Girls at risk

Why are women’s bodies the cause of such distress and what is being done to help?

I write this piece because the young women interviewed for this national survey will be the young mothers of the next generation and unless we do something now to build their sense of self-worth and self-confidence we will inherit, yet another generation of children whose lives are blighted by parental mental illness.

As a society there is still a lot of shame associated with mental illness and a reluctance to speak about it in families and in communities. In fact, some communities do not recognise mental illness as an illness, but as a stain on the family honour, and the mentally ill person is often socially isolated and alone with their distress. This must change at a national level and the increasing noise around mental health needs to include a more open attitude to mental illness as well as mental health. When we can’t talk about it, we cannot think about it and this leaves the children of parents with a mental illness confused and distressed.

The NHS Digital Report from November 2018 on Mental Health of Children and Young People in England 2017 makes for very interesting reading. This research report provides the best source of data on trends in child mental health. The survey concluded that one in eight 5-19 year-olds had a mental disorder and rates were similar for boys and girls. Generally, there is very little evidence that children’s mental health is getting worse but there is a slight increase in rates of emotional disorder (depression and anxiety). Our work with families also shows that depression and anxiety are the most common mental health issues.

One of the most striking findings from this research is that rates of mental disorder in children and young people tended to be highest in children living with a parent with poor mental health, and that family functioning was the most significant determinant of the children’s mental well-being. This is why working with the whole family is fundamental to our work. One of the basic building blocks in our work with families is to offer them a safe place to talk about the parent’s mental illness and to help the whole family develop a more open attitude to discussing this illness, encouraging them to talk about it, helping them to understand it and most importantly helping the children to develop coping strategies to protect them against developing a mental health problem themselves.

Notably in this survey was the difference between girls and boys in the age group 11-16 year-olds. At this age, boys and girls were equally likely to have a disorder but they tended to have different disorders. Girls were more likely than boys to have an emotional disorder (10.9% compared to 7.1%). Boys were more likely to have a behavioural disorder (hyperactivity disorder ADHD). In the age group 17-19 year-old, girls were more than twice as likely as boys (23.9% as opposed to 10.3%) to have a disorder.

Several recent surveys have identified young women as a high-risk group for poor mental health (McManus et al 2016). One in four young women aged 17-19 have a mental disorder according to this survey, with rates of emotional disorder and self-harm being higher than other groups – 5% of young women were identified with body dysmorphic disorder (BDD) which is an anxiety disorder characterised by the obsessive idea that some aspect of one’s body/body part or appearance is severely flawed and warrants exceptional means to hide or fix it.

Nearly 2% of young women were identified with an eating disorder (anorexia or bulimia). 52.7% of young women with a disorder also reported having self-harmed or made a suicide attempt at the time of interview.

So what do these statistics tell us? They demonstrate the importance of supporting young people and particularly young women more in the home and school to help them navigate an increasingly difficult public space where they take in messages about how they should look.

Teenagers tell us that they mostly get criticism and judgement from adults and pressure from peers to ‘fit in’.  There is enormous pressure on children and young people. We need to see more compassion and less pressure in all our dealings with young people.