms.
When the Government promises to invest in improving the mental health of the young, I’m convinced that we don’t need more of the same. Our young people need social groups; sports clubs; community services; and opportunities to experience wonderful things. They need to have bright futures to look forward to, a promise of exciting times ahead.
It’s high time we stopped offering children ‘mental health support’, when all they really needed was a healthy environment to begin with.
Dr Katie Musgrave is a newly-qualified GP in Devon and quality improvement fellow for the South West