Child mental health crisis: Better resilience is the solution, say experts

Jane Graham, a school nurse with nearly 20 years of experience, says the nature of her job has fundamentally changed during that time. "When I first started, we were mainly providing physical health support, such as asthma, allergic reactions, and injuries. But now, the focus has shifted to mental health," she stated.

She has observed that an increasing number of school-aged children are struggling with mental health issues. "This is particularly noticeable among secondary school students, but some children are as young as seven," she explained. "We're seeing kids with depression, anxiety, and stress, which leads to panic attacks, self-harm, and eating disorders. They're unable to attend school properly or are too anxious to participate in lessons."

GPs, youth workers, and social workers I spoke to shared similar experiences, with many noting that cases of mental health problems among young people are growing at an alarming rate. Official figures suggest that one in five children and adolescents aged between eight and twenty-five in England are now considered to have a mental health disorder. Unsurprisingly, the National Health Service (NHS) is struggling to cope with the challenge.

In 2024, England's Children's Commissioner, Dame Rachel de Souza, described the situation as "shocking" and said the system was in "crisis." However, the reasons for this are not clear-cut. Experts have proposed numerous explanations: the pandemic, the rising cost of living, and the advent of social media have all placed additional pressure on this generation of young people.

But some experts in the field of mental health have raised another question: Is this truly a mental health crisis? Or are young people today simply not resilient enough? In other words, do they lack the ability to withstand or quickly recover from the everyday difficulties that their predecessors also faced?

This question has sparked fierce debate. The term "resilience" can be interpreted by some as dismissive or even derogatory, akin to the "snowflake generation" label. But Professor Andrea Danese, one of the UK's leading experts in child and adolescent psychiatry, believes the concept of resilience must be taken seriously. Professor Danese, Secretary General of the European Society for Child and Adolescent Psychiatry, argues that while greater awareness of mental health is "overall a positive thing," he is concerned it may also be "unintentionally leading to an over-pathologizing of young people’s distress."

He continues that distress should not automatically be seen as a sign of mental illness. "Facing challenges and experiencing distress is normal and crucial for personal growth," he says. "This is how young people develop emotional resilience – they learn coping skills when faced with many small challenges and build confidence in their ability to cope. The narrative we construct matters." School nurse Ms. Graham also believes that many of the struggling children she sees, particularly those with mild mental health issues, would benefit from becoming more resilient.

She argues that if young people had better coping skills, they might better navigate the challenges they may face, thus preventing them from developing into a full-blown crisis – which, in turn, would help ease the pressure on services, allowing them to focus on those at high risk. "We need to teach resilience better in schools, as well as how to maintain good mental health," she says. "But the way we treat children, such as primary school sports days where everyone is declared a winner, doesn't help them."

In popular culture, the concept of resilience was popularized in the 1970s by the work of psychologist Emmy Werner, who studied children from low-income families in Hawaii. More recently, it has been the subject of several best-selling books, including "Option B: Facing Adversity, Building Resilience, and Finding Joy," co-authored by former Meta COO Sheryl Sandberg. Research conducted by Polish scholars suggests that higher levels of resilience can improve life satisfaction and act as a buffer against mental health problems in young people.

Two studies of young people aged between 13 and 18 found that those with greater resilience were better able to develop their own coping strategies when dealing with stress, including seeking support and advice from others, and were less likely to dwell on negative emotions or turn to drugs, alcohol, or smoking. However, not everyone agrees on the issue of resilience or questions the potential downsides of raising mental health awareness.

Dr. Sally McDiarmid, Head of Policy and Evidence at the Mental Health Foundation (Scotland and Northern Ireland), believes that any suggestion that increased awareness is causing the rise in mental health problems is "misleading." She points out that a person must meet a clinical threshold to qualify for treatment for a mental illness, and that the support they receive must be considered beneficial. In her view, on the contrary, greater awareness leads to better "mental health literacy," which, in turn, equips people with the tools to identify and manage their everyday emotions.

"What we need to do is work harder to prevent young people's mental distress from escalating into illness – and we can do this through a whole-society approach, creating mentally healthy communities, schools, and workplaces, as well as nurturing individual resilience in young people," she says. "The two approaches go hand in hand." Dr. McDiarmid argues that the current generation of children and adolescents face a unique set of challenges, having been toddlers and babies during the 2008 financial crisis, and experiencing the divisiveness of Brexit and the Covid pandemic during their formative years.

"We know that adverse events are cumulative – the more you experience, the more likely you are to struggle," she says. Social media also plays a part. While it has its benefits, Dr. McDiarmid points out that cyberbullying and body image pressures on social media can cause additional stress. "Unrealistic images have always been around... but social media has complicated things," she adds. Social psychologist Jonathan Haidt argues that advances in the digital world have led to a "major reshaping of childhood," with children spending less time in face-to-face social interactions and more time on screens. In his book "The Anxious Generation," he argues this affects self-esteem and relationships, which are crucial for good mental health.

But Professor Danese says that social media use alone cannot "fully explain" why mental health problems have become so prevalent. He believes it is more likely to "amplify" problems, rather than cause them. "The reasons [for the rise in mental health problems] are complex, and I'm not sure we fully understand them." It is the cumulative effect of many challenges, rather than isolated ones, that has created the perfect storm. As one young person put it: "From social media platforms that are making us more isolated and anxious, to the crumbling underfunded mental health services, and the global climate crisis that is jeopardizing our future – it’s no wonder young people are struggling to stay positive."

Adele Zeinep Walton, 25, has written extensively about the negative impact of the online age on the mental health of her generation, including her book "Offline: The Human Cost of Our Digital World." She argues that "while individual resilience can be a powerful tool in protecting us from the severity of the challenges we face and helping us recover from the struggles of everyday life, to say it’s the answer to the problems facing young people today is like putting a plaster on a gaping wound." Instead, she believes the answer lies in addressing the addictive and toxic nature of social media platforms, and investing in community spaces, as well as listening to young people’s own voices.

"Young people need to recognize that the world we live in today makes it difficult for young people to thrive, and there needs to be a real effort by those in power to address the fundamental barriers to wellbeing." Adam Jones, Policy and Public Affairs Manager at the mental health charity YoungMinds, is also cautious about the term "resilience," which he believes can be used in a "stigmatizing" way. But he does also worry that the current approach is "overly medicalized."

According to NHS England figures, more than 600,000 young people aged 15 to 25 were prescribed antidepressants in England in 2023-24, and it is believed that thousands more are prescribed other drugs to treat conditions such as anxiety. "Medication can be useful for some people, but clinical guidelines clearly state that it should not be the first-line treatment for most," Mr. Jones says. Hamza Dar, a 26-year-old health influencer from Manchester who shares mental health advice with his followers on TikTok and Instagram as Humz D, agrees that there needs to be a change in the way support is provided. He suggests, among other things, that children should be taught strategies such as meditation in schools from year one.

Nevertheless, he believes that young people are already well aware of the importance of resilience. "[It] has become an essential trait for every young person to have to survive and thrive in this world." Professor Danese is quick to emphasize that he is not saying that young people do not need support. Rather, he believes they may simply need different support from that which is currently on offer – while also identifying early those at risk of developing the most severe mental health problems. For Professor Danese, the true meaning of resilience is not what it appears to be on the surface. He says that emotional resilience is not just about individuals coping alone, but also the back-up they receive from friends, family, and their communities, whether through community centers, sporting opportunities, or social activities.

But he says that some of these opportunities have been lost, referring to past withdrawals of funding and the closure of some networks that could provide support to young people. Mr. Jones agrees, arguing that young people should be given more opportunities to participate in activities that connect them to their communities and build friendships. He also says that there needs to be non-clinical support for issues such as housing and employment, as well as more personalized approaches to treatment. There are some projects that offer examples of this joined-up help, often a collaboration between local councils, charities, and sometimes the NHS.

Mr. Jones points to "The Nest" in South London and "Young Person's Advisory Service" in Merseyside as two schemes that take a flexible approach, offering diverse support, including employment training, budgeting, and benefits advice. The problem is that, more generally, the current prevailing approach in most of the NHS is not conducive to connecting networks in this way. "We need a radical rethink of the mental health system for young people," Mr. Jones argues. Perhaps, then, the crux of the mental health crisis is not whether young people are resilient enough, but whether they have access to enough support to become resilient.