Adolescents’ everyday problems not always mental ill-health

Mental health problems or normal reactions to a life that sometimes gets tricky? Is the picture of young people’s increasing mental ill-health exaggerated? The statistics in the studies that have been made – what do they say? Two LiU researchers are looking for answers.

Young people with their smartphones Photo credit: ViewApart“Report after report paints a picture of an increase in mental health problems among young people. But we often know too little about the reasons behind the problems the young people report, and what their answers mean”, says Anette Wickström (to the right below).

Sofia Kvist Lindholm and Anette WickströmShe manages a project at LiU’s Department of Thematic Studies – Child Studies where she and fellow researcher, Sofia Kvist Lindholm (to the left below), are carrying out an in-depth study of the figures. The analysis of the responses will continue until autumn 2019, but they can already see two trends in the results. One is that ordinary difficulties in life risk being labelled as mental health problems – even if they are not. The other is that some young people really do need support and help.

More and more people are getting diagnoses

“One explanation for why young people report more problems than they did in the 1980s could be that society views these issues differently today, so people talk about themselves differently, and that more and more people are getting diagnoses”, says Anette Wickström.

She and Sofia Kvist Lindholm interviewed 41 pupils in year nine in two schools, both individually and in groups. The pupils responded to an annual survey that is analysed by the Public Health Agency of Sweden, with questions formulated by the World Health Organization. The survey, which contains questions about physical and mental health, is sent to pupils in some 45 western countries. Sweden has taken part since 1985.

The two LiU researchers have focussed mainly on two questions in the survey, and spoken to the young people about the nature of the problems they selected. The survey questions include for instance whether in the past six months the respondent has had a headache, a stomach ache, been irritated or in a bad mood, or had difficulty falling asleep. The response options are from “basically every day” to “rarely or never”.

“When we talk to the pupils another picture emerges, compared to what the reports say. For instance the adolescents might say that sure, they have a headache sometimes, or a stomach ache, but they point out that at the end of the day they feel well. They also say that it’s difficult to fill out surveys like these, and that the responses they give can depend on how they’re feeling on the day.”

Everyday life becomes a medical issue

Young people walking in a corridor Photo credit: HalfpointThe risk is that everyday life, for instance being nervous ahead of a test, or period pain, soreness after a workout or a minor disagreement with a friend, becomes a medical issue, according to the two researchers.

“If we categorise this as a mental health problem, we medicalise our day-to-day lives, and risk that young people develop an incorrect view of themselves. That emotions like stress, sadness, nervousness or anxiety are signs of illness, when in reality they are part of life.”

“Also, the one-size-fits-all reporting on increased mental ill-health among adolescents can lead to the creation of general measures in schools, measures aimed at all pupils, regardless of whether they are experiencing any problems. The risk is that you miss the categories that really need support”, according to Anette Wickström.

“We hear stories about serious and difficult situations that can concern things like sexual harassment, severe loneliness and social rejection. These adolescents need professional help, not some general feel-good programme. To help these pupils, the school healthcare services require more resources”, says Anette Wickström.

Need a much more nuanced approach

Despite it not being finished, the study has attracted interest. In April Anette Wickström was interviewed on a Radio Sweden science programme, in a series on mental ill-health among adolescents, and on 2 June she took part in a short documentary on the Radio Sweden programme Tendens. (In Swedish, see links below.)

Increasingly, researchers in Sweden and abroad are delving deeper into how the growth in mental ill-health is being reported.

“When the studies measure negative aspects of adolescents’ experiences, they focus on their shortcomings. We need a much more nuanced approach when we study mental health – both positive and negative aspects.”

Tendens, 2 June

Vetandets värld, 18 April

Translation: Martin Mirko

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