What Happened to the Mental Health Crisis among Younger People?

Before Covid-19 struck, mainstream media were constantly raising the alarm about a mental health crisis among younger people. However, during this pandemic, the mantra protect the NHS has been drummed into us so hard that mental health care has been side-lined. Although concerns are now being expressed about the psychological impact of lockdown, one presumed cause of the pre-Covid crisis is touted as the new normal: reliance on digital devices and remote interaction. Loss of face-to-face contact is inevitably detrimental. Yet campaigners and educationalists are doing little to oppose the draconian restrictions—indeed, many have urged the closure of schools and universities.

Back in the old normal of 2019, colleagues from King’s College London and I conducted a study on the perceived mental health crisis (the study has yet to be published and has now been superseded by events). There was evidence that younger people were struggling: a cohort study by Yvonne Kelly and colleagues showed that 24% of fourteen-year-old girls had depressive symptoms; Childline reported a rising tide of calls from children with suicidal feelings; and government data showed an increase in student suicides. As a mental health lecturer, I was perturbed by millennial culture’s elevation of vulnerability to a virtue, a phenomenon described by Jonathan Haidt and Greg Lukianoff in The Coddling of the American Mind. But was there really an epidemic of mental illness among our youth?

Our study focused on the role of the national newspapers, both print and online. The press has always influenced public attitudes towards mental illness. In the past, stigmatising stereotypes were standard fare, but there was a turning point following the outrage caused by the Sun’s use of the headline “Bonkers Bruno,” after the popular boxer was admitted to a psychiatric unit under the Mental Health Act. Mental health is a prominent topic in younger people’s discourse, and newspapers may enhance awareness and understanding. However, alarmist reporting could be harmful.

We examined coverage by tabloid newspapers (Daily Star, Sun, Daily Mail, Daily Mirror, Daily Express) and broadsheets (Guardian/Observer, Daily Telegraph, Times, Independent), including Sunday editions, over a three-year period from 2016 to 2018. Using the LexisNexis newspaper database, we ran an automated search for the term mental health crisis and screened for articles relating to adolescents and young people (aged 10–24, according to the World Health Organisation definition) in the UK. Of the 191 qualifying articles, the broadsheets accounted for 151 (79%), with 32% in the Guardian alone. Five main themes emerged from our content analysis.

1: The Internet Is Toxic for Teenagers

The most commonly reported cause of mental health problems was the internet, especially social media. The Times covered a Legatum Institute think tank report recommending that parents “put down their smartphones and tablets and spend more face-to-face time with their teenage children to avert Britain’s adolescent mental health crisis.” Another Times article stated that “Instagram is worst for children’s mental health,” due to compulsive use, sleep disruption and “fear of missing out.” The Daily Star reported a study showing that “smartphones and iPads are making kids behave badly,” and opined that addiction to social media was “fuelling a mental health crisis.” In the Daily Mirror, child welfare campaigner Esther Rantzen blamed the internet for family breakdown, while columnist Miriam Stoppard warned that screen time is “toxic for teenagers.”

The Daily Telegraph launched a duty of care campaign to improve internet safety for children. Meanwhile, the Times campaigned for the regulation of social media companies, citing Head of NHS England Simon Stevens’ call for “a levy to fund treatments for a mental health crisis that they are helping to create” and Higher Education Minister Sam Gyimah’s analogy with a petroleum company’s liability for an oil spill.

2: Girls Are More Vulnerable than Boys

The Times described a University College of London survey of fourteen-year-old children who were part of the Millennium Cohort Study. Asked how often they felt miserable, lonely or unloved or hated themselves, 24% of girls scored highly, compared with 9% of boys. Drawing on the same study, the Guardian quoted researcher Nihara Krause’s conjecture that girls with a “hyper brain” have “a much higher emotional reaction” and are “constantly overthinking things.”

Pressure to be perfect was highlighted, with girls said to be perpetually comparing themselves with peers on social media. The Guardian frequently quoted Natasha Devon, the then government advisor on mental health in schools, who remarked that “girls are taught anger is unacceptable and boys are taught showing distress is unacceptable.” In the Guardian, Bernadka Dubicka of the Royal College of Psychiatrists blamed body dissatisfaction for increasing self-harm by girls. The Daily Mirror reported a freedom of information enquiry showing that 115,596 girls had visited hospital after self-harming, compared with 21,721 boys. The Telegraph and Guardian emphasised the highest ever number of female suicides in the 15–19 age bracket (56), although over two thirds of the total of 177 suicides were male.

While gender was cited in these articles as a prominent factor, differences in help-seeking behaviour were rarely considered. For example, the Independent interviewed a psychotherapist with nine times as many female as male clients and suggested that this reflected an extreme disparity in the incidence of mental health problems. Articles tended to feature female cases, as did a Sun report—despite stating that 97 of the 130 students who committed suicide in the previous year were male. Feminist writers blamed sexism. “Patriarchy is costing young women their mental health,” wrote Harriet Hall in the Independent: “why are we still twiddling our thumbs wondering what could possibly be the cause of their suffering?”

3: Schools and Universities Are Overwhelmed by Mental Health Problems

Many articles blamed exam stress. A Telegraph article quoted educationalist Sir Anthony Seldon’s plea that schools be reorientated from “exam factories” towards holistic personal development. The Telegraph also reported that Higher Education Minister Sam Gyimah had urged universities to prioritise mental health over learning. In a Guardian feature, a student services manager at Nottingham Trent University attributed the high incidence of anxiety and depression to “the burden of student debt, economic uncertainty, global political upheaval and apocalyptic climate change.” In the Independent, Benjamin Clayton proposed a “mental health league table for universities.” An upward trend in campus suicides was highlighted by newspapers, but without accounting for the growth in numbers of younger people attending university.

4: Politicisation of Mental Health

Left-wing newspapers such as the Daily Mirror repeatedly criticised the Conservative government’s penny-pinching on mental health services. The Independent published an open letter to the health secretary by a carer representing the Royal College of Psychiatrists, under the heading “Mr Hancock, this happened to my daughter as a result of the mental health crisis.” The Guardian’s Frances Ryan commented that “Our children’s mental health crisis is shocking, but so is the Tory silence” and opined that suicidal children were being abandoned.

5: Nurturing Resilience

There was a consensus in favour of more coaching in mental health and wellbeing for younger people, to boost resilience. Psychiatrist Max Pemberton, in his Daily Mail column, argued that “too many of today’s teens and young adults have not been taught to deal with frustration, conflict, failure, boredom or even just plain old unhappiness.” Young people were adaptable and not as fragile as portrayed, according to Times columnist David Aaronovitch, who criticised psychologist Jean Twenge’s oft-cited book The Narcissism Epidemic and its “doomed generation” message. In the Guardian, however, Natasha Devon “condemned those who said the younger generation needed to toughen up to deal with the stress of life.”

Moral Panic?

The mental health crisis tended to be presented as fact, although numerical evidence appeared in less than a third of articles. Indeed, official statistics showed no significant increase in mental illness among younger people. As journalist Evan Davis explained, the favoured narrative reinforced a pervasive view that was immune to counter facts. Many of the reported surveys did not refer to diagnosed mental illness but self-reported feelings, potentially pathologizing the angst of adolescence. The siren was shriller in the broadsheets, perhaps reflecting greater mental health awareness among worried middle-class parents.

The internet is a double-edged sword. Although some academic studies have found correlations between social media and psychological problems, this is not conclusive evidence of causation, as my systematic literature reviews in Adolescent Research Review and the International Journal of Adolescence and Youth have shown. According to the social compensation hypothesis, online communication is beneficial to shy or anxious young people, but, according to Robert Kraut and colleagues, “the rich get richer”: the socially skilled gain most, while the less adept are prone to adverse experiences. Certainly, there are hazards on social media, such as addictive use, harmful sexual content, trolling and cyber-bullying, but the personality of the user is probably the most important relevant factor.

Articles relied heavily on experts, whose judgment was not always objective: often the platforms were used to demand more resources. In their generally longer articles, the Guardian consulted charity leaders, campaigners, politicians and psychologists, as well as some pessimistic students. Yet a mere eight of its reports featured a psychiatrist.

Some psychiatrists have criticised the catastrophising of mental health by the media. Arguing that the “epidemic is a myth,” Richard A. Friedman explains:

There is a difference between an anxiety disorder and everyday anxiety. The first impairs people’s ability to function because they suffer from excessive anxiety even when there is little or nothing to be anxious about. The second is a perfectly normal and rational response to real stress. Teenagers—and people of all ages—will and should feel anxious occasionally.

Child and adolescent psychiatrist Sami Timimi warned against mental health obsession in the Sunday Express: “We need to stop the anti-stigma campaigns and try to de-medicalise the area … We are making a big mistake and instead of alleviating problems we are creating a group of people who believe they have enduring mental health problems.”

Overall, newspapers appeared to be contributing to a moral panic, which criminologist Stanley Cohen has defined as “a situation in which public fears and state interventions greatly exceed the objective threat posed to society by a particular individual or group.” Cohen viewed the reaction to battling mods and rockers in the 1960s as a social emergency created by politicians and the media. However, whereas older generations have traditionally chided teenagers for antisocial behaviour, the youth of today is seen as endangered rather than dangerous.

The Impact of Covid-19 and Lockdown

An 2019 Action for Children survey of young people found that the biggest concerns were bullying (61%), exams (60%), peer pressure about appearance and behaviour (55%), terrorism (49%) and climate change (48%). Each generation has faced challenges, but more attention is paid to these concerns than in the past. The impact of the Covid-19 regime, however, is likely to dwarf the perceived mental health crisis of the period before March 2020.

The adversities are obvious. On the BBC podcast Generation Covid, presenter and King’s College London researcher Sally Marlow said:

Rates of mental illness were already escalating pre-Covid, and services and treatment to support those struggling were woefully inadequate. Add to that social isolation throughout lockdowns, uncertainty about exam results, and parental anxiety about jobs and finances, and all the ingredients are there for mental health to worsen.

Many young adults live in single occupancy dwellings, there are fewer available jobs in hospitality and retail, leisure and nightlife have been severely curtailed, and the news and social media incessantly spout alarm. A year has already been lost, with prospects of worse to come. I shudder in anticipation of the suicide statistics for 2020. Yet the BBC podcast was typical in failing to see the wood for the trees. The argument was that inequality is exacerbated by Covid, and that mental health support should expand. But there was no criticism of lockdown, as if it were merely incidental, rather than the most destructive state intervention in young people’s lives since the slaughter of the First World War.

If the mental health crisis before Covid was a self-fulfilling prophecy, apparently now the reverse is happening. Mainstream media cried wolf then, but now that a real crisis is emerging they have little to say.