Children’s mental health in the pandemic: An opportunity to water the roots not just tend to the garden

It’s great that children and young people’s mental health is being brought into the spotlight with the appointment of a new Youth Mental Health Ambassador. But let’s not allow the Government to use lockdown and school closures as a scapegoat for the rise in mental health problems we’ve seen as a direct consequence of a decade of austerity.

It’s great news that Dr Alex George has been appointed Youth Mental Health Ambassador by the UK Government. Alex is clearly someone who is passionate and knowledgeable on the subject and who sadly has first-hand insight into the impacts of poor mental health on people’s lives with the death of his brother to suicide last year.

It is especially welcome that Dr George wants to see mental health prioritised on the curriculum alongside core subjects, a call that many education and mental health charities have been making for some time. Given the onset of many mental health disorders in childhood, with up to half of adult cases beginning during the school years, tackling this issue couldn’t be more important. Schools and colleges have a crucial role to play in recognising and supporting children’s mental health and well-being. They can promote the social and emotional skills which help children manage their emotions and develop positive relationships. And they act as an important buffer to the potential risk factors resulting from childhood adversity. All reasons why in the current lockdown situation it’s so important that children and young people get back to school and college as soon as possible.

We’ve come a long way – as someone who felt so desperate at school that I finally stood in front of my school office counter, crying and asking for help, only to be given the number of a counsellor, with no follow up whatsoever (let alone a call to my parents), I am relieved for this generation that children’s mental health is finally being taken seriously. The emphasis on mental health we’re now seeing in schools is a huge leap forward and is sure to not only change many children and young people’s lives, but to save many too.

But let’s ensure that the Government can’t get away with using the pandemic and school closures as a scapegoat for the rising mental health crisis we are now witnessing. Yes the impact on children and young people is huge but this was a crisis long before Covid-19 hit. We need to shine a light on why there is such a growing prevalence of mental health problems in the first place.

The causes of mental health difficulties are of course multiple and complex. But whilst they include hereditary and biological factors, just as important are psychological and environmental factors such as trauma and stressful living conditions. Neuroscientists and psychologists are now able to tell us so much about how early adversity impacts on mental health in childhood and throughout people’s lives and about the delicate interplay between risks and protective factors in children and adolescent mental health.

While the goal of putting an educational psychologist in every school is to be welcomed, really addressing mental health issues in children and young people requires unravelling a decade of austerity (not to mention the years of ever-growing individualism and meritocratic striving which preceded it – see for example Michael Sandel’s brilliant The Tyranny of Merit).

Addressing children’s poor mental health means tackling the underfunding of the health system and CAMHS, the underfunding of youth work, and the underfunding of schools. It means supporting teachers’ own social-emotional well-being, those expected to do so much but who are under so much pressure to improve attainment that they often have little time to focus on social and emotional development. It means supporting parents, relieving stress brought about by unstable job situations, insecure housing and lack of money to pay for food.

This requires far reaching measures to address inequalities in society and makes creating an Ambassador for Youth Mental Health position look a little like a PR stunt. The scientific evidence is there and the Government must not gloss over the fact that, as studies such as the Millennium Cohort Study have demonstrated, the prevalence of severe mental health problems in children is strongly related to social inequalities, which is sadly being thrown into stark relief by the current situation. 

While steps have been taken in moving away from a biomedical understanding of mental health and towards much more cognisance of social and psychological factors, there remains too much resort to medication and addressing the symptoms rather than the causes of poor mental health. We know that the first few years are key to an individual’s mental and physical health. If the science of early childhood development were really to be taken seriously, what would this say for policy around maternity and paternity care, addressing social disadvantage and the conditions under which people live, quality early childcare, support for parents’ well-being and so on?

There is a desperate need to implement a long-term preventative approach which actively promotes social and emotional health in children and doesn’t wait until mental health problems emerge. It is shocking that we have a system where kids can’t be seen by mental health services because their self-harm didn’t meet the levels needed for it to be taken seriously. Let’s put much more focus on promoting positive mental health – what do children need to thrive and lead happy lives? As well as understanding and responding to the impacts of the pandemic, this perfect storm is a prime time to make supporting the social and emotional health of our children and young people a national priority and bring into being some thorough-going changes.

The Government needs to stop offering quick fixes to deep and complex problems and deal with issues at the root. Their strategy towards mental health mirrors their approach to every social issue; they tackle racism through pouring money into anti-bias training for example but fail to address the structural inequalities which are responsible for people developing prejudiced attitudes in the first place.

I wish Dr Alex the best of luck in his important new role. Let’s hope that the flattery and bluff of the Prime Minister and the small PR-friendly gestures they will concede will not deter him from using this as an opportunity for a deep critique of the status quo. We have got to highlight the part that Government policies have played in worsening mental health conditions over the past decade and more, well before the fall out we are now witnessing in mental health due to the pandemic. On behalf of this generation of youth who are suffering the consequences of so many failings of those who’ve gone before, my plea to the new Ambassador is to make sure that the Government’s response to the crises in our children and young people’s mental health is more than just a sticking plaster over a gaping wound.