Turning growing up into going mad
A new campaign to tackle ‘ignorance’ about mental health issues among the young pathologises being a teenager.
As someone who endorses spiked’s ambition to raise the horizons of humanity it may seem paradoxical for me to argue that at times ignorance can, indeed, be bliss. Certainly it is preferable to the propositions of the multiple awareness-raising campaigns we are subjected to in relation to mental health.
According to a recent survey by Great Ormond Street Hospital in London, the youth of today are ignorant when it comes to mental health issues. The study of 500 young people concluded that almost half of British schoolchildren cannot name a single mental health condition.
For Dr John Goldwin, a consultant child and adolescent psychiatrist, such ignorance is not benign but is ‘probably one of the reasons why for too long now there has been a stigma attached to living with a mental health condition’. Dr Godwin is concerned that this stigma is preventing young people from talking about their problems, which are left to escalate to the point where youngsters injure themselves. It is reported that between one in 12 and one in 15 children and teenagers deliberately self-harm each year, with over 25,000 admitted to hospital due to the severity of their injuries (1).
Great Ormond Street Hospital plans to set up its own child mental health information website to complement the Children First for Health site that it currently runs (2). The argument is that raising awareness of mental ill-health among the young will lower the incidence of self-harm.
Now, I have great respect for many mental health professionals working with children who do indeed have serious emotional problems, and Great Ormond Street is often at the forefront of this. Nevertheless, there are some problematic assumptions around this debate and the proposed solutions.
First, it is difficult to predict with accuracy the true scale of deliberate self-harm among young people. For example, statistics can include a wide range of instances that are classified as acts of self-harm, from cutting (usually wrists and arms), bone breaking and gnawing at flesh to over-consumption of alcohol or drugs.
So the statistical rise in self-harm could partly be explained by the rise in alcohol consumption among the young. Yet most young people view getting drunk as a rite of passage or as teenage experimentation, rather than as an act of deliberate self-harm due to an undiagnosed mental health condition.
Similarly, definitions of what constitutes a mental health problem in children can be very wide-ranging – from the severe psychotic and eating disorders, which are thankfully rare, to things like attention-deficit hyperactivity disorder (ADHD), awkward, aggressive and anti-social behaviour. Also included are street drug or alcohol abuse, stopping sports you used to enjoy and truanting. This just about covers every pupil in my old school.
What we are seeing here is the pathologisation of childhood and social problems, rather than any significant rise in mental disorder amongst children. As social attitudes to childhood change, so does the way we relate to the young and their problems.
For example, in his excellent study on the rise of ADHD, Sami Timimi, a consultant child psychiatrist, notes how the rise of Ritalin to control children’s behaviour coincided with the moral condemnation of corporal punishment (3). In other words, as it became less socially acceptable to smack our children it became more acceptable to drug them.
Moreover, it is far from clear that setting up yet another child mental health information website will do any good. We already have MIND, Young Minds, Childline, Careline, the Mental Health Foundation and the NSPCC, to name but a few. If such services were successful then surely we would not need another one now. In fact, it could be argued that awareness-raising campaigns are not only unsuccessful, but that they can make the problem worse, by increasing our anxiety as we focus on myriad potential dangers to our physical and emotional well being.
There is also a real danger that such awareness-raising campaigns will weaken the parent-child relationship by introducing a third party ‘expert’ to inform the young not only about how they should act, but also how they should feel. This can be seen in the advice given on Great Ormond Street’s website which, far from being the province of psychiatric wisdom, informs children, amongst other things, to eat a healthy and varied diet, exercise, get a good night’s sleep, talk through problems and avoid nicotine and alcohol (4). This is all good parental advice in my book.
Why should children and young people dwell on psychiatric problems or attribute the emotional angst of growing up as a manifestation of a mental disorder that requires professional intervention? The vast majority will navigate the journey to adulthood without major problems, and this will be done more successfully if they focus more on the world outside their heads.
If young people are indeed ignorant on mental ill-health, it is something they will come to learn about from age and experience. So they might come to see that the role of the expert professional in identifying mental illness is grossly exaggerated. It is a common misconception that psychiatrists are the people to first identify bizarre behaviour. In actual fact, it is usually the sufferer’s relatives, friends, neighbours or the police who make the initial diagnosis that something is wrong. The person then gets taken to a psychiatrist who gives the behaviour a more specific diagnosis and formulates a treatment plan. This would indicate that, if left alone, the ‘ignorant’ youth of today will become the primary diagnosticians of tomorrow.
I suspect that even today many young people can identify when someone is in severe mental distress, even if they cannot give it a specific name. What they are not doing is pathologising their own and their friends’ more mundane experiences, however unpleasant they may be, as a mental disorder. This is one instance where the professionals could learn from the youth.
Ken McLaughlin is a senior lecturer in social work at Manchester Metropolitan University, England. His book Social Work, Politics and Society: From Radicalism to Orthodoxy is published by Policy Press.
Ken McLaughlin said widening definition of mental illness and the increase in therapeutic measures put strain on mental healthcare. He called the introduction of the Mental Capacity Act a mad affair, and wondered whether multiculturalism could be bad for your mental health. The war against anger made Brendan O’Neill see red. Dr Michael Fitzpatrick urged us to get off the couch. Or read more at spiked issue Mental health.
(1) Young ‘ignorant on mental health’, BBC News, 7 September 2008
(3) Naughty Boys: Anti-social behaviour, ADHD and the role of culture, by Sami Timimi, Palgrave, 2005
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