Children’s Mental Health and the Permacrisis

After living through an extended period of turbulence, how are our children and young people coping? Charlotte Burdge and Tamsin Ford highlight what the research reveals and how we can better support our young people.

The mental health of children and young people deteriorated over the last decade, particularly among young women in their mid-teens and early twenties, who were more likely to struggle with anxiety, depression and self-harm than previously. This may come as no surprise, considering today’s children and young people have lived through what could be called a permacrisis; or an extended period of uncertainty and instability resulting from a chain of catastrophic events. Those born since the Millennium have experienced – directly or indirectly – severe financial crises, COVID-19, war, and increased global insecurity. Many young people have also voiced concerns about their own prospects for longer-term issues such as climate change, political instability, and the cost-of-living crisis. 

Given that some children and young people in the UK did not enter the pandemic in good mental health, it is hardly surprising that there were reports of further deterioration as the population contended with huge disruption and threats to health, family life, education and financial security. Indeed, England’s Mental Health of Children and Young People (MHCYP) follow up survey found 16% of young people aged 5-16 years old had a probable mental disorder in July 2020, compared to 11% in 2017. The sharp deterioration between 2017 and 2020 was maintained according to further follow ups in 2021 and 2022. The most recent survey suggests that young women aged 17 to 24 and boys of primary school age are particularly likely to struggle.

The impact of these events is not uniformly negative or experienced equally across different groups in society. Although over half of secondary school pupils reported that the 2020 lockdown made their lives worse or much worse, over a quarter reported that it made their lives better. Understanding how and why experiences differed may identify potential targets for prevention and treatment of mental health conditions.  

A good example of how experiences varied is the impact of school closures on learning. Home-schooling was possible if a family had access to reliable WiFi, available parental support, and a device to connect with school systems. However, the MHCYP survey found 19% of children did not have a quiet space to study, while 12% lacked access to reliable WiFi connection and a similar proportion had no laptop or tablet to work on.

Many parents had no choice but to juggle home-schooling alongside working, which even if they could work from home is a major and sustained stressor. Interviews conducted between March and April 2020 found parents felt unable to fulfil both roles, a concern amplified for single parents and parents of children with special educational needs and disabilities (SEND). Support for parents is paramount to prevent transgenerational poor mental health, particularly given strong links between parental and child mental health.

Home-based learning also distanced school-age children from friends and adults outside of their family who are both a source of support and monitor their well-being. This may have been mitigated among secondary school children, as nearly all have access to a Smartphone, which provided a means to keep in touch with peers. However, many children and young people missed important milestones such as the transition from primary to secondary school or major public examinations and consequently have not have fully developed the social skills and mastery that would usually come from these experiences.

As well as social circumstances, the differing impact of the pandemic among children will be driven by their age and developmental stage at the time. Lockdowns banished access to previously available support networks for many parents of very young children, increasing the pressure on new parents but also reducing the exposure of babies and toddlers to other children. It is therefore not surprising that the children currently going through Foundation and Key Stage 1 have higher than expected rates of language delay and poorer social skills.

All families experienced disruptions to work and education, but these did not affect all groups equally. For example, the parents of children from ethnic minority groups were less likely to have worked more from home and more likely to have struggled financially. All three MHCYP follow-up surveys found a strong link between financial, housing and food insecurity and probable childhood mental health disorders. This well-established association between mental health with socioeconomic deprivation in both adults and children needs urgent policy attention, given the increasing number of families struggling with the current cost-of-living crisis. Mitigation of housing, food and financial insecurities may well relieve some of the stress that undermines mental health among those facing deprivation and adversity.

Childhood mental health conditions throw typical development off course, persist over time, and adversely impact adult mental health, relationships, and occupational function. The dramatic increase in the prevalence of probable mental health disorders is therefore of great concern and highlights the immediate need for prevention and intervention. However, as dire as these data are, many children and young people are managing to cope well through this period of turbulence. Efforts should focus on the reduction of clinical-level presentations, through prompt and timely support for those most vulnerable. The mental health of families who face financial hardship, have limited childcare support, experience employment or mental health challenges, or support children with SEND seem to be suffering the most. We should target support for those most in need to improve well-being not only today but tomorrow and thereafter.

Charlotte Burdge is a visiting research assistant in the Applied and Social Science Group (ASSG) at the University of Cambridge.

Tamsin Ford is a Professor of Child and Adolescent Psychiatry at the University of Cambridge. Her academic work focuses on the effectiveness of interventions and the efficiency of services in relation to the mental health of children and young people.

This blog is based on research presented by Professor Ford in the recent UCL Division of Psychiatry Seminar “What do the Mental Health of Children and Young People suggest about the impact of the current permacrisis?” Please visit our website for details of upcoming events.