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A rapid increase in mental health problems has been reported by several studies among children and adolescents (roughly the age-group 7-17) in several rich countries, particularly during the last decade or so. Such a trend is visible even in studies that end in early or mid-2019, or before this, and hence entirely exclude any COVID impacts. At the same time, there is enough evidence of the situation deteriorating further in COVID times. In addition among all adults, mental health problems are increasingly reported to be the highest in the youngest adult group (18-24). In the USA as well as in Europe, suicide is the second highest cause of death in this entire age-group (7-24).
A widely used data for USA is for approximately one sixth of children and adolescents being affected by mental health problems. However some other statistics suggest that the situation may be even more serious in the USA. Statistics of Centers of Disease Control and Prevention, USA, ( as cited in the Psychiatry Advisor 30.4.2021, paper by Tori Rodriguez), inform us that in 2009 , as many as 26% of school students were affected by persistent sadness or hopelessness and this had increased to 37% in 2019, surely a very worrying trend. During the same decade, among these students, serious contemplation of suicide increased from 14% to 19%, suicide planning from 11% to 16% and suicide attempts from 6% to 9%. Again this should be a cause for very great concern.
According to the National institute of Mental Health, 3 million US adolescents experienced major depression in 2020, and two-thirds of them received no treatment. This is deeply disturbing, also because of longer-term impacts. A third of those who suffer from childhood depression make at least one suicide attempt in their life. According to a study published in the Lancet in 2020, in the 9-10 years age, 1 in 12 children had suicide thoughts. Parents of nearly half of children having suicide thoughts are unaware of this.
Several studies have tried to find sources of greater vulnerability—according to a 2018 study published in JAMA Pediatrics in the age group 5-12, double the suicide rate is reported for black children. According to Trevor Project, 42% of LGBTQ youth in the USA covered in their study had experienced suicide thoughts. Predictably those who are victims of abuse and neglect have been found to have higher suicide rate. Those living in care have higher rates than those living with their families. In the context of bullying, not just the victims but also the perpetrators of bullying have a higher suicide rate. By the age of 13, a third of bullies have already considered ending their life, according to a study published in the Journal of Adolescent Health.
Access to and familiarity with weapons is another serious factor. Children living in families having guns have suicide rates four times higher than those growing up in families without guns.
Dr. Jean M. Twenge of the Department of Psychology, San Diego University, has played an important role in drawing attention to the role of social media in high rates of mental health problems among adolescents.
In her paper in Psychiatric Research and Clinical Practice, 27 March 2020, she cites several studies which establish very tragic increase in mental health problems of children and adolescents even before the advent of COVID. These studies show, among other conclusions, a very worrying increase in depression, anxiety, loneliness, self-harm, suicidal ideation, suicide attempts and suicide during the period roughly of 2009 to mid-2019. Emergency room visits for suicidal ideation and attempts nearly doubled among children and adolescents. Suicides among girls in 10-14 year group doubled. Cases of self-poisoning among girls of 10-12 years age-group quadrupled. In the age-group of 10-14 years for girls, hospital admissions for self-harm tripled.
What is happening? In her paper titled ‘Increase in depression, self-harm and suicide among US adolescents after 2012 and links in technology use :possible mechanisms’, Jean Twenge attributes this largely to the spurt of digital media and use of smartphones during this period. While this is certainly an important factor, this is unlikely to be a complete explanation of such significant trends.
Such disturbing trends are reported also from several other rich countries. According to UNICEF annual report on children for 2021 , in Europe in the 15-19 age group, 19% boys and 16% girls are affected by mental health disorders. In the 10-19 year age-group 9 million teenagers in Europe are affected by mental health disorders, one half of them by depression and anxiety. A WHO report said in 2020 that 1 out of 4 children in Europe are affected by nervousness, irritation and problems in getting to sleep. 35% had started drinking alcohol by age 15. 10% had experienced cyber-bullying in the last two months. Only 41% of boys and 33% of girls said they were mentally healthy. A German health insurance company DAK stated in 2019 that 1 in 4 German children were affected by mental illness problems.
While the emphasis of several studies has been understandably on more recent trends, there are other studies from the last decades of the previous century which also reveal a disturbing trend. A study of 15 year old British girls in more prosperous sections of society revealed a high and increasing trend of mental health problems-- startling increase from 24% to 38% from 1987 to 1999. However such a trend was not noticed by this study in the less prosperous sections.
Hence it is important to look beyond only more recent factors like the pandemic or sharp rise in digital media and form a more comprehensive understanding of socio-economic factors which are responsible for the high and rising trend of mental health disorders among children, adolescents and young adults. To be effective in checking this disturbing trend, more familiar and specific steps need to be accompanied by policy reform at several levels.
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The writer is Convener, Campaign to Save Earth Now. His recent books include ‘Planet in Peril' and ‘Man Over Machine—A Path to Peace'
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