A mental ill-health epidemic in #FE or something else entirely?

Social influences, labelling or a mental health epidemic? Understanding learner mental-ill health and its drivers is critical for us as #FE educators.
Image credit: Tim Gouw (Unsplash, 2019)

PD North member Rebecca Gillett from Myerscough College shares her fascinating research into student mental-ill health.

“A mental health epidemic is underway in Britain’s schools” (Moran 2019)

 But is there really???

At the moment it seems that we are hard pressed not to pick up a newspaper, see posts on social media or internet news pages informing us that adverse mental health is on the rise. I too seem to be coming in to contact with more students each year that identify as having adverse mental health, a belief that seems to be shared by some colleagues. Ultimately, I have the same goal that I am sure is shared by all teachers; I want to ensure that I support students that identify as having adverse mental health to reach their goals, aspirations and achieve their full potential within the educational system. However, although I am empathic towards the plight of these students I do question if there is true rise in adverse mental health? Could there be other factors contributing to this apparent epidemic?

Scouring the internet to source figures that document the prevalence of mental health disorders in Britain, it becomes apparent that differing authors use different terminology and age rages. The differences in age ranges and terminology used to quantify data can sometime make it difficult to understand the true extent of the problem for the 16-18 year old age range. The best major survey to examine trends of mental health in Britain appears to be that completed by NHS digital in 2017 and published in 2018. This survey allows data to be compared to the previous surveys completed in 1999 and 2004. However, although these surveys seemed to be the best source of data on the prevalence of mental health disorders, prior to 2017 16-18 year old were not included in the samples. Therefore, it becomes very difficult to confirm that data validates the belief that there is a rise in mental health disorders.

The NHS digital survey documents 4 categories of mental health disorders; ‘Emotional disorders’, ‘Behavioural or Conduct disorders’, ‘Hyperactivity disorders’ and ‘Other less common disorders’. Stepping away from my interest in the figures for 16-19 year olds for a moment and viewing the data on the age bracket of 5-15 year olds, it becomes apparent that ‘Emotional disorders’ are the only category that has seen a rise in prevalence for children aged 5-15. Emotional disorders have risen from 4.3% in 1999 to 5.8% in 2017, all other groups have stabilised in frequency (NHS digital 2018). Included in the category of ‘Emotional disorders’ are 3 subcategorises; Depressive Disorders, Bipolar Affective Disorder/Manic Episode and Anxiety Disorders. Anxiety disorders includes conditions such as; Separation Anxiety, Generalised Anxiety Disorder, Obsessive-Compulsive Disorder, Specific Phobia, Social Phobia, Agoraphobia, Panic Disorder, Post-Traumatic Stress Disorder, Other Anxiety Disorders and Body Dysmorphic Disorder (Vizard et al 2018). However, it cannot be assumed that the 1.5% rise in emotional mental health disorders are directly transferable to 16-19 year olds, without having previous statistics to compare the current findings with. Approximately one in eight 17-19 year olds are documented as having an anxiety disorder and approximately one in twenty 17-19 year olds are documented as having a depressive disorder (Vizard et al 2018) but is this any worse than it was in 1999 for this age group?

Society is also not was it was; could the constructs of society also be contributing to the higher reported figures of children and adolescents’ with emotional mental health disorders? It is documented by Time to Change (2019) that the Attitude to Mental Illness survey indicates a 9.6% change in the attitude of the public during 2008-2016, with an estimated 4.1 million people having improved attitudes towards mental health. By decreasing the stigma attached to adverse mental health and creating a more accepting society this must surely lead to increased public confidence in disclosure of emotional mental health disorders. Maybe this epidemic has always been there; maybe we are now just aware of its existence. Could what we are seeing in the education system not be an explosive rise of emotional mental health disorders but adolescents’ that now just feel more comfortable in vocalising their troubles?

Looking on the flip side of the coin, could it also be argued, that a change in what degree of problem consists as an emotional mental health disorder has impacted on the prevalence of these conditions? Research has documented to me the belief of some authors that some children are identifying upsetting emotions as emotional mental health disorders. The definition of adverse mental health may have altered so much over recent years that normal human emotions are now being misidentified as emotional mental health disorders. Could a moral panic around adverse mental health be happening, McKinstry (2017) suggested that ‘gas-lighting’ is beginning to occur around mental illness; society is convinced that once normal, acceptable emotions are actually a sign of physiological illness.

Worryingly, could we be making the mental health epidemic worse with our ‘love’ of labelling?  Labels can be placed with the best of intensions; increasing the likelihood of access to services and support. However, if the threshold has changed between experiencing emotional difficulties and that which requires treatment, labels then placed for emotional mental health disorders will have increased in prevalence. It is also no secret that mental health services are struggling to meet demand, leaving adolescents’ that identify as having adverse mental health without the required support. Coupling this with the self-fulfilling prophecy, the placement of labels could be impacting on the figures for adverse mental health; placing a label of adverse mental health could cause the sufferers to identify more with the symptoms. Considering this with the belief that upsetting emotions could be being misidentified from sufferers as a mental health disorders in the first place, the self-fulfilling prophecy could then occur and perpetuate the likelihood of adverse mental health.

So circling back to where I started, is a mental health epidemic really underway? Figures support that there is a rise in emotional mental health disorder, albeit for a different age bracket. However, let’s assume for a moment that this figure rise is directly transferable to the 16-19 year old age bracket, it appears that it isn’t as simple as saying- “yes emotional mental health disorders are increasing”. Societal influences, changes within definitions and labelling all could have their part to play in an increasing number of adolescents’ with emotional mental health disorders. Whatever the cause, the statistics suggest that more adolescents’ will present identifying as having adverse mental health. Ultimately I suppose that as a teacher the cause of the rise in prevalence will have no bearing on lesson delivery but does help me to put in to perspective what current headlines are screaming at me.

References

McKinstry, L. (2017).  Our obsession with mental illness is far from healthy, (Online), Available from: https://www.express.co.uk/comment/columnists/leo-mckinstry/803114/mental-health-illness-campaign-lobby-depression-obsession-leo-mckinstry. (Accessed on: 17/2/2019).

Moran, L. (2019). Layla Moran: A mental health epidemic is underway in Britain’s schools, (Online), Available from: https://www.newstatesman.com/politics/education/2019/02/layla-moran-mental-health-epidemic-underway-britain-s-schools. (Accessed on: 07/04/2019).

National Health Service(NHS) digital. (2018). Mental Health of Children and Young People in England, 2017 Summary of key findings. Leeds: NHS Digital.

Time to Change. (2019). Our impact, (Online), Available from: https://www.time-to-change.org.uk/home/about-us/our-impact. (Accessed on: 27/09/2019).

Vizard, T., Pearce, N., Davis, J., Sadler, K., Ford, T. Goodman, A., Goodman, R. & McManus, S. (2018). Mental Health of Children and Young People in England, 2017 Emotional disorders. Leeds: NHS Digital.