That there is a crisis in the mental health of young people is something that few psychologists and therapists doubt. It also seems clear that the pandemic has worsened the situation, even if the problem comes from before. More complicated is to give concrete numbers – due to the border nature of many disorders and the difficulty in obtaining data among minors -, and also to discern the causes: there are purely conjunctural, but also cultural and biological.
Some studies show that cases of anxiety, depression or suicidal behavior have increased in prevalence in recent years, although the beginning of the upward trend is earlier. According to the European version of a report published last year by Unicef, in 2019 – before the development of the pandemic on the continent –, 16% of boys and girls from 10 to 16 years old suffered from some mental disorder. Considering only the teenage years, from 18 to
, the proportion increased to about 18%.
In addition to the “macrodata”, it was the doctors and psychologists themselves who, from the front line, alerted to this increase in cases. This is what the head of the mental health area at Hospital Sant Joan de Déu in Barcelona did in an interview with El País last summer. More recently, the Spanish Pediatrics Association described the situation as “alarming” in a press release, while its American counterpart declared a “national state of emergency” regarding the mental health of minors.
Increase in suicidal and self-injurious behavior
The data referring to suicidal behavior are of particular concern, whether in the degree of thoughts, attempts or completed suicides. In many western countries, suicides have been increasing for years among young people, while their prevalence among the rest of the population has fallen. In general, the number of completed suicides fell by 145 because of confinement, but then it increased again, often with greater intensity than before.
Self-injurious behaviors have been on the rise for years, especially among girls.
This suggests some indirect evidence. For example, in many hospitals in Spain, urgent care for mental health issues has increased considerably, as has occurred in other nearby countries, such as France. On the other hand, the ANAR Foundation’s anti-suicide phone answered, last year, 145 % more calls from minors with suicidal intentions.
Self-injurious behavior also seems to have increased in recent years, although before the pandemic the trend was already clearly on the rise. As a report from the Hospital Sant Joan de Déu published last year explains, the first research on the subject, carried out in the years 28 of the last century, indicated a prevalence of less than 1% among European minors. However, the most recent studies point to a much higher rate, between 16 and %, although there is no homogeneity between the data collection criteria.
In any case, the testimonies of nurses and doctors from different hospitals indicate an unequivocal reality: more and more young people have to attend to young people – especially girls – who, without suffering from any psychiatric disorder, have self-harmed.
)Age and gender matter
Daniel Rama is a psychologist specializing in adolescence, university professor and vice-president of the Spanish Association of Child and Adolescent Psychology (APSNAE) ). His research and clinical activity offer him a privileged position to address the phenomenon of crisis in the mental health of young people.
Rama differentiates between the situation of children and adolescents. “By age, mental disorders (e.g., anxiety, depression, schizophrenia or bipolar disorder) are much more frequent after 18 years, while behavioral ones (hyperactivity, attention, antisocial behavior) appear at younger ages.”
A factor to take into account, points out him, could be the transition from college to institute; a moment that, in his opinion, implies an important change, and for which children are often still not prepared: “To the 12 years, our educational system dumps them, with just a few conversations and a tour of the new institute, in a very important change not only in the educational methodology, but also in the socialization model. This can generate feelings of distrust towards the adult figure and an increase in the feeling of incomprehension and loneliness”.
“Internal” disorders, such as depression or anxiety, are more frequent in girls; conduct, in boys.
On the other hand, the scientific literature has consistently shown that the sex of young people influences mental health. For example, in suicidal behaviors. Suicide ideation and attempts are much more frequent in girls than in boys, even though they are the ones who actually die the most from this cause. Some experts indicate that this asymmetry between attempts and deaths is partly due to boys sharing their negative feelings less (which would explain, for example, their underrepresentation among those who call the so-called “phones of hope”), and when decide to end their lives, they choose more lethal means.
But, in addition to suicide, Rama explains that “girls tend to internalize problems more (hence, disorders such as depression, anxiety, obsessive behaviors, etc.), while boys are more externalizing (therefore they are over-represented among those diagnosed with ADHD or behavior problems)”.
Overprotection, drugs and social networks
Nevertheless, external factors also play an important role in the mental health of young people. For example, cultural stereotypes associated with each sex: “Women are more likely to be diagnosed with depression, anxiety and common mental disorders. According to WHO figures, they have 18 % more likely to receive psychiatric medication In addition, the tendency of men not to ask for psychological help or not to show symptoms of depression is another reason that some mental disorders are diagnosed more in a gender than in another”.
The family is another relevant external factor. Rama refers, on the one hand, to the breakdown of more and more homes, but also to the style of upbringing: “Many children have been brought up to be overprotective. This causes them to have a low tolerance for frustration, a tendency to make little effort, and a high alarm in that are not so important”.
On the other hand, he is concerned about the normalization of drugs and alcohol: “There is an early consumption among young people that is causing a lot of damage, with boys and girls who smoke marijuana at 13 years. Consumption of alcohol and marijuana can trigger mental health problems such as personality disorder”.
Social networks are, without a doubt, another concern of psychologists dedicated to minors. The above-mentioned Save the Children report dedicates an appendix to this topic. Specifically, it warns about the existence of pages that offer advice for suicide, and the negative effect that certain challenges can have that go viral through these channels.
Hypersexualization and anticipation of puberty
Rama focuses on the hypersexualization of young people’s lives that social networks can feed, when they are misused. “Girls, above all, appear situated in a false maturity that they don’t understand, surrounded by messages of sexy content that can result in a lack of security, in the construction of young people. fragile who will feel obliged to fight a battle with their bodies in search of an unattainable ideal.Sexualization also presupposes the imposition of adult sexuality on girls and boys, who are neither emotionally, psychologically nor physically prepared for it. “
Sexualization in social networks and access to pornography affect psychic development
For the same reasons, accessing pornography at an early stage is also harmful. Some studies have pointed out that its excessive consumption affects the volume of gray matter in the right lobe of the brain, which affects functions such as learning and memory. In statements to Cuidate Plus, Sergio Oliveros, a psychiatrist, explained that the decrease in frontal activity and other brain alterations impair “cognitive performance due to the difficulty in maintaining attention, concentrating or memorizing content, which substantially interferes with the learning process in adolescents and young people, an age group in which consumption is widespread”.
This early access to pornography coincides with another phenomenon that is increasingly documented: the anticipation of puberty, especially in the girls. As Rama explains, “when this anticipation is not accompanied by an increase in the level of psychological maturity, it generates dissonances that the person is not able to understand. teenagers bored with the world and tired of these constant contradictions, which translates into increasingly alarming anxious and depressive behaviors”.
The effect of the pandemic
If the mental health situation among young people was already worrying before the pandemic, this one has worsened it even more. According to some reports and pediatric departments of several hospitals, cases of depression, anxiety, eating and behavioral disorders have increased, as well as other more serious phenomena, such as schizophrenia, bipolar disorders and suicidal behavior.
Rama points out some indirect consequences of the pandemic that could have a negative effect on the psychic health of young people. On the one hand, the increase in time spent in front of screens, which was already excessive and which “is related to an insufficient number of hours of sleep and a greater risk of suffering emotional and behavioral problems in the child population”. On the other hand, work and economic problems in families, which “generate a feeling of uncertainty in the minors”.
Faced with such a less optimistic outlook, mental health professionals are insisting on importance of family and school as “refuges”. As explained by Rama, young people who spent confinement in rooms shared with other young people experienced more psychological problems than those who spent it with their parents. In turn, the CDC study documented a lower rate of depression and anxiety among students who maintained closer contact with their school center.
© 2022 Acpress. Published with permission. Original in Spanish.