A new report from the Millennium Cohort Study suggests that mental health problems are highly prevalent in today’s generation of early adolescents, with a staggering 1 in 4 girls and 1 in 10 boys at age 14 reporting high levels of depressive symptoms.
We talk to Dr Praveetha Patalay, the lead researcher on the report, to find out more about the study and what it means for the future of mental health in young people.
What is the Millennium Cohort Study (MCS) and why is it important for mental health?
In Britain, we have a long history of birth cohort studies - research that follows people from birth through their lives. The MCS started at the beginning of the millennium and follows the lives of approximately 19,000 children born in 2000 and 2001.
Assessments have been carried out with children and their parents at ages 9 months, 3, 5, 7, 11 and 14 years – the next sweep will be when the participants are 17 years old.
The data we collect each time gives us an in-depth perspective on a wide range of outcomes – from their physical health to their cognitive development and also, importantly, their mental health.
It provides good data to understand mental health problems and wellbeing in this generation and because it also gives rich information on things like family structure, economic situation and peer relationships – we can also begin to understand risk and protective factors, how symptoms develop and the consequences of them.
From your perspective, what findings do you think are most important from the report?
The findings that are most striking are the high prevalence of depressive symptoms in young people. 24% of 14-year-old girls reported high depressive symptoms and 9% of boys.
How were these findings established?
The young people completed the Short Moods and Feelings Questionnaire, which assesses symptoms of depression, it wasn’t a diagnosis made by a clinician. Scores above an established threshold are meant to be indicative of depression. We analysed the data to get a national understanding of the prevalence of depressive symptoms because the datasets are from a large and nationally representative cohort.
Why do you think there’s such a marked difference in the prevalence of depression between boys and girls?
The gender difference is not unexpected, in other studies looking at mental health in young people there has also been a gender difference in symptoms at this age. What’s surprising is the difference is so much higher between the genders than we’ve previously seen. In previous data, for example the last national mental health study in 2004, we saw that girls were around 1.5 to2 times more likely to experience depressive symptoms than boys, in this data they’re over 2.5 times more likely. That’s a big difference.
We’ve tried to hypothesise why we’re seeing the prevalence gap widen between boys and girls. Other studies have shown that there’s an increased pressure on appearance in girls and girls have a higher rate of body dissatisfaction, which appears to be particularly driving depressive symptoms in girls at this age.
In relation to this, it could also be down to the widespread use of internet devices and the fact that there is more image-based sharing which is affecting girls more.
Another possible hypothesis looks at academic pressure, a Swedish study shows that the pressure to perform well in exams disproportionately affects girls.
There are more theories as to why, what we haven’t done yet is investigate these possible reasons in the Millennium Cohort. I suspect it is a combination of factors that are disproportionately affecting girls.
Does this research show a rise in mental ill-health in young people?
In a previous study, we compared two cohorts of early adolescents which were only five years apart. Even in just five years we can see that the prevalence of high depressive symptoms in adolescent girls increased from 13% to 20%. It’s worth noting that these datasets only came from England.
If we take the two studies together we can see there is a marked increase in the number of young people reporting symptoms associated with depression.
And there’s other data from other sources and other countries which also indicates increasing prevalences. At all ages, we are seeing data that is telling us that younger generations are suffering from higher prevalences of mental health difficulties.
What are some of the theories as to why we’re seeing an increase?
There are a lot of possible explanations out there including increases in inequality, economic pressures and also loneliness. Much more research is needed to understand the striking increase we observe in today’s young people.
What impact could the findings have for the future of mental health care?
We know that experiencing mental health difficulties when you’re young increases your risk of developing mental illness later in life.
Given we find that the prevalence of problems is on the rise, this should inform how we plan services and provision for mental health. Mental health is underfunded, and resources keep getting cut – surely in the face of increasing prevalences resources need to be increased too?
It’s also important to explore how the findings can inform prevention interventions. We should be doing everything we can to understand why it’s increasing and creating policy to prevent the high prevalences of problems we are seeing. We should also aim to reduce the impact of mental health difficulties on quality of life.
What are the next steps for the research?
It’s important to understand what the risk and protective factors for mental health problems are. We need to be thinking about how we identify young people who are at risk earlier, and how we support them so we can prevent problems from getting worse.
More generally, I think we need to reduce the stigma around mental health and try to increase people’s understanding of how common these difficulties are and what people can do to help themselves, their friends and their family.
Why are you interested in exploring mental health difficulties in young people?
I’ve always been interested in the early years in human development, given childhood is really important and sets us up for the rest of our lives. We know that more than 80% of people who experience mental illness later in life have already experienced symptoms in childhood - so mental health is an area in which it is really important to research early in the lifecourse so we can have the biggest impact long term.
Last updated: 27 July 2018
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