The public cries of “crisis” are in the air, especially when it comes to child/teen mental health in the schools. Britain’s government-appointed Mental Health Champion, Natasha Devon, rang the latest alarm bell in The Telegram (April 29, 2016) claiming that the “child mental health crisis is spinning out of control.” In issuing her “Mental Health Manifesto” for Britain’s schoolchildren, Devon frequently cites a scary figure to buttress her public claims — the statistic that “rates of depression and anxiety among teenagers have increased by 70 per cent in the past 25 years.”
Not everyone accepts her public pronouncements at face value — and a few are looking more deeply into the nature, definition, and prevalence of the so-called “child public health crisis.” Devon’s further claim that it constitutes an “epidemic” has sparked even more skepticism. Is this the proverbial twenty-first century equivalent of “crying wolf” or just a manifestation of our contemporary tendency to ‘pathologize’ social-psychological trends?
One of Canada’s leading teen mental health experts, Dr. Stan Kutcher, devotes his life to educating teachers, students and families about mental health disorders, but he is very skeptical about overblown claims. When asked about the purported “crisis” at St. Francis Xavier University a few weeks ago, he startled a local newspaper reporter with this statement: “there is no mental health crisis for crying out loud.”
Dr. Kutcher was not minimizing the severity of the problem, but rather questioning the veracity of some of the recent public claims. “We have the same proportion of mental illness in our society now that we had 40, 50, 60 years ago,” he explained. “There is no epidemic of illness, there is better recognition of illness, which is good but what we’re seeing now is an epidemic of ‘I think I have a mental disorder when I’m just really feeling unhappy,’ and that is a direct reflection of poor mental health literacy.”
Like many health professionals, Dr. Kutcher sees the popular media as contributing to the public misunderstanding about the nature and prevalence of mental disorders. He’s critical of those who exaggerate the “crisis” and equally concerned about others too quick to dismiss
it as a ‘teenage fad.’“Now the depression happens in adolescents and depression is a serious disease and if you have depression you need the proper treatment for depression, but feeling unhappy, that’s not depression,” he said.“So I think a lot of people have become confused with all the talk about mental health and mental illness without the literacy to understand what they’re talking about.”
Stress and distress is not all bad, according to Kutcher. “People do have daily distress, that is normal, ubiquitous, necessary and good for you,” he said.“And all of us are going to have a mental health problem like the loss of a loved one, moving to a new city, losing your job – those are substantive challenges in our lives and we need extra help for that. But those two things aren’t mental illnesses and they don’t need to be medicalized, they don’t need medications, they don’t need specialized psychotherapy, they don’t need access to the mental health care system.They can be dealt with, the first one, mental distress, by yourself with your friends. The second one with special support, sometimes counselors, sometimes your clergy, whoever.”
As the Sun Life Chair of Teen Mental Health at Dalhousie University Medical School, Kutcher’s assessment carries considerable weight and he makes the critical distinctions that the popular media tend to completely miss: “Mental illnesses are different; they need specialized treatment like a treatment for any illness. But one of the challenges we have is that socially we’re tending to confuse mental distress and mental health problems with mental illness. So, because I feel unhappy today I feel like I should have therapy, because I take umbrage at what you said to me I have an anxiety disorder, that’s not true at all.”
Dr. Kutcher seems to dispute the whole approach taken by Britain’s Mental Health czarina and ‘body health’ counsellor, Natasha Devon. While Devon and her Self-Esteem Team (SET) target standardized tests and exams as “stress-inducers,” Kutcher and other specialists, including Dr. Michael Ungar, see value in competitive activities in developing “resilience” in teens. Dr. Kutcher puts it this way: “We have to be very careful to differentiate the slings and arrows of outrageous fortune in real life which we have to learn to deal with and overcome, and for which we don’t need treatment, and those things which actually require treatment.”
Mental health disorders are serious and providing more accessible, effective and sustainable services should be a top public policy priority, inside and outside of schools. “Teenage angst,” as Ella Whelan recently pointed out, “is not a serious mental health issue.” It is important to carefully consider all public claims for their veracity and to be skeptical of mental health charities seeking to “normalize mental illness.” We must also recognize that “not all of the kids are all right.” Nor are mental health services accessible or available when and where they are needed in and around the schools. Therein lies the real problem.
What ‘s driving the public call to address the “child mental health crisis” in schools? Are school authorities and educators equipped to make the critical distinction between normal ‘mental health stresses’ and serious disorders requiring treatment? Is there a danger that those ringing the alarm bells are ‘pathologizing’ teenage anxieties and stress? Is it possible to identify and support those in serious personal crisis while recognizing that competition and stress develops ‘resilience’ and is part of healthy preparation for life?
Educhatter 
While I might think that we live under more stress these days, especially since the decades long post WW2 boom has led to economic stress, I suspect Dr.Kutcher has some points to consider
– the media may overhype this mood (Donald Trump and the general malaise in the US despite economic progress since 2008
– we are better / or are we quicker to diagnose mental illness?
– a century ago such illness was ignored or unrecognized
– decades ago students under stress in school just dropped out and got jobs that today do not exist or require more than grade 8 education
I hope the answer to the last question above is YES, but schools and their communities and the larger society have to work at at least separating myth from reality.
Steven Pinker’s The Better Angers of Our Nature is one book that should be read to put this in the widest historical context.
One trend in schools with increasing research to support its role in promoting student achievement is the explicit work in social and emotional learning (noted in an earlier thread).
One challenge in looking at non-academic outcomes is determining their effects. When I worked with students repeating a credit and convincing them to persevere and supporting them while not dropping my standards (saw lots of this in math) I knew I was successful when they
– passed
– were proud that they did
– even took the same subject in the next grade
In a recent NY Times article looking at drop out rates in freshmen college the role of
– identifying students who struggle early then
– offering support and quality feedback
resulted in lowering dropout rates significantly
Agree with the suspicion regarding hyperbolic talk of a mental illness epidemic. Another factor underlying the hyperboli is the phenomenon that, with less exaggeration, might be described as an epidemic of psychology. Back in the 80s there was more of a tendency to see issues as political. That has waned, and what has taken its place is a growing tendency to psychologise social problems. Natasha Devon does it when she refers, for instance, to student debt and frames it as a psychological issue, driving up levels of anxiety. And we have been struck by discussions from American campuses where obviously political issues (to do with things like racism) are talked about in terms of things that individuals find “triggering”, thereby reducing the political to the psychological. There is a terrible narrowing of popular culture, whereby almost everything gets framed in narrowly personal terms.
In short, the diagnosis ails as much as the ailment being diagnosed.
Breaking News: Mental health champion for UK schools axed after criticising government
The Guradian, Wednesday 4 May 2016 19.04 BST
“The government has dropped its mental health champion for schools after she publicly criticised current education policies, in particular the testing regime, which she claims is detrimental to children’s mental health.
Natasha Devon was appointed by the government last August to raise awareness of and reduce the stigma surrounding young people’s mental health, as part of a wider £1.25bn drive to improve care.
On Wednesday, however, it emerged that the high-profile role had been axed, raising concerns that the government was attempting to silence her.
The Department for Education denied this, saying Devon would remain on their mental health steering group, which would be making recommendations in the summer.
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Supporters said they were not surprised she had been let go as she had become “a thorn in the flesh” of the DfE after speaking out against government policies.
Last week, at a conference of headteachers in London, she highlighted the academic pressures facing young people, saying she knew her opinions would not be popular in some circles, but felt she had to be brave and speak out.
“Time and time again over recent years young people – and the people who teach them – have spoken out about how a rigorous culture of testing and academic pressure is detrimental to their mental health,” she said.
“At one end of the scale we’ve got four-year-olds being tested, at the other end of the scale we’ve got teenagers leaving school and facing the prospect of leaving university with record amounts of debt. Anxiety is the fastest growing illness in under 21s. These things are not a coincidence.”
The DfE denied that the axing of the role was connected to Devon’s criticism of government policy, or that she was being silenced, but said it was because a new cross-government mental health champion was being appointed, which made Devon’s role obsolete.
Luciana Berger, mental health shadow minister, said Devon had spoken out “openly and honestly about the challenges facing children’s mental health under this Tory government.
“If she has been silenced then this raises serious questions over the government’s commitment to listening to the evidence and acting in the best interests of young people’s mental health and wellbeing.
“Ministers must explain themselves as a matter of urgency. Nicky Morgan [the education secretary] claims to be in ‘listening mode’ but it would appear that this does not extend to those that do not agree with her.”
A DfE spokesperson said Devon had done “a great job of helping us to raise the profile of young people’s mental health since her appointment last year.
“Since that time, the independent NHS taskforce report has been published, which recommended that a cross-government mental health champion be created – for this reason we have had to reconsider the department’s own role.
“We have asked Natasha and others who have been involved in our work to empower schools and young people to promote good mental health to continue to work with us as we prepare to launch our activity later this year.”
The spokesperson added: “Natasha will remain a full member of the DfE’s mental health steering group, which will be making recommendations this summer. Natasha will stay closely involved with all our work.”
Sarah Brennan, chief executive of the charity YoungMinds, said: “We are very surprised and sad that Natasha’s role as mental health champion has ended. She’s done a superb job of drawing attention to the crucial importance of mental health and wellbeing in schools.”
News of Devon’s departure came the day after hundreds of parents chose to keep their children at home on Tuesday in a day of protest against tougher primary school tests, which they claim are causing stress anxiety in schools.
But Devon’s criticism went beyond mental health in the classroom. In a column for the Times Educational Supplement she accused the government of engineering “a social climate where it’s really difficult for any young person to enjoy optimal mental health”.
She said parents “work every hour God sends”, which reduces quality family time, while spiralling poverty had pushed a million young people into dependence on food banks.
On Wednesday Devon told the Guardian she was assessing her options. “I can confirm that I am no longer authorised to comment as the government’s mental health champion for schools.
“The DfE have extended an opportunity for me to continue working on the peer-to-peer project they were seeking my advice on.”
She was also in talks regarding another offer, adding: “Either way I’m not going anywhere and will continue to campaign for the rights of young people and those who teach them.”
While Devon’s role with the government was unpaid to enable her to be completely independent and objective, the new cross-government mental health champion – which will be advertised shortly – is expected to be salaried.
Appointing her as the first ever mental health champion for schools, education and childcare, minister Sam Gyimah said: “Natasha is an inspiration to many young people and I’m delighted to have her on board as our first mental health champion.”
She is the founder the Self-Esteem Team and Body Gossip, organisations that deliver mental health education to young people and visit three schools a week, delivering classes to more than 50,000 teenagers, as well as parents and teachers.
Mary Bousted, general secretary of the Association of Teachers and Lecturers, said: “The department has got rid of a thorn in its flesh. Natasha has been a completely trenchant and very brave campaigner and advocate for children’s and young people’s mental health.
“She has spoken forcefully about teenage and children’s mental health and she has said really important things. Firstly that resources available for dealing with young people’s mental ill-health are inadequate.
“She has also said that the current government’s – and previous administration’s – education policies and the increase in testing have led to an increase in stress and pressure in schools.
“That will have really annoyed the department. I’m not surprised they’ve let her go.”
The problem belongs to those penny pinches and tax cutters who pour over public expenditure asking “is this really necessary”. They end up paying far more when inadequately treated teens become adults. Blowback is always more expensive.
Dr. Kutcher makes some excellent points. The distinction between mental/emotional health and bona fide mental illness is an important one, and one that can be difficult to make, even for skilled professionals. The true crisis I see is that we are not terribly adept or effective at dealing with either, personally or systemically. Many young people don’t have what they need in their lives – at school, at home, in the community – to cultivate resilience, feel genuinely and meaningfully connected to themselves and others, nor to discern the difference between emotional distress that can be worked through, and a mental health crisis that puts them or others at risk of harm. In my experience, school-based mental illness education programs done without a firm foundation of mental health/emotional literacy can exacerbate this. When my kids were in grade 5, I spent days delivering my own ad hoc version of mental health/illness education to them because they came home from school terrified that they had mental illnesses and needed immediate help.The same is true for many adults and media awareness campaigns, I suspect.
The ‘crisis’ is further compounded by various awareness and educational initiatives that tell people to reach out for help if they experience a checklist of things…and so they do reach out, only to discover that the help often isn’t available in a reliable, holistic, effective way, whether from the medical system or friends, family and community. Then, chronic un-supported mental/emotional distress can indeed escalate and morph into a more entrenched mental health issue with greater consequences.
Torn Halves also hit on another key point about this ‘crisis’: that popular culture has individualized, psychologized and pathologized issues that probably have much deeper collective, political, and sociological roots. Ironically, the more we individualize, psychologize and pathologize our distress about the state of the world and our own minds, the less able we are to mobilize for political and social change. I’m a firm believer that a solid streak of creative maladjustment is actually a mark of good mental health, and not something to be medicated or talked away, especially in our kids.
Maybe many of our kids (and our adults) are anxious and depressed because so many things we experience in our world are anxiety-provoking and depressing, and we’re not allowing for – or providing people with – the time and the diverse tools to process and work with that properly.
I’m currently reading Sherry Turkel’s “Reclaiming Conversation”, and she presents a grim view of children in an elementary school that she studied.
The book’s genesis was visit to a private school where the teachers were concerned that 9- and 10-year-old students were unable to organize themselves on the playground, they seemed to have the social skills of 6-year-olds. She found that they were lower-than-expected on the empathy scale, unable to put themselves in the viewpoint of other children.
This led Turkel to investigate the role and nature of our “plugged in” environments; ubiquitous phones and tablets always ready to distract and entertain us, and the consequent decline of solitude and disciplined self-reflection. One of her main claims is that lack of self-reflection leads to lower resilience, less independence, anxiety, and depression.
It’s a wide-ranging book and I have not finished it. But perhaps we should not discount that a whole generation might have mental health problems. I know this sounds extreme, but Turkel is not a fool and her arguments are carefully constructed and worth considering.
Here’s a quotation that I believe broadly summarizes Ms Turkel’s book:
“There is nothing wrong with texting or email or videoconferencing. And there’s everything right with making them technically better, more intuitive, easier to use. But no matter how good they get, they have an intrinsic limitation: People require eye contact for emotional stability and social fluency.
A lack of eye contact is associated with depression, isolation, and the development of antisocial traits such as exhibiting callousness. And the more we develop these psychological problems, the more we shy away from eye contact. Our slogan can be: If a tool gets in the way of our looking at each other, we should use it only when necessary. It shouldn’t be the first thing we turn to.
– – –
Two example papers are cited for the claim that “People require eye contact for emotional stability and social fluency”.
This is a deeply disturbing book, which should be read by all parents, educators, university students, and managers (and maybe everyone who uses facebook and twitter). Sadly the people who need it the most no longer can; their hyper-connected phones have wiped their capacity to sustain attention to read a book. Ask yourself if YOU can still sit are read for 2-3 hours at a time.
But “yes” to Educhatter’s question. We may be facing a new, unprecedented, and severe mental health crisis among the young.
You really want to save money in education can the gifted program or cut the funding by 75%. Any honest gifted program teacher will tell you there are only 3-4 actual gifted kids in a class of 22.
The rest are middle/upper class kids from well connected, pushy parents who won’t take no for an answer regarding their special child.
As much as I deplore testing I would demand either an IQ test of 150 or a very stringent SAT type test for entry. 3/4 would fail and please spare me the multiple intelligence horse feathers.
Much like French Immersion it is a scam in order to stream kids way too early and give special advantages to a chosen few within a public school system that was designed to treat kids equally as much as possible.
Reblogged this on The Echo Chamber.
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