Young people’s mental health is a ‘worsening crisis’. Action is needed

In both the UK and US, services for young people are being cut, leaving those from marginalised groups at greatest risk of suicide.‘Whatever the language deployed to describe the scale of mental health challenges facing Britain’s young people, it has to be addressed immediately.`

One recent report called the problem a “silent catastrophe” while a survey of teachers labelled it an “epidemic”. But, whatever the language deployed to describe the scale of mental health challenges facing Britain’s young people, it has to be addressed immediately.

NHS figures published last month revealed that almost 400,000 children and young people aged 18 and under are in contact with the health service for mental health problems. According to the figures, the number of “active referrals” by GPs in April was a third higher than the same period two years prior. Those seeking help for conditions such as depression and anxiety showed a sharp increase.

Demand for help is up, but services are diminishing. Last month also saw new figures showing a 30% fall since 2009 in the number of hospital beds for people with acute mental health conditions. This follows the revelation in November 2017 that two-thirds of children referred for specialist mental healthcare are not receiving treatment. Last week, the charity Barnardo’s warned that ministers were “sleepwalking” into a deeper crisis in children’s mental health, after the government’s response to a parliamentary select committee report and green paper failed to promise urgent action to plug “gaping holes” in services.

Of course, an increase in referrals over time may be, in part, an indication of more young people self-reporting and GPs being more receptive to it. Nevertheless, the warning flares on children and young people’s mental health have come thick and fast lately. In June, the NHS England boss, Simon Stevens, said a major expansion of serviceswas needed to deal with growing demand. A few days earlier, a report from the Association of Child Psychotherapists warned of “a serious and worsening crisis” following a survey of staff in child and adolescent mental health services (Camhs). Underfunding on top of service reorganisation was an ongoing threat to specialist services, it concluded. “There was never a golden age of funding” for young people’s mental health, as Andy Bell of the Centre for Mental Health explains, but help must include a concerted focus on groups that face additional inequalities, such as LGBTQ youth who are much more likely to experience common mental health problems. Research shows that almost twice as many young LGBTQ people in the UK (44%) have considered suicidecompared with heterosexual non-trans young people (26%).

In the US, concerns about young people’s mental health have come to the fore lately, too, including for common problems like anxiety, depression and suicide. Suicide is the second biggest cause of death for 10- to 24-year-olds in the US and 90% of those who die have a mental health condition. And research shows the proportion of young people treated at children’s hospitals for suicide attempts or suicidal thoughts more than doubled between 2008 and 2015.

The 2018 State of Mental Health in America report tells a story similar to Britain’s. “Rates of youth with severe depression increased from 5.9% in 2012 to 8.2% in 2015,” it reports. And again, access to treatment is a problem as budget cuts put pressure on insurance coverage and services. “Even with severe depression, 76% of youth are left with no or insufficient treatment.”

And, as in Britain, for youngsters from marginalised groups the picture is especially challenging. Amit Paley, chief executive of the Trevor Project, which offers suicide prevention and crisis intervention support for young LGBTQ people in the US, points out that the rate of gay, lesbian and bisexual young people who have seriously contemplated suicide is around three times that of heterosexual young people. The evidence tells us that early identification and intervention can mitigate damage to young people’s mental wellbeing. We know, for example, that if children’s centres and young people’s services and schools are better equipped to promote wellbeing they can make a difference.

When it comes to young people in extreme distress or at risk of suicide, effective crisis services and access to support are utterly essential. But so too is preventing youngsters from reaching a crisis in the first place.

 In the UK the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org.

 

Link to The Guardian article here 

Please follow and like us:

Are smartphones causing more teen suicides?

‘All of the possibilities traced back to a major change in teens’ lives: the sudden ascendance of the smartphone.’
 ‘All of the possibilities traced back to a major change in teens’ lives: the sudden ascendance of the smartphone.’ 

 

Around 2012, something started going wrong in the lives of teens.

In just the five years between 2010 and 2015, the number of US teens who felt useless and joyless – classic symptoms of depression – surged 33% in large national surveys. Teen suicide attempts increased 23%. Even more troubling, the number of 13 to 18-year-olds who committed suicide jumped 31%.

In a paper published in Clinical Psychological Science, my colleagues and I found that the increases in depression, suicide attempts and suicide appeared among teens from every background – more privileged and less privileged, across all races and ethnicities and in every region of the country. All told, our analysis found that the generation of teens I call “iGen” – those born after 1995 – is much more likely to experience mental health issues than their millennial predecessors.

What happened that so many more teens, in such a short period of time, would feel depressed, attempt suicide and commit suicide? After scouring several large surveys of teens for clues, I found that all of the possibilities traced back to a major change in teens’ lives: the sudden rise of the smartphone.

Because the years between 2010 to 2015 were a period of steady economic growth and falling unemployment, it’s unlikely that economic malaise was a factor. Income inequality was (and still is) an issue, but it didn’t suddenly appear in the early 2010s: this gap between the rich and poor had been widening for decades. We found that the time teens spent on homework barely budged between 2010 and 2015, effectively ruling out academic pressure as a cause.

However, according to the Pew Research Center, smartphone ownership crossed the 50% threshold in late 2012 – right when teen depression and suicide began to increase. By 2015, 73% of teens had access to a smartphone.

Not only did smartphone use and depression increase in tandem, but time spent online was linked to mental health issues across two different data sets. We found that teens who spent five or more hours a day online were 71% more likely than those who spent less than an hour a day to have at least one suicide risk factor (depression, thinking about suicide, making a suicide plan or attempting suicide). Overall, suicide risk factors rose significantly after two or more hours a day of time online.

Of course, it’s possible that instead of time online causing depression, depression causes more time online. But three other studies show that is unlikely (at least, when viewed through social media use).

Two followed people over time, with both studies finding that spending more time on social media led to unhappiness, while unhappiness did not lead to more social media use. A thirdrandomly assigned participants to give up Facebook for a week versus continuing their usual use. Those who avoided Facebook reported feeling less depressed at the end of the week.

The argument that depression might cause people to spend more time online doesn’t also explain why depression increased so suddenly after 2012. Under that scenario, more teens became depressed for an unknown reason and then started buying smartphones, which doesn’t seem too logical.

What’s lost when we’re plugged in

Even if online time doesn’t directly harm mental health, it could still adversely affect it in indirect ways, especially if time online crowds out time for other activities.

For example, while conducting research for my book on iGen, I found that teens now spend much less time interacting with their friends in person. Interacting with people face to face is one of the deepest wellsprings of human happiness; without it, our moods start to suffer and depression often follows. Feeling socially isolated is also one of the major risk factors for suicide. We found that teens who spent more time than average online and less time than average with friends in person were the most likely to be depressed. Since 2012, that’s what has occurred en masse: teens have spent less time on activities known to benefit mental health (in-person social interaction) and more time on activities that may harm it (time online).

Teens are also sleeping less, and teens who spend more time on their phones are more likely to not be getting enough sleep. Not sleeping enough is a major risk factor for depression, so if smartphones are causing less sleep, that alone could explain why depression and suicide increased so suddenly.

Depression and suicide have many causes: genetic predisposition, family environments, bullying and trauma can all play a role. Some teens would experience mental health problems no matter what era they lived in.

But some vulnerable teens who would otherwise not have had mental health issues may have slipped into depression due to too much screen time, not enough face-to-face social interaction, inadequate sleep or a combination of all three.

It might be argued that it’s too soon to recommend less screen time, given that the research isn’t completely definitive. However, the downside to limiting screen time – say, to two hours a day or less – is minimal. In contrast, the downside to doing nothing – given the possible consequences of depression and suicide – seems, to me, quite high.

It’s not too early to think about limiting screen time; let’s hope it’s not too late.

 

Link to Guardian article here 

Please follow and like us:

Screen teenagers annually for depression, say US doctors

 

The American Academy of Pediatrics suggests that annual checkups from the age of 12 could ensure those with depression get appropriate and timely help.
 The American Academy of Pediatrics suggests that annual checkups from the age of 12 could ensure those with depression get appropriate and timely help. 

Should teenagers face annual screenings for depression? Under new guidelines from an American doctors’ group, all children aged 12 and above would be questioned about their mental health every year.

On Monday the American Academy of Pediatrics (AAP) published new guidancethat adolescents should be examined every year from the age of 12 to ensure those with depression can get timely help.

Meanwhile, on Friday, the UK government finished consulting on a green paper on adolescent mental health, which focuses on early intervention and suggests schools should play a more central role. Strategies include mental health awareness training for school staff and incorporating mental health into personal, social and health education lessons.

Many teenagers are not diagnosed until adulthood, and doctors believe helping vulnerable teenagers early on could help prevent them suffering in silence. Mental health campaigners have said screening for depression is just one piece of the puzzle.

“My depression started during my childhood and worsened from the age of 13, and I was admitted into hospital at 14,” said 21-year-old mental health campaigner May Gabriel.

Gabriel said if she had been screened for depression at 12 she might have received treatment before she became so ill she attempted to take her own life.

“Many young people are not sure where or how to get help, or even that they may need help, and integrating mental health with regular services in this way would enable more young people to get help.”

Sarah Kendrick, of children’s mental health charity Place2Be, said more than half of all mental health problems start before the age of 14.

“It is by picking up on problems early and helping children and young people to build their resilience that we can equip them with the tools they need to cope with life’s difficulties and to thrive as adults,” she said.

“Continuous support, and an open environment in which [children] are encouraged to talk about their feelings, enables early identification of any problems or challenges.”

Universal screening as advocated by the AAP would involve doctors giving teenagers questionnaires on their emotional wellbeing to complete as part of regular checkups.

“Teenagers are often more honest when they’re not looking somebody in the face,” Dr Rachel Zuckerbrot, a child psychiatrist and professor at Columbia University who authored the guidelines, told NPR.

However, many campaigners believe integrating discussions about mental health into conversations in schools and improving the help available are integral to solving the issue.

An NSPCC spokesperson said screening for mental health conditions could help normalise conversations about depression, but must be accompanied by easy access to support services.

“The government must build on the proposals in its recent green paper to ensure all children who need it can access high-quality and timely mental health support,” they said.

“The big question is what happens when you screen positive [for depression],” mental health writer and campaigner Mark Brown said.

“I assume that in the US that means a referral to a specialist covered by health insurance. In the UK, a referral … for every young person who screened positive would have no chance of working, given current resources.

Some experts also have reservations about the recommended age of 12, particularly as UK doctors are hesitant to prescribe antidepressants to minors.

In the UK, the NHS does not usually recommend antidepressants to those under the age of 18, as there is some evidence they may trigger suicidal thoughts and affect brain development.

Dr Vikram Patel, professor of global health at Harvard Medical School, said there was no global precedent for screening at such a young age.

“I would advocate for screening, though I am not convinced this needs to begin at such young ages, as the incidence of depression is relatively low compared to later in adolescence,” he said.

Patel suggested screening should be twinned seamlessly with a treatment programme including psychological interventions and antidepressant medication.

“In my view, this is one of the most important opportunities to the detection, diagnosis and appropriate care for depression,” he said.

 

Link to Guardian article here 

Please follow and like us: