Children are having a hard time of it at the moment. They’re experiencing higher levels of anxiety and stress, are more likely to be bullied, and have more suicidal thoughts. Nine years ago Unicef judged child well-being in the UK to be the lowest in Europe – 21st out of 21. And although we’d gone up a couple of places by 2010, spending cuts in young peoples’ services look likely to put us back down the table.
Good news, then, that the ASCL (one of the organisations that speaks for headteachers) has spoken out against the rise in child mental health issues, and the low standard and quantity of support children and schools receive in this area. Good news right? If a child is suffering from stress, anxiety, self-harm or suicidal thoughts we should get some support out to them, right? Surely, Phil, you’re not going to get your anti-psychiatry out on this most-vulnerable group of people and say they shouldn’t be treated as ill?
No, I’m not. Obviously it’s a good idea to support someone going through awful times. To borrow an analogy I have no right to borrow, when my arthritis manifested as an unsightly rash on my forehead, I was pretty keen to get that seen to. Treating the symptom was important.
But what happens next? Do we allow the symptom to tell us something important about what is causing it, or do we ignore it because it’s being treated?
Many years ago your man Laing (King of the anti-psychiatrists) wrote that in a fundamentally insane world, a ‘schizophrenic’ response was more reasonable and rational than a ‘sane’ response. He saw mental illness as a symptom of bad situations in the world, and so alongside helping his patients change and adapt, he advocated for change in the world. He took their symptoms seriously, and listened to them. For example, writing in the late 60s Laing pointed out the number of patients he saw who were suffering mental ill-health because of the stress placed on them by impending nuclear war. As well as helping them to come to terms with this stress and to live with it, he also campaigned against nuclear arms and wrote prolifically on the subject, helping wider society understand the fears that some people found overwhelming them. That is, he took the symptom and allowed it to have a voice in shaping society as a whole.
So what does it tell us that the incidence of child mental ill-health is rising, and that child well-being is the lowest in Europe? What can it tell us about us? Nothing; it’s a statistic. To learn the lessons, we need to go out and listen to the children who are suffering, and we need to allow their voices to change us. I have my own theories (what little contact I still have with the education system has shown me ever-increasing efficiency inversely proportional to genuine human contact) but it’s not about my theories – it’s about the voice of the children – the most unempowered, unlistened-to, vulnerable group in society.
Last week I wrote about the importance of allowing narratives other than the physicalist narrative to emerge and have a voice in mental health. This is especially the case with children, who lack the social and political weight to make their voices – their understandings – heard in society at large. If we don’t make the effort to listen, and don’t allow their voices to change us, then in the coming years child mental-health will go the same way as adult mental health and education: it will become increasingly efficient, evidence-based, physicalist, and inhumane. It will become a private issue for specialists rather than a public issue which everyone is obliged to engage with. It will treat symptoms more effectively (which means CBT-style coping strategies for children, ‘psycho-education’ the parents, and medication for both as an all-too-reachable second-line), and so will obscure the problem which caused the symptom, allowing us to ignore that problem and continue to push children through the system out into the global race. And soon, we hope we’ll have an education system which rivals that of South Korea. Great.