The Child Mental Health Crisis Debate: Part 3

Continued from yesterday

As discussed in the previous two posts, there is every reason to doubt the existence of a general “mental health crisis” in children in the UK. However, here I want to ask whether if we were to accept that there were such a crisis, would we accept the progressive take that it is caused by exams or traditional schooling?

The main prompt I had to return to the issue of whether there was a child mental health crisis was listening to this BBC Radio 4 programme about children’s mental health in Sweden. There is a debate there that reflects our own, although the programme suggests there is more evidence for increased mental health problems among the young in Sweden. As presented in the programme, when it comes to suggesting causes for an increase in problems there has been no push to blame exams or traditional education (perhaps because the declining Swedish education is one the world’s most progressive, although they do still do exams). Other explanations are mentioned. Social media is one possible cause, as is a culture of encouraging young people to worry about their mental health and consider upsets to be problems, which then appear in statistics based on self-reporting. One of the most interesting ideas is from psychiatrist, David Eberhard. I heard him speak at the Battle Of Ideas in 2014 and he describes children who are indulged and protected from all obstacles at a young age, only to be identified as having mental health problems when coping with the ordinary difficulties of adolescence. Whether or not his explanation is correct, the claim that Swedish children are happy when young and unhappy in adolescence adds a genuine complication for those who wish to make childhood happier and less troubled in the hope that it will improve mental health in general.

So as well as a lack of evidence there is a crisis in the UK, we can suggest alternative explanations for the causes of the alleged crisis, were it to exist. But let’s press on and look at the progressive case, that seeks to blame it on exams or traditional schooling. The version I’ve been seeing for years, has consisted largely of assertions that countries with a more high pressure education system, particularly Korea, have higher youth suicide rates. There’s not great data on this, but what there is suggests that this is a best a myth (and at worst a racist lie).

Other than this, the only other “evidence” for exam stress causing mental health problems can be found in this blogpost by Debra Kidd. She claims:

• 29% of teenage suicides can be attributed to examination stress according to a report by The University of Manchester – the second biggest dominant cause. Again this must be reported with the caveat that there will have been other contributory causes.
• In 2014 Childline reported that for the first time ever, school and exam stress came into the top ten causes of significant stress for children. Way below bullying and family issues, but still a cause. In the 16-18 age group, there was a 30% increase in the number of depressed teenagers citing school/exam stress as the main cause of their distress.

The first of these seems to be misinterpretation or repetition of inaccurate news reports.  The actual study of 145 suicides, found antecedents for 130 of them. 35 (27%) of those who committed suicide were found to have experienced “academic (especially exam) pressures”. Yet this hardly makes it the cause of those suicides, and according to this review there was widespread misreporting:

Coverage in the UK media was widespread. Different organisations chose to highlight different factors from the report, perhaps reflecting their own interests.

For example, The Sun reported that, “The Internet played a role in a quarter of recent teen suicides in England”, while the Daily Mail stated that, “Drugs linked to one in three teen suicides”. The Times, The Guardian and The Daily Telegraph highlighted exam stress.

Not all news stories were clear that these factors cannot be seen as direct causes of suicide.

For example, most teenagers have exam stress and develop acne, and many dabble in drugs and alcohol. But, thankfully, most teenagers don’t kill themselves.

Given how common academic pressures and exams are, 27% seems, if anything, low particularly when you consider how vague the phrase “academic pressures” is and the fact that the age group would have included university students.

As for Childline, they have a real knack for press releases that raise an issue. A search for “Childline report increase” and “Childline record levels of” and a year will find calls relating to how the following have increased at some point:

• suicidal feelings;
• cyberbullying;
• self harm;
• five year-olds;
• attempting suicide;
• child sex abuse;
• sexual abuse by women;
• anorexia;
• mental health problems;
• bullying;
• eating disorders;
• drink and drug abuse.

Also they have reported increases in:

• Out of hours calls;
• Calls made by boys;
• Calls being answered;
• Total calls.

A search for “Childline report decrease” found nothing relevant.

This does not mean Childline are making things up; this simply means they know how to get a headline out of any set of data. Every problem will have a dramatic rise at some point, particularly if you compare to a low point, and particularly if the number of calls being made and being answered are increasing. We should not, for one second, consider reforming the education system due to such reports. Nobody denies that children can be stressed about exams and we should seek to help those who are. But the idea that exams are a major cause of children’s mental health problems seems to be without good evidence.

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