Research Realities: the psychological welfare of young people in the UK

Psychologist Ann Phoenix examines a study that spans three decades shows worrying changes in the mental well-being of children in the UK, and backs reports of widespread unhappiness

Authors: Helen Sweeting, Robert Young and Patrick West

Title: “GHQ increases among Scottish 15-year-olds 1987-2006”, Social Psychiatry and Psychiatric Epidemiology, 44

Background

This study examined changes in young people’s mental well-being over 19 years from 1987 to 2006. Using the General Health Questionnaire, it compared Scottish 15-year-olds’ psychological distress in 1987, 1999 and 2006. There was an increase in young women’s and young men’s self-reported symptoms at each of the three time points, which was greater for young women.

Objectives and methods

Reports that British children and young people are among the unhappiest in affluent countries have fractured ideas of childhood as a halcyon period of life.

This raises a number of questions for research and practice: is there good evidence of childhood unhappiness? If so, is this a new phenomenon? What is the trend in children’s experiences of unhappiness? Does it affect all children or particular groups?

The paper compared Scottish 15-year-olds surveyed in 1987 and 1999 with those surveyed in 2006. All were given the 12-item General Health Questionnaire (GHQ-12), a measure of self-reported psychological distress assessed in terms of inability to do everyday functions and the emergence of distressing symptoms.

The GHQ-12 consists of 12 statements for participants to agree or disagree with. It can be used to identify three sets of factors: anxiety and depression; anhedonia (inability to experience pleasure from normally pleasurable life events) and social dysfunction; and loss of confidence or self-esteem.

The sample was representative of 15-year-olds resident in central Clydeside. They completed the GHQ-12 questionnaire at home in 1987 and in their classrooms in 1999 and 2006 (in the context of a health and lifestyle survey).

More than 500 15-year-olds were studied in 1987; more than 2,000 in 1999 and more than 3,000 in 2006. The questionnaire used ifferent definitions of psychological distress, varying in stringency.

Findings

The major finding was that the number of 15-year-olds categorised as having symptoms of psychological distress rose steadily for young women and young men at each of the three time points.

Between 1987 and 1999, using the most stringent defintions, rates rose from 3% to 5.5% among young men but almost tripled among young women, from 7% to 18%. “By 2006 the rates were 10.2% for males (three times that in 1987) and 26.7% for females (four times that in 1987),” the report said.

Using the least stringent definition of psychological distress, rates for young women rose from 19% in 1987 to 33% in 1999, to 44% in 2006. For young men they increased from 13% in 1987 to 15% in 1999 to 22% in 2006.

The increases in psychological symptoms were more marked for some symptoms than for others. For example, 15-year-olds were four times more likely to say that they thought of themselves “as a worthless person” in 2006 than in 1987 and five times more likely to say that they were less able to concentrate on whatever they were doing. Only being “able to enjoy normal day-to-day activities” did not show a significant increase between 1987 and 2006.

In terms of gender differences, young women were consistently more likely than young men to report symptoms of psychological distress. In particular, they were more likely to say that they “felt constantly under strain”, “lost much sleep over worry”, found it difficult to concentrate and difficult to enjoy things they did (had anhedonia).

Young men were less likely to report symptoms of psychological distress, their answers showed greater increases for “losing confidence in yourself” and “thinking of yourself as a worthless person” between 1987 and 2006 than those of young women.

In relation to the three sets of factors into which the questionnaire was grouped, although all factors increased for young men and young women over the three time points, there were small yet significant differences.

The anxiety and depression factor and loss of confidence or self-esteem increased more over time than did anhedonia and social dysfunction, for example, while it was steepest for loss of confidence.

Despite these gloomy findings, it is worth noting that there were increases in the percentages of young people who agreed with the statement that they had “been feeling reasonably happy, all things considered”. Six per cent of young men said this in 1987, compared with 10% in 2006. For young women, the corresponding figures were 9% and 22%.

Similarly, there was an increase in the number of young people who said that they felt they were “playing a useful part in things” and “felt capable about making decisions about things”. In all these cases, young women were more likely to start from a higher baseline percentage than young men and to show a more marked increase in positive reports.

Overall, young women were more likely than young men to report more symptoms of psychological distress and to report more feelings of control and happiness. In both cases, however, more young people reported negative than positive feelings.

Analysis of findings

These findings show us that current attention to well-being by government departments is not only justified, but crucial if we are to understand how to prevent and address psychological distress in children and young people.

This quantitative study is helpful in pointing out trends in psychological distress, but other studies are needed, including on subjective well-being and its implications for what young people do. A recent survey of 818 11- to 19-year-olds similarly found that one in five boys and young men, compared with one in three girls and young women, said they self-harmed.

When analysing the reasons for these changes, the social context clearly plays a large part. Various researchers suggest that increasing affluence has been accompanied by social pressures including:

● Increased solitariness.

● Faster maturity.

● Commercial pressures.

● A perceived loss of community cohesion.

● Increase in gang behaviour and bullying.

● Increased parental separation and step-parenting.

● Increasing income differentials and widespread child poverty.

● A loss of independence.

● Increasingly sedentary lifestyles in response to parents’ fears of paedophilia and the growth of technology and parents’ working patterns.

Links and resources

YoungMinds

NSPCC has some informative material on suicide and young people

Family and Parenting Institute

Young People in Focus (formerly trust for the Study of Adolescence)

PRACTICE IMPLICATIONS

Personalised approach

Interventions need to be multi-faceted and focus on children’s lives at individual, interactional and societal levels

Resilience

Practitioners should recognise that individuals can have relatively good outcomes despite suffering experiences that could be expected to have serious consequences. But resilience is not an individual characteristic; it results from interactions with other people and social environments.

Importance of respect

Stressful experiences that are not overwhelming may have a “protective steeling effect”. Young people are likely to feel better and be more inclined to co-operate with their parents if they are treated with respect and not over-monitored or controlled. It is increasingly argued that young men are inclined to be violent if they feel themselves to be disrespected by their peers.

Author of this article: Professor Ann Phoenix is a psychologist and director of Thomas Coram Research Unit at the Institute of Education, University of London

Published in the 12 November 2009 edition of Community Care under the heading Measuring mental distress of young people since 1987