Looking closely at the big picture: Children and Young People’s Mental Health

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Looking closely at the big picture: Children and Young People’s Mental Health

In this week’s blog, the fourth in our Children and Young People (CYP) series, Yasmin Smith, Lecturer in Nursing and Mental Health and Rebecca Reynolds @becksreynolds, Lecturer in Children’s Nursing from Plymouth University discuss the big picture in CYP’s Mental Health.

Problems in children and young people’s mental health are on the rise. “Epidemic”, “crisis”, “mental health explosion” – whatever the hyperbolic phrase of the day, the sentiment has been consistent for many years. Why is this? And how are we as professionals, supposed to stem the tide? In this blog we will, at break-neck pace, consider what might be the cause, how we can start to think differently, and what the evidence suggests.

Rates of probable mental health disorders in children increased by 50% in the post-COVID-19 landscape1.  Children have reported feeling unable to cope due to the scale of rapid changes to their lives2. The negative impact of the epidemic was disproportionately felt by the most deprived and vulnerable groups in society3. This is compounded by 85% of care givers reporting concerns about the subsequent cost of living crisis4. Stress adversely affects parenting quality, consequently, the economic impact of COVID-19 has directly compromised child development5.

Children are placed firmly at the centre of a number of interdependent systems, over which they have no control. They have maximum exposure to information through social media in a way that no previous generations had. The only context they have to understand this, is the stress they observe in the adults around them. Culturally they are exposed to negative rhetoric around different groups in society promoting apathy about the welfare of others. However, the literature recognises it is empathy for others which is a key quality in ensuring lifelong health6. Pervasive comparison culture presents a distorted reality with unrealistic, unattainable expectations, influencing children’s self-perception and view of the world, negatively affecting their wellbeing.

15-year-olds in England are among the saddest and least satisfied in Europe2. In England approximately 200 teens take their own lives each year, an issue which disproportionately affects young men7. Throughout Europe, UNICEF is condemning governments for paying lip service to the problem of children’s wellbeing and failing to appropriately fund services, particularly for specified vulnerable groups8.

Despite nearly 8% of the nation’s children having been referred to CAMHS, these and associated services represent only 1% of NHS spending9. In practice, this results in limited appointments and shorter treatment periods, forcing nurses to focus narrowly on only the problem in front of them, allowing no opportunity to explore the broader context and underlying issues. The symbiosis between physical and mental health is well established, so we must enable nurses to apply this knowledge for holistic practice.

Why should this matter to you as a nurse?

By attempting to understand individual young people’s circumstances and approach them with empathy and curiosity we can ask: what has happened to this young person? What is it like to live in this young person’s shoes? We open the possibility of an attuned conversation, and relational working. Only then, can a nurse start developing creative solutions and ways of working with families that support the factors which are actually making young people unwell. In a problem-focused culture, it’s easy to attribute blame to individual children, or specific groups of children. So often we hear about problems such as, school refusal, challenging behaviour, and self-harm. This is an embedded neoliberal trick, to get us locating problems inside of people, instead of inside the systems and structures which sculpt the environment children are raised in. There are so many factors which influence the health of modern children, in ways we are only just coming to understand. However, one cause is clear, children and families are a casualty of the short term ‘sticking plaster’ politics of the last 14 years10.

A call to action:

It is the responsibility of every nurse in every setting to consider how broader aspects influence the development of mental and physical health. We should challenge our own attitudes and beliefs around mental health in young people. We must not relegate the care of children’s mental health to specialist services only.

It takes a village to raise a child, as healthcare professionals we are observers of the village and embedded in it, so we must use our opportunities wisely and urgently.

References

  1. NHS Digital. Mental Health of Children and Young People in England, 2020: Wave 1 follow up to the 2017 survey. [Internet] 2020 [cited 2024 September 5]. Available from: https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-of-children-and-young-people-in-england/2020-wave-1-follow-up
  2. Children’s Society. The Good Childhood Report 2020 [Internet] 2020 [cited 2024 September 5]. Available from: https://www.childrenssociety.org.uk/information/professionals/resources/good-childhood-report-2020
  3. Marmot, M. Allen, J. Goldblatt, P. Herd, E. Morrison, J. Build Back Fairer: The COVID-19 Marmot Review 2020 [Internet] 2020 [cited 2024 September 5] Available from: https://www.health.org.uk/publications/build-back-fairer-the-covid-19-marmot-review
  4. Children’s Society. The Good Childhood Report 2022 [Internet] 2022 [cited 2024 September 5]. Available from: https://www.childrenssociety.org.uk/information/professionals/resources/good-childhood-report-2022
  5. Reich SM, Dahlin M, Tulagan N, Kerlow M, Cabrera N, Piroutek MJ, Heyming T. Caregivers’ Experiences During the COVID-19 Pandemic and Their Children’s Behavior. J Fam Issues. 2023 Apr;44(4):1093-1112. doi: 10.1177/0192513X211055511.
  6. Borba M. Why Empathetic Kids Succeed in Our All-About-Me-World. Surrey: Touchstone; 2017. 304p.
  7. Latest Statistics [Internet]. 2022 [cited 2024 July 3]. Available from: https://www.papyrus-uk.org/latest-statistics/.
  8. State of the World’s Children: On My Mind – Promoting, protecting and caring for children’s mental health [Internet]. 2021 [cited 2024 July 3]. Available from: https://www.unicef.org/eu/media/2021/file/State%20of%20the%20World’s%20Children%202021.pdf.
  9. Children’s Commissioner. Childrens Mental Health Services 2022-23 [Internet]. 2024 [cited 2024 July 3]. Available from: https://www.childrenscommissioner.gov.uk/resource/childrens-mental-health-services-2022-23/.
  10. Labour’s Child Health Action Plan Will Create the Healthiest Generation of Children Ever [Internet]. 2024 [cited 2024 September 5]. Available from: https://labour.org.uk/updates/stories/labours-child-health-action-plan-will-create-the-healthiest-generation-of-children-ever/.

 

 

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