The Child Mental Health Crisis Debate: Part 1July 16, 2016
I’ve written a few blogs recently that touched on children’s mental health, and particularly claims of a crisis.
In The Trendiest Current Arguments For Progressive Education Part 1 I mentioned that children’s mental health is increasingly being used as a weapon in the debate about progressive and traditional education:
I have seen increasing attempts to blur the line between actual mental health issues, and any kind of emotional discomfort for children. I have seen bullying described as a mental health issue. I have seen people take the leap from concern about mental health, to the importance of “wellbeing” , or “resilience” as an aim of schooling and then to a downplaying of the academic purpose of schooling, or the need for knowledge. Most commonly though, I have seen “stress” and “anxiety” join “self-esteem” as an argument against various traditional practices, from strict discipline to setting exams. Indeed, the idea that children are traumatised by exams seems particularly popular at the moment, often tied to the bizarre claim that the amount of exams children sit is being increased by politicians.
In Lies, Damned Lies and Child Mental Health Statistics I observed that a number of interested parties (particularly the charity Young Minds and the now sacked “mental health champion” Natasha Devon) were claiming that children’s mental health problems had massively increased, by misusing and misinterpreting statistics.
In The mental health fad in schools I explained why, despite children’s mental health being a legitimate concern to have, the currently fashionable preoccupation with it should be scrutinised:
- Teachers are not therapists and not doctors. We can try to be supportive and we have an important duty to try to refer students to those who can help. But we are not qualified to treat mental health problems.
- Like SEN, mental health is full of folk tales and quack treatments. Anything done to support people with mental health problems, or to prevent mental health problems, should be based on the best evidence and judged by people with appropriate clinical qualifications. Even some of the treatments with the best average effects are ineffective or even harmful in some cases.
- The causes of mental health problems are complex. It is simply not good enough to assume that anything any child could worry about is a cause of mental health problems that has to be eliminated. The aim of removing worry from childhood, anxiety from adolescence or pressure from studying is not a realistic one.
- Charities working with young people should not be given a free pass. We know from Kids Company that it is perfectly possible for them to be wasting money on vanity projects. It is not impossible for them to be promoting nonsense or ripping off schools. They should be scrutinised, just as schools should.
Now a lot of the recent wave of concern seems to have been a result of the government’s ill-judged decision to give credibility to Natasha Devon a charity worker who has promoted crank therapies, abused people online and used mental health as an excuse to attack testing. But moving on from her, are there serious questions to answer? Could there be a children’s mental health crisis? If so, could it have something to do with our education system?
Much of the question of whether there is a crisis comes down to the analysis of statistics. Studies of the prevalence of mental health problems can only really measure a few things. Many are based on self-reporting, which is highly subjective and subject to fashion and tends to result in really large numbers of people being considered to be mentally ill. Statistics gathered this way have resulted in claims that 1 in 10 children and 1 in 4 adults have mental health problems in the past year, the majority of people have mental health problems in their lifetime and that 30% of children feel depressed all or most of the time. Some are based on clinical data which are shaped by people’s decision to seek help, which again is highly subjective and subject to fashion. Clinical data based on diagnoses might be more accurate that based only on numbers seeking help, but it will still be shaped by who actually seeks help, and in the long term by changing standards of diagnoses. On top of that there are huge debates over the nature of mental health problems, with both philosophical and clinical debates over what counts. It is the easiest thing in the world to cherry-pick statistics to show a crisis, and the hardest thing in the world to get reliable evidence that would actually answer the question of whether there is a crisis.