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The Perfect Storm

There has always been a generation gap that has vexed many an older person as they struggle to comprehend what’s going on in the minds of young people. But now there is broadening acceptance amongst experts and clinicians alike, that there is something more serious happening this time.

The mental health crisis engulfing our young people has come to the forefront of national attention.  Is this a new problem or have young people always been a bit mentally unhinged? The scientific data seems to indicate that in fact the mental wellbeing of young people has been slowly but steadily declining over the past several decades.

Something has declared war on the psyche of our young people. The enemy is invisible and yet its casualties are everywhere. It has claimed the lives of many, killing some and leaving others devoid of the prospects of fulfilling their lives, a kind of spiritual death that no parent would want for their child.

A recent analysis of more than 50 years of mental health data collected on US university students, for example, shows that their mental health has been in a steady decline since the late 1950s. As mental health declines in a group of people, the proportion that become so unwell that they need professional help increases. Thus we are seeing so many more young people turning up in our clinics, counselling sessions and hospitals seeking assistance for mental health issues or the immediate consequences of them.

Interestingly, while the data indicates a steady decline in young people’s wellbeing over the decades, there are some researchers who feel that the average IQ has increased markedly over the roughly the same period of time. If this is true, it is even more concerning that the potential of the current younger generation may be frustrated by the looming challenges to their mental health.

The Mental Health Crisis

It’s thought that up to 25% of people under the age of 25 will experience clinical depression, for example. In fact current health figures indicate that75% of all mental illness begins before the age of 25!

  • The greatest number of people with a mental illness are within the 18 24 year age group.
  • Many people with schizophrenia first experience symptoms in their mid to late teen years.
  • One third of people with a mental illness who are admitted to public hospitals are less than 30 years old.
  • Depression is one of the most common health conditions in young people and increases during adolescence.
  • Drug use can complicate diagnosis and exacerbate or trigger illness in vulnerable young people.

The mental health of young Australians

  • Young people are more likely to experience a mental illness and prevalence of mental disorders declines with age. In 2007, 26% of 16-24 year olds had experienced a mental disorder in the previous 12 months, while only 5.9% of 75 year olds and over had experienced a mental disorder during that time.
  • Data published in 2008 revealed that during a 12-month period, 7% of Australian children and adolescents aged 0 – 17 were experiencing mental health problems. This rate of mental health problems was similar across both gender groups14.
  • In 2004-2005, one in 10 young Australians had a long-term mental health or behavioural problem15.
  • In 2003, mental disorders were the leading contributor to the total burden of disease among young Australians, accounting for 49% of that total16.
  • There is a higher prevalence of child and adolescent mental health problems among those living in low-income, step/blended and sole-parent families.
  • 25% of males and 19.7% of females living in step/blended families, and 22.2% of males and 26.7% of females living in sole-parent families experienced mental health problems, compared to 11.3% of males and 10.7% of females living with their original parents.
  • Only one out of every four young persons with mental health problems had received professional health care.
  • Family doctors, school-based counsellors and paediatricians provide the services that are most frequently used by young people with mental health problems. Younger children (4-12) were more likely to visit paediatricians and family doctors, while older children were more likely to visit school-based counselling services.
  • Even among young people with the most severe mental health problems, only 50% receive professional help. Parents reported that help was too expensive or they didn’t know where to get it, and that they thought they could manage on their own.
  • Adolescents with mental health problems report a high rate of suicidal thoughts and other health-risk behaviour, including smoking, drinking and drug use.
  • 12% of 13-17 year olds reported having thought about suicide, while 4.2% had actually made a suicide attempt. Females had higher rates of suicide ideation than males.
  • In 2004-2005, there were 8,013 hospitalisations among young people for mental and behavioural disorders due to drug and alcohol use (almost 2% of all hospitalisations among young people)

Medical science is struggling not only with trying to understand the causes of mental illness but also how to treat it. Most importantly, recognising the devastating effects that mental illness can have on a person’s life, researchers are trying to find strategies that may actually prevent mental illness in the first place. An important step in this process is to understand what might be underlying this new epidemic.

A Perfect Storm

In our efforts to understand how this situation has come about, we need to take a close look at the modern environment in which our young people are immersed. An environment that we, their parents, have participated in constructing for them.

Young people typically face a range of challenges from the usual events such as the death of a pet, the loss of a friend or lack of success in some endeavour to more major and less common things such as the mental illness of a parent, being involved in an accident, the break-up of the family unit or some other traumatic experience.

However what seems to be new is the addition of a background noise of constant challenges that have blended themselves seamlessly into the cultural and social environment.  Both academic researchers and front line professionals who work with young people are coming to realise there are several uniquely modern factors converging on our young people. They have developed so insidiously that they it is only now that they have become  so extreme that their influence is becoming obvious to any one with common sense. Many are about to reach their logical endpoint creating a perfect storm of mental health risk. Let’s look at some:

See also http://richardeckersley.com.au/attachments/IJEpi__culture_1.pdf

Consumerism: This generation of young people, like no other, is almost contsanntly bombarded with marketing messages. The Advertising industry has targeted young people as important consumers who have high discretionary spending and who are particularly easy to influence because they are inexperienced, naive and often quite insecure about themselves. As a result children today are more brand conscious than ever before. They are more than ever concerned about whether or not they are wearing the latest fashion and feel pressured to look and conform with the images that the advertisers use. The latest jeans, phone, gadget, video game and sneakers have all become key to helping them feel like they fit in.

Ironically,  the insecurity that drives their need to belong is specifically targeted and amplified by marketers who have long since discovered that the best way to make a person buy is to make them dissatisfied with themselves and then convince them that the best way to assuage that dissatisfaction is to purchase a particular product. The strategy is so ubiquitous now that hardly we notice it. The tragic by-product of this is those people repeatedly exposed to the message build up a constant sense of dissatisfaction and self dislike. Our consumer society keeps telling our young people that the more they own, the more up to date their belongings are, the more fashionable they appear then the more valued they are. The notion that unhappiness can be treated with “Retail Therapy” has supplanted the idea of spending time with friends or family, nature or self-development. The logical result is an increasingly materialistic and unhappy generation of young people who have now been well trained from birth to willingly engage in the consumer rat race.

Loss of spirituality: The logical flipside to a materialistic and consumer orientated society is the loss of connection with transcendent values and ideas. In many western countries church attendance, for example has slumped by much more than half over the last several decades. Admittedly, this may be due to increasing dissatisfaction with orthodox explanations of how to understand the world. However, in absence of something more convincing than old fashioned religion many have opted for increased entertainment and consumption.

The notion that a gadget could evoke the same kind of emotion as a religious figure would not have been imaginable until we saw with our own eyes the streets long queues all over the world of people waiting patiently not for the pope, the queen or even a rock star but for the latest iphone, ipad and ipod. They didn’t care that Apple’s plan was to make the very gadget that they were queuing for out of date within a year or two, and then get them to throw the old one out and get a new one. The media coverage of Steve Jobs death was greater than that of any human rights advocate that I can recall, for example. True, he was a design genius, but what was his ultimate contribution to the human condition other than to accelerate our progress down the path of ever increasing obsession with consumer gadgets and sophisticated gratification of the monkey mind?

Again, when material acquisition supplants spirituality, life can quickly become meaningless. The emotional and spiritual vacuum is at best termporarily filled with the latest purchase but ultimately, a young person deprived of a sense of higher meaning that is any greater than the ipod that they hold is bound to be more susceptible to depression, stress and other mental health issues. For many young people the Macstore has more significance than church and so Steve Jobs can be credited, or perhaps held accountable, for creating the “iGeneration” – the greatest consumers ever to walk the planet.

Family breakdown. The divorce rate in many developed countries is approaching 50%. The growing number of children in single parent or blended families are exposed to a myriad of social and emotional problems. The absence of good role models at home prevents them from developing constructive behaviours. The insecurity of split parents creates deep emotional problems that are often difficult to resolve. Children who witness unhappy relationships are less likely to commit to a relationship themselves, and when they do, find it difficult to adopt the relevant roles and responsibilities to be successful at it. Thus the problem of unstable relationships is transmitted down the generations further undermining the emotional stability and security of subsequent children as well as of the broader social fabric. When young people are unable to get the emotional support that they need from a stable family they can become more focused on hazardous relationships with peers, people online or simply the things they own. It is no surprise that family breakdown is widely recognised as a fundamental driver of mental health risk in young people.

Drugs and alcohol. While the consumption of marijuana continues to fall in Australia, and the media seems obsessed with cocaine, meth, speed and heroin, the real drug problem affecting our young people is alcohol. Recent surveys show that 20% of people 14 and under are consuming alcohol regularly, often with the consent of an adult. Even more concerning is the trend towards binge drinking of spirits such as vodka. While alcohol consumption across the population has fallen very slightly the rates of binge drinking amongst teenagers, especially females, continues to rise dramatically. The number of young people admitted to hospital with alcohol related problems is at an all time high.

At the same time, new understandings of the developing human brain serve only to emphasise the exquisite sensitivity of this important organ to the effects of alcohol. While it was always assumed that the brain achieved most of its development by puberty it is now widely accepted that the brain continues to develop into the mid and even late twenties. The parts of the brain that develop in the teenage and early adult years are those parts that are involved in relating to others, self-management of behaviour, impulse control and social skills. Binge drinking, which is a pattern of drinking specifically designed to achieve drunkenness, is probably the most effective way to damage the brain since the aim is to drink large quantities in a short amount of time in order to overwhelm the brain’s ability to protect itself. The short term effect is drunkenness however there is now growing acceptance that each binge episode leaves behind a small amount of damage which, over repeated binges leads to reduced ability to learn effectively, for example, and an increased risk of mental illness, particularly alcoholism and depression.

Experts agree that over the past decades the alcohol industry has increasingly targeted younger and younger demographics until now the line between commercial promotion to those under or over the legal age has become very blurred. The development of premixed drinks and alcopops, for example, are designed to make alcohol palatable to the inexperienced palate by masking it with the familiar and sweet taste of soft drinks. The brightly coloured packaging is also more attractive to young people who, even if they don’t drink now, are effectively primed, and probably tempted to bring forward, that time when they do permit themselves to drink. Of course the alcohol industry denies that they are targeting young people but a common sense appraisal of their marketing suggests otherwise.

More recent and disturbing developments include the launch of “no frills” alcohol which is sold through supermarket chains. This alcohol is so cheap that it is often less expensive than the same amount of bottled water. Yet the experts all agree that raising the price of alcohol is the main way to stop prevent young people from purchasing it. They also agree that, if we were to take a truly scientific approach to the legal age limit for alcohol, it would probably have to be 25 years.

Again, the ever-growing consumer orientation of our society has inevitably pitted the formidable forces of commerce against our young people.

The Media: Our young people are immersed in a media saturated world that has no historical or cultural precedent. They are connected via mobile phones, internet, television and other avenues, mostly screen based, to a continuous stream of images, ideas, messages and, logically, values. There are many disturbing trends in the media for which there is growing evidence of their negative impact on young people’s mental wellbeing.

First, the emphasis on celebrity, fame, financial success is producing a skewed concept of what our young people should aspire towards. Rather than wanting to become doctors, teachers or astronauts surveys indicate that today’s young people want to become bikini models, millionaires and rock stars. Goals that are less realistic and thus more likely to frustrate, confuse and disappoint while at the same time prevent them from chasing constructive opportunities. The emphasis on money and fame as a barometer of achievement has also created a sense that excessive consumption of luxury goods and extreme self-indulgence, if not outright vice, is what young people should aspire to. The values of community mindedness, altruism and the betterment of others are usurped in favour of self-indulgence.

Second, the constant promotion of fashion and stereotypical beauty, particularly the unachievable beauty of today’s fashion models and airbrushed Hollywood starlets, has put unprecedented pressure on young people, especially girls, to achieve a certain body shape and appearance. As a result surveys in australia of what young people are most concerned about in their lives repeatedly puts body image at or near the top of the list, higher than the environment or discrimination. The emphasis on unhealthy thinness has contributed to climbing rates of dieting and disordered eating even amongst girls in primary school and junior high school. Hence the alarming rates of eating disorders such as bulimia in western countries. An poignant illustration of this is a study in Fiji where prior to the introduction of television body image and eating disorders were virtually unknown, then immediately following the launch of public TV, eating disorders emerged in the general community.

Third, the increased use of highly sexualised imagery in marketing material and even news content has created a pressure on the very young to aspire to not only grow up  but to also become sexualised earlier than they need to. The progressive sexualisation of advertising and marketers is a particularly cynical strategy to increase the appeal of the product that they are trying to sell. The social effect however is that young people are now effectively being told that in order to be accepted, popular, fashionable and cool you must be both sexy and ready for sex. Girls are told that to be an empowered and confident female they must not only be pretty but sexually hungry. The feminism of the 60s and 70s which sought to empower women has undergone a bizarre transformation so that now women are told that to be empowered they must in fact change themselves into hypersexualised objects of desire. Young men are told that they need to be sexually aggressive and to perceive females primarily as sexual objects available for their pleasure. This naturally contributes to profound  negative impacts on self esteem and self confidence. It contributes to confusion about how to relate to the opposite sex and again teaches young people to mistakenly gauge their value in accordance with their sexual attractiveness.

The increasing sexualisation and pornification of our media and society, driven primarily by the engine of commerce, is undermining human relationships and indeed the way in which our young people will come to understand themselves and their value to the world.  All of these media trends are responsible for an increasingly toxic cultural environment that inevitably takes its logical toll on the psyche of our young people.

Cyberspace and Screen Culture: The constant connection to cyberspace brings with it both positives and negatives. The social networking sites allow young people to connect with their peers more than ever before which facilitates their sense of community and belonging. The fact that their parents are substantially less knowledgeable about cyberspace however reverses the usual power structures and makes it difficult for parents to be effective in assisting their children to make wise decisions online. Indeed, the internet and mobile phones place tremendous power in the hands of young people who are often not yet mature enough to handle it.

As a result we see phenomena such as sexting and cyberbullying. Cyberbullying is currently regarded as the foremost problem that schools must deal with, for example. Unlike face to face bullying which occurs in the school yard but ends when the victim gets home, cyberbullying can continue throughout the day and night which gives it a much greater potential to do psychological harm.

Similarly, computer games have become a multibillion dollar industry to rival hollywood.  The evidence linking violent videogames with aggressive behaviour is now indisputable. Evidence for the addictive potential of such games is now causing concern amongst many mental health professionals with debate occurring at the highest levels about whether or not internet addiction needs to be formally recognised.

Finally, increasingly easy access to pornography has led to the fact that by early to mid teens most young people have viewed it and many young men consume it regularly. Much of this is seen online where it is now available easily and free of charge without any of the sense of community/social disapproval that usually tempered its consumption in past when most porn was in print form. Moreover the porn that is available today is exponentially more explicit than the porn that young people accessed in pre-internet days. The rise of the incredibly popular consumer driven porn sites where viewers are themselves upload their own home made porn now blurs the line between make believe and reality, between producer and consumer. When young people see this kind of material involving grown-ups, along with a substantial proportion of their favourite mainstream celebrities “accidentally” having their personal sexual encounters or nude photos find their way onto the internet (no doubt with significant but unofficial assistance from their marketing agents) it is no surprise they then seek to emulate this behaviour thereby giving rise to phenomena such as sexting, promiscuity and short term relationships.

Moreover, the internet being what it is, makes access to extreme and bizarre forms of porn easy and free as well. As a result young people are at great risk of developing a distorted view of what it is to have healthy physical relationship with another person. Many health and counselling professionals describe encountering relationships that are placed under strain when, usually the male, partner begins to expect to replicate pornographic routines at home and tensions arise in the relationship when this doesn’t happen. Another common scenario is when one partner becomes excessively preoccuopied with online porn at the expense of their real world relationships.

Despite the attractions and potential positives of the internet there is also a growing realisation that young people are becoming increasingly disconnected from nature and physical activity. A recent survey of school children in NSW showed that young people are spending on average 3 hours per day in front of a screen (computer or tv), the majority of which is computer time. On weekdays bout 44% of primary school and 61% of secondary school children spend more than the recommended 2 hours per day on recreation in front of  a screen whereas on weekends it is 80% for primary and 85% for secondary school children . Experts currently recommend 2 hours per day as the upper limit of healthy consumption of screen based content. It is not surprising that approximately half of parents in this survey were unaware that the recommended screen time for young people is less than 2 hours. In fact, 20% of young children have a TV in their bedrooms and this increases to 40% of year ten students. While 13% of pirmay and 37% of highschool students stating that their parents never set rules on their TV and computer game use (http://www.health.nsw.gov.au/pubs/2011/pdf/spans_2010_summary.pdf).Like many of the issues contributing to the mental health problems of young people, parents are unwitting accomplices.

Similarly, physical activity is a known protective factor against mental illness, yet less than half of primary school children meet the Australian physical guidelines for young people. In secondary that proportion changes to just over one third in summer and close to half in the winter. With all the mental health implications that lack of exercise and disconnection from the natural world brings. One wonders how long it will be before the health cost of having a fully wired, constantly connected, screen orientated generation of young people will become apparent.

A common thread that interconnects the various elements of the perfect cultural storm is that they each chip away at a different aspect of the young person’s psyche, creating insecurities, negative thought patterns and self destructive ideas that, on one side make them more amenable to commercial messages, but on the other leads to the creation of a very fragile personality.