Below is a transcript of a talk I did for the Trauma Healing Institute in the Kingdom of Bahrain, on 20th April 2022, and on the topic of "mental health and young people"
In the time we have together, I'd like to look at three questions around this topic of mental health in young people:
Where are we?
Why are we here?
Where should we go?
1. Where Are We?
Let us begin with some statistics to put this issue of mental health in young people into context. These figures are from the World Health Organisation last year:
Globally, one in seven 10-19-year-olds experiences a mental disorder, accounting for 13% of the global burden of disease in this age group.
Depression, anxiety and behavioural disorders are among the leading causes of illness and disability among adolescents.
Suicide is the fourth leading cause of death among 15-19 year-olds(1).
The statistics from the United Kingdom are even more grim. These are figures from the leading mental health charity Young Minds:
In 2018-19, 24% of 17-year-olds reported having self-harmed in the previous year, and seven per cent reported having self-harmed with suicidal intent at some point in their lives.
Suicide was the leading cause of death for males and females aged between 5 to 34 in 2019
Nearly half of 17-19 year-olds with a diagnosable mental health disorder has self-harmed or attempted suicide at some point, rising to 52.7% for young women (2)
Monaco, A.P. An epigenetic, transgenerational model of increased mental health disorders in children, adolescents and young adults. Eur J Hum Genet 29, 387–395 (2021
And finally, above is a graph showing the situation in the United States of America. This was from a paper published last year in the European Journal of Human Genetics and shows that a range of illnesses have seen a large increase in prevalence over the last few decades amongst young people(3). In particular, it shows that since the early 1990s, the rates of depression have been steadily increasing, and this was all before the start of the Covid pandemic. Granted, we do have to be a little cautious with graphs like these, and it may be that we are investigating and therefore diagnosing more mental health issues. I think that is partly true. However, I personally do not think that can fully explain this dramatic rise- I do think the actual incidence of depression and other mental illnesses has been significantly increasing in recent decades.
2. Why Are We Here?
This then begs the question of: why? Why are we seeing this steady increase in mental illness in young people around the world?- what I think is legitimate to call a "pandemic of mental illness".
Now, I certainly wouldn't claim to have a comprehensive or exhaustive explanation. But I do have some theories about some factors that I believe have contributed to the rise of mental illness in young people. And there are three factors in particular that are worth briefly exploring.
a) Social Media
Firstly, one issue that I think has played an important role in this mental health pandemic is the rise of social media. Social media has radically transformed the fabric of society, and changed the way all of us view reality (even those of us who don’t use social media). And many young people do not know a world without social media. I count myself in that- I remember when social media was first becoming popular, but I can’t really remember much about life before it. There are several reasons why social media can negatively impact people’s mental health.
Some of these reasons are very explicit and obvious, such as the rise of cyber bully and internet trolling, as well as the very dark areas of social media where users can find and discuss information on how to harm themselves and attempt suicide. But as well as these sharp and very explicit links between social media and mental illness, there is a whole range of more subtle and subversive ways social media can damage people’s mental health.
For one thing, social media is designed to be addictive. The algorithms are programme to feed us with whatever maintains our attention and keeps us clicking. The CEO of Netflix, Reed Hastings, was once asked who his greatest competitor was and he answered: sleep!(3) Netflix are trying to displace our sleep with movie watching.
So social media is addictive. But secondly, it can also lead to a lot of issues around image. On social media, we can project to the world any version of our reality we want to, with all the bad bits removed, and all the good bits enhanced and filtered to make them literally picture-perfect. And so if all people see are the air-brushed best bits of other people’s lives, it’s unsurprising if it often then leads to jealousy, insecurity, and discontentment with oneself and one’s life. And then for some people, these can be crucial steps down the path to illnesses such as depression, anxiety, body dysmorphia and eating disorders.
So I think social media is one key contributing factor in the mental health pandemic in young people.
b) Expressive Individualism
Another key factor I think, is the rise of so-called “expressive individualism”. Expressive individualism is the philosophy that says the true human flourishing and contentment can be found by finding your true inner identity, and then living out this identity in the world. "Your life is all about you". This narrative of expressive individualism is now very noticeable in education, entertainment, advertising, and even sometimes in the Church. Young people are being pumped with messages such as “just do you”, and “the most important thing is to just be yourself, be true to who you are, and do what makes you happy”.
However, as my friend and Professor of Psychiatry Glynn Harrison argues in his book Ego Trip, expressive individualism has been a massive failure. Rather than creating a generation of self-confident, secure individuals, there is now substantial evidence that shows that expressive individualism has led to an increase in insecurity and a rise in mental health issues in the young. This is what Harrison writes:
“The deceit of the self-esteem movement as it has been marketed in popular culture is to suggest that worth and value can simply be asserted: ‘I’m special!’ ‘I attract people to me now!’ ‘Think positive!’ But as studies have shown, rather than producing new improved versions of the self, brimming with confidence, these self-affirming statements leave people with low self-worth feeling more depressed. It is hard to believe your own propaganda, and so self-affirmation tends to backfire for the people who need it most. Indeed, the pursuit of self-esteem for its own sake appears to increase contingency and drive people back into yet more approval-seeking and the quest for status.”(5)
So I think our current culture of expressive individualism and self-esteem is also a contributing factor to the rise of mental illness in the young.
And then we have the small matter of the global Covid-19 pandemic. Covid has hammered many people's mental health for a wide variety of reasons, from fear of sickness and mortality, to the grief of sudden bereavements, to anxieties around financial and job insecurities, to the loneliness of national lockdowns and government restrictions. And personally, I think that young people have borne a disproportionately heavy burden during this pandemic. We all know that social interaction is vital to the development of school children. And a large part of university life is meant to be group activities and social events- things that have been hit hardest by Covid and government restrictions. And therefore I think young people have sacrificed a huge amount this past two years, generally in the name of protecting the health of those several decades older than them. As the charity Young Minds have reported, “83% of young people with mental health needs agreed that the coronavirus pandemic had made their mental health worse.” (2)
And so those are just three of no doubt many contributing factors to the mental health pandemic in young people. Of course there will be many more issues at play, but I hope that gives a little flavour of why we are where we are when it comes to mental health in young people.
3. Where Should We Go?
Which leaves us with the big question of: where should we go? How do we begin to think about tackling mental illness in young people?
Now obviously, child and adolescent mental health is a huge medical specialty, and there are many different and important aspects of treating mental illness in young people. And so I’m not even going to attempt to give an overview or summary of the possible treatment approaches in this area. Rather, in the time we have left, I just want to look at one specific aspect of mental health management that I have found particularly helpful during this pandemic, and that is the concept of “mental hygiene”. And full disclosure, I’ve pinched this concept from my friend Prof. John Wyatt, who is Professor of Medical Ethics, and who wrote an article on the topic titled "How to be a Recovering Perfectionist"(6).
The principle behind mental hygiene is that every day, in fact multiple times per day, we have to wash our hands. And so even though I washed my hands this morning, I am still going to have to wash my hands this afternoon, and this evening, and tomorrow morning, and every single day until I die. Every day I have to wash my hands. Of course we do this because we want to keep hygienic- we want to be physically clean.
The same is true with our minds. Every day, we need to make sure that our minds healthy and clean. And we do this by practising mental hygiene.
And actually this concept is found in the bible. Here is a verse from Paul’s letter to the church in Philippi, in Philippians 4:8:
“Finally, brothers and sisters, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable—if anything is excellent or praiseworthy—think about such things.”
Here we have a list of things we are all to fill our minds with as Christians. These are things we are to meditate on, to immerse our minds in, on a daily basis.
As John Wyatt points out in his article, there are three broad groups of things that Paul says we are regularly fill out minds with. Paul starts with “truth”: “Finally, brothers and sisters, whatever is true.” He then goes on to things that are morally good: “whatever is noble, whatever is right, whatever is pure”. And then he ends on things are beautiful and pleasing: “whatever is lovely, whatever is admirable—if anything is excellent or praiseworthy”. In other words, the things Paul says we are to fill our minds with are truth, goodness and beauty. All of us are to regularly, daily, meditate on things that are true rather than things that are false, things that are good rather than things that are evil, and things that are beautiful rather than things that are ugly. And that is mental hygiene.
I think the concept of mental hygiene is very useful for people of all ages, and whether or not we suffer from mental illness. However, I think it is of particular value in the context of mental illness in young people.
Perhaps filling our minds with truth could involve limiting the amount we consume the airbrushed or sometimes downright fake version of reality propagated by social media, and instead trying to ensure our diet of news and information comes predominantly from credible and wholesome sources.
Perhaps filling our minds with goodness could involve being conscious of how much time we spend reading and watching grim, sad, and unpleasant stories on the news or online. Of course we shouldn’t bury our heads in the sand when it comes to current affairs and the realities of life. But how much of our news consumption makes us feel uplifted, joyous and positive, compared with depressed and negative?
And perhaps filling our minds with beauty could involve making an effort to regularly lift our eyes up from our phones, to enjoy the beauty of God’s creation, whether it be through music, art, nature, sport or whatever else that makes your heart sing. I spent a lot of the Covid lockdowns walking around the parks in London and developed a new-found appreciation for greenery and nature.
But ultimately, I believe the true and complete embodiment of truth, goodness and beauty are all found in the man of Jesus. Here are a couple of lines from John chapter 1:
1 In the beginning was the Word, and the Word was with God, and the Word was God. 2 He was with God in the beginning. 3 Through him all things were made; without him nothing was made that has been made. 4 In him was life, and that life was the light of all mankind. 5 The light shines in the darkness, and the darkness has not overcome it…
… 14 The Word became flesh and made his dwelling among us. We have seen his glory, the glory of the one and only Son, who came from the Father, full of grace and truth.
In verse 1 we see that Jesus is the epitome of truth, for He is the Word or "Logos" behind the universe. In verse 4-5 we see that Jesus is the epitome of goodness, for He is the light who shines into the moral darkness of the world. And in verse 14 we see that Jesus is the epitome of beauty, for He is no less than the glory and majesty of God in human form.
To maintain mental hygiene we are called to constantly fill out minds with Jesus and all He has done for us, for Jesus is the ultimate embodiment of truth, goodness and beauty.
So that’s my very quick tour of the mental health pandemic amongst young people. We’ve looked at some of the statistics from around the world. We’ve looked at some of the factors that I think have contributed to the rise in mental health issue in this age group. And we finally touched on one aspect of a potential approach to mental health as followers of Jesus.
Adolescent Mental Health, World Health Organisation, 2021
Mental Health Statistics, Young Minds, 2021
Monaco, A.P. An epigenetic, transgenerational model of increased mental health disorders in children, adolescents and young adults. Eur J Hum Genet 29, 387–395 (2021)
Sulleyman, A., "Netflix's biggest competition is sleep, says CEO Reed Hastings", The Independent (2017)
Harrison, G., Who Am I Today?- The Modern Crisis of Identity, Cambridge Papers, 25, 1 (2016)
Wyatt, J. "How to be a Recovering Perfectionist" (2019)