A landmark review led by top psychologist Prof Peter Fonagy has confirmed that the mental health of children and young people in Britain is at crisis point. The government commissioned the review to investigate whether the apparent increase in mental illness in the country was real, and the picture is mixed.
Presenting their findings to the media, the lead authors were adamant that life has become harder for young people and described why. They said this is the first generation in living memory where young people have no confidence that their lives will be better than their parents’ generation.
Key factors: employment, housing, and constant comparison
Lack of employment opportunities and access to secure housing are big factors, with getting on the housing ladder feeling like a pipe dream for many. But more surprisingly, the report outlined how young people’s lives are characterised by constant “evaluation and comparison” – whether comparing physical appearance or social standing on social media, which can lead to bullying, or how schools constantly test and push pupils towards improved academic achievement.
This constant comparison causes stress and has come as modern lives give them fewer opportunities to mentally rest and recover. More of daily life is spent online with less opportunity for physical activity, time in nature and uninterrupted sleep.
Younger children in particular are missing out on unstructured play where they can lose themselves in their imagination and decompress. Previous generations of children played out in the street or climbed trees, but modern lives have made this less available. Busy families struggling to make ends meet often mean kids move from breakfast club, to school, then after-school clubs followed by homework and screen time. Late nights and poor diets don’t help.
Rising rates of mental illness and the ADHD tipping point
Mental illness among 16–24-year-olds has increased from around one in six to one in four, with young women now reporting the highest rates of any group. Self harm and eating disorders have surged. Worry, anxiety, depressive ideas and panic have risen, while conduct problems have remained stable.
Recorded diagnoses of ADHD and autism have risen more than six-fold and twenty-fold respectively. The review’s authors said people have been getting a diagnosis who would have historically had their ADHD or autism missed. But they added that the UK has likely now caught up – and is at a “tipping point” where soon more people will be diagnosed than actually have the conditions.
This opened up a debate about the risks of being given a life-long medical diagnosis for a condition like ADHD, where the experts said it was possible to have “traits” while not meeting the clinical threshold to be diagnosed.
Diagnosis benefits and risks, and calls for change
The review states: “Diagnosis is important because it can provide an explanation for someone’s problems and validation of their experiences, guide treatment and open access to support. But being diagnosed may also carry risks, including stigma and narrowed expectations.
“Like any clinical intervention, diagnosis has potential benefits and potential harms. For many people it provides understanding, guides treatment and opens access to support. In other circumstances it may prove less helpful, particularly if it delays more appropriate forms of support, is the wrong or incomplete diagnosis, narrows what they and those around them believe is possible, and defines people by what they cannot do.”
Prof Fonagy said that conditions like ADHD and autism are characterised by broad spectrums and people diagnosed can vary wildly in how these conditions affect them. A medical label by itself does not on its own reveal how best to support that individual.
The report said: “Most people are sometimes inattentive, anxious or socially uncomfortable. Having ADHD or autism-related traits does not necessarily mean someone has a diagnosable condition.”
The Fonagy review is calling for nationwide changes to the NHS and school system so that support for symptoms – such as inability to concentrate and impulse control – is not conditional on a diagnostic label. It is also recommending the NHS employs a single diagnostic pathway for mental health that evaluates for all conditions.
The problems the Fonagy Review lays bare have been years in the making. This Labour government has committed to raising the healthiest generation of children and must now come up with a plan to make that a reality.
