How can we better support teenagers' mental health?

The World Health Organisation’s (WHO) recent report claimed that British teenagers are among the most troubled in the world, coming off 3rd worst in terms of happiness within a survey of 42 countries.[1] This statistic is startling and demands serious attention. But why are teenagers so distressed? What are the implications? And what can we do about it?

To fully grasp this issue we need to understand two things. Firstly, there is clearly an epidemic of unhappiness plaguing young people. But, unlike viral epidemics, there is no instant vaccine to solve or guard against unhappiness, let alone eradicate it altogether. The human brain is both a remarkable and unimaginably complex system. Unhappiness in the modern world is often the result of multiple and complexly interrelated external factors impacting on equally complex internal factors, shifting our neural chemistry in slight and undetected ways. And boy is there a vast array of complex input facing young people today: the anxiety of curating identity in a social media world, the pervasive threats of terrorism and global warming, distrust of the political establishment, the age-old turbulence of puberty – take your pick. This problem of unhappiness is multi-factorial.

Secondly, by normalising the need to be happy we inadvertently pathologise unhappiness. The Dalai Lama says “the very purpose of life is to seek happiness”. Bookshop shelves are warped by the overabundance of self-help tomes. Social media feeds depict images of friends, peers, colleagues, and celebrities having fun, always at a zenith of happiness but never in a nadir of unhappiness. But this discursive and pictorial construction of happiness as something we should have if only we put the right amount of effort in creates a misreality gap whereby self-expectations become unrealistic, unattainable, and thus torturous. Even the WHO outlines an all too utopian definition of health, describing it as “a state of complete physical, mental, and social wellbeing and not merely the absence of disease or infirmity.” Happiness, by consequence, is the total absence of unhappiness, meaning we struggle against unhappiness. Yet, as Carl Jung perceived, “what you resist persists,” meaning our delusional desire to eradicate unhappiness is not only futile but creates a nocebo that gives increased potency to misery.

The expectation to be happy dints the experience of happiness itself and renders the experience of unhappiness all the more catastrophic – especially for young people during their fragile, formative years. They may conclude that their unhappiness reveals a personal fault and that only they are unhappy, leading to feelings of abnormality and isolation. This adds fuel to the fires of metacognitions like rumination, worry and stress about the unhappiness felt, only exacerbating negative emotions.

Although it may arise unpredictably, unhappiness is a normal part of universal human existence. But our society suggests to young people that it isn’t. Evolution has shaped our minds so that we strive to increase our intellectual faculties, status, and belongings. The flipside of this pursuit is that we sometimes come up short against our own aspirations and our perception of others. But the negative emotions that result aren’t the result of some ineffable force’s spiteful design; rather, they are part of the evolutionary process that encourages us to learn and develop, to adapt and improve. Unhappiness is not abnormal but inevitable – even necessary. Without it we wouldn’t even have happiness, or, at least, we wouldn’t know we did.

New therapies, such as Professor Steven Hayes’ Acceptance and Commitment Therapy (ACT), seeks to re-evaluate notions of happiness and unhappiness, helping individuals come to terms with happiness’ impermanence and unhappiness’ inevitability. Along the lines of Viktor Frankl’s ‘paradoxical intention’ in Logotherapy that involves the deliberate practice of a thought or habit to remove it, ‘acceptance therapies’ provide patients relief by encouraging them to better understand unhappiness, even finding comfort and stability in their unhappiness. Ultimately its goal is to normalise unhappiness rather than pathologise it.

With this in mind, rather than directly tackling happiness, I offer two alternatives to mitigate levels of youth unhappiness noted by the World Health Organisation. The first is instigating a perspectival shift away from pathologising, fearing, and negatively branding unhappiness, instead reattributing unhappiness connotations of normality, universality, and inevitability. We should view unhappiness and happiness not as distinct, binary terms but as ends of a continuum along which we all travel. By perceiving un/happiness as impermanent – and even unexclusive – states, we can begin to relate in a healthier manner to our own emotional reactions. As the Japanese phrase mono no aware teaches, awareness of the transience of all things heightens appreciation of their beauty.

The second approach – which is not divergent but actually gains traction from the aforementioned change – involves a holistic, community-based approach to increase collective responsibility and provide upstream interventions rather than downstream treatment of psychological ill health in young people. This can be achieved by teaching them about the brain, their emotions, normalising unhappiness, and providing tools and techniques to bounce back quickly from adversity.

Much of the current responsibility for spotting and stopping the aggravation of mental health issues in youngsters is borne by teachers. “There is a growing expectation,” writes professor Despina M. Rothi, “that schoolteachers should not only act as educators by delivering the national curriculum, but also be more involved as tier one mental health professionals”.[2] But Rothi et al.’s report also observes that a significant proportion of teachers feel “ill-equipped to cope effectively” with such demands.

This is partly due to the strain put on teachers to ensure their students attain highly in accordance with strident academic standards and guidelines. As the NSPCC’s Senior Research Officer Dr. Mary Baginsky notes, any teachers neglecting their pastoral role likely do so “because of the constraints imposed by National Curriculum, SATS and the resulting pressures of work”.[3] And who can blame them; in the endgame, a class’s grades are the precipice upon which a teacher’s job and reputation teeters.

The problem here seems to be that, despite a latent understanding of psychological wellbeing’s importance to the performance of both teachers and students, governments, communities, parents, and schools aren’t doing enough to facilitate the teaching of ‘soft skills’ to young people. Such ‘soft skills’ – emotional, social or ‘non-cognitive’ skills, as Nobel Laureate James Heckman explains – lead to greater successes later in life. Enhanced ‘soft skills’ help create environments that increase psychologically protective factors and decrease risk factors by raising levels of interpersonal awareness, acceptance, compassion, and trust.[4] This would improve psychological wellbeing over time, as neuroplastic and epigenetic processes strengthen healthier, more positive mindsets.

In an ideal situation, time teaching ‘soft skills’ would be required by the national curriculum. But, aside from wholesale government policy changes, there are interventions we can make now to improve the mental health of young people. By moving away from blindly chasing notions of happiness and instead targeting psychological wellbeing – which is attainable, adaptive, measurable, and the key to high performance – we will become healthier and improve our quality of life.

But the paradigmatic belief that responsibility for effecting such a change falls mostly on teachers needs shifting. The impetus must be far more widely dispersed and more deeply felt. Parents, governments, leaders and businesses must all recognise their role as crafters of young people’s expectations, beliefs, and mindsets. Rather than outsourcing duty, we must unite to normalise unhappiness on a societal level while recognising how responses to unhappiness effect psychological wellbeing and how wellbeing effects performance and health, teaching young people simple tools and techniques that they can use to sustain wellbeing throughout life. Because the ill health of young people now, like a train hurtling towards broken tracks, has terrifying implications for the future generation of workers, guardians, and world leaders.

[1]http://www.euro.who.int/en/hea...

[2] Rothi, Depsina M. et al., On the front-line: Teachers as active observers of pupils’ mental health, Teaching and Teacher Education 24 (2008) 1217–1231

[3] Baginsky, Mary, School counselling in England, Wales and Northern Ireland: A review. NSPCC & Keele University. (2004)

[4] Brackett, Marc A. & Rivers, Susan E., ‘Transforming Students’ Lives with Social and Emotional Learning’, Handbook of Emotions in Education, (Yale Centre for Emotional Intelligence), http://ei.yale.edu/wp-content/...