Mental Health: Much More Than a 'State of Mind'

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Last month the British Medical Association (BMA) released a shocking report which found that as many as one in ten children and young people between the ages of one and 16 are suffering from a serious mental health problem.

These range from sleep and eating disorders through to severe obsessive and depressive conditions.

So what is going on? Why are so many more children suffering from mental health problems today? The report itself contains many of the answers and reads like a catalogue of the inequalities still rife in Blair's Britain - poverty, racism, the stigmatisation of mental health problems and woefully inadequate services.

Although children from all social backgrounds can suffer mental health problems, class and social background have a massive impact on a child's mental wellbeing. Children at the highest risk are those who come from poor backgrounds. Some 54 percent of all those suffering an emotional disorder live in households with incomes under £300 a week while just 5 percent come from families with a weekly income of over £600.

Children from black and minority ethnic families are also more likely to experience mental health problems, says the report, because they are more likely to face the social deprivation and discrimination which can trigger mental health crises. On top of this mental health services are still rife with institutional racism.

The increased mental suffering of so many young people is an indictment of the government's failure. Its zeal for bringing competition into public services has added to the pressures on young people, as institutions that are supposed to aid them founder. In schools, children are now forced to sit a relentless round of tests and assessments which have led directly to a rise in behavioural problems.

That was the conclusion of Tested to Destruction, a 2004 study by the Mental Health Foundation. It looked at children taking the government imposed Standard Assessment Tests (SATs) and found that the tests had created a huge rise in anxiety and stress levels, including mental health problems in children as young as four.

Child psychiatrist Adrian Sutton says that school league tables, the national curriculum and a narrow focus on academic achievement can have "severely adverse effects on vulnerable children; compound children's difficulties and cause a failure to understand what assets or resources will or will not provide developmental opportunities for a particular child".

Problem to be controlled

Not only are children expected to achieve more at school and behave better in the classroom, they are constantly under pressure to have the latest gadgets and trainers, to be slim and follow fashion. And yet, if they do not meet these expectations, it is the child and their parents that get the blame.

Children are increasingly seen as a problem to be controlled. Over the past two decades there has been an inclination towards "medicalising" mental distress and emotional problems - a tendency to diagnose any resulting problems as medical/biological disorders that need to be treated with drugs.

Prescriptions for Prozac and similar anti-depressants for young people under 18 soared from 13,227 prescriptions a year in 1995 to 27,658 a year in 2003. A few weeks ago the European Medicines Agency gave the go ahead for Prozac to be prescribed to children as young as eight.

One of the most stark examples of the medicalisation of behaviour is the treatment of Attention Deficit Hyperactivity Disorder (ADHD) - a diagnosis given to children who are inattentive or disruptive, usually in a school setting. Overwhelmingly ADHD is categorised as a medical problem and the stimulant methylphenidate, or Ritalin as it is better known, is prescribed. Ritalin is an amphetamine-related drug - with effects so strong it has been dubbed the "chemical cosh". According to the Prescriptions Pricing Authority, in 1991 there were just 2,000 prescriptions for Ritalin. In 2004 there were 359,100.

Yet it has to be questioned whether it is right to give children, sometimes as young as six, such a powerful drug to treat behaviour that often seems little different to the way that some children have always behaved.

Dr Gwyneth Lloyd, an expert in ADHD at Edinburgh University, has contested some of assumptions behind the diagnosis of ADHD. She said, "Our research shows that a lot of children are being categorised without evidence from school about their behaviour problems. This kind of medication for children as young as six is crazy. Their brains are still developing and yet they are being given mind-altering drugs."

That thousands of children are being pushed to breaking point, with nothing being done to deal with the root causes, is surely the most telling indicator of the unequal and competitive society we live in.


To read the BMA's report, Child and Adolescent Mental Health, go to www.bma.org.uk/ap.nsf/Content/Childadolescentmentalhealth