6 hours Ago By Rupert Hawksley
Watch a few TikTok videos on subjects like depression or anxiety and the site will soon start sending you a torrent of similar content. What many parents may find more surprising, however, is that their children’s schools are now also delivering a stream of activities around mental health . There are regular lessons on the subject, evening seminars for parents, and the school calendar is liberally sprinkled with various mental health awareness weeks.
Like many parents, I initially thought all these well-intentioned activities were probably useful. But they could in fact be making children’s mental health problems worse. Some experts say that the rising rates of depression and anxiety seen in children and young people could be fuelled by some of the very activities that are supposed to tackle them – namely, mental health awareness campaigns.
Please don’t mistake me for someone who dismisses the impact of mental health problems. Such conditions really are on the rise, especially among children and young adults, with latest NHS figures showing that one in five children aged eight to 16 have a probable mental health condition. Many possible causes are being debated, from smartphone use, to climate anxiety to the stress or isolation caused by the Covid pandemic.
While any and all of these recent factors could be contributing, there are probably also longer-term trends involved, as careful and systematic surveys suggest mental health problems among UK teenagers have been increasing for decades. The idea that one such culprit could be awareness campaigns was first set out in a paper published in 2023 by two psychologists at the University of Oxford, Dr Lucy Foulkes and Dr Jack Andrews, in the medical journal, New Ideas in Psychology . Awareness campaigns are a common response to any health condition.
Often led by charities or campaigners and usually featuring celebrities with the health problem in question, they have several potential benefits. The public can be educated about symptoms, and possible diagnoses and therapies. People who have the condition but don’t know it could be encouraged to get help, while those without the condition could become more understanding and helpful to those affected.
But when it comes to mental health, there are also potential downsides. Such campaigns often encourage people to scrutinise their thoughts and feelings for any possible mental health symptoms. This could lead people to believe they have depression and anxiety, for instance, when they really just have minor or transient feelings of sadness or worry.
And unlike with physical health conditions, if someone wrongly labels themselves with a mental illness, it could become a self-fulfilling prophecy. “If people are repeatedly told that mental health problems are common and that they might experience them..
. they might start to interpret any negative thoughts and feelings through this lens,” the researchers say in their paper. Taking the example of anxiety, someone who wrongly starts thinking they have this as a diagnosable condition could pay more attention to every minor fear, and start avoiding situations that trigger further such emotions – which is likely to worsen their symptoms.
Alarmingly, over time there could have been feedback loops, where higher awareness led to more people getting diagnosed, leading even more awareness-raising efforts. Drs Foulkes and Andrews call this idea the “prevalence inflation hypothesis”. We should bear in mind that the psychologists are calling their idea a hypothesis – emphasising that it has by no means been proven yet.
But some recent studies suggest they are on to something. Read Next Stem cell clinics tout miracle cures for arthritis. Why patients should think twice For instance, an analysis of Swedish teenagers who did a short cognitive-based therapy course aimed at preventing depression found it had some negative effects as well as positive ones.
Some teens said that it had forced them to dwell on feelings of sorrow and “small problems became larger than they should have been”. In UK schools, a large trial of mindfulness training – which involves paying attention to your thoughts, feelings and perceptions – found that it worsened symptoms of depression in those who were at higher risk of the condition to start with. Mindfulness training had until recently generated high hopes that it would be a solution to the teenage mental health crisis, so these results caused consternation among health professionals when they were announced in 2022.
Then, earlier this year, a huge Finnish study found that when one person in a school class gets a mental health diagnosis, the odds increase of their classmates getting such a diagnosis later on. It is as if mental health problems can spread through groups of teenagers like a contagion. While this study didn’t evaluate official awareness campaigns, the researchers think that greater awareness could be one explanation, simply because kids tend to hear about their classmates’ problems.
This could lead to more diagnoses among both people who really do have the condition and those who don’t, they say. Where do such findings leave us? The Oxford psychologists are not asking that mental health awareness campaigns come to an abrupt halt – and this would be unlikely to happen in any case, as charities and health bodies tend to have well organised programmes of such activities planned far in advance. But they have called for more research to test their hypothesis as a matter of urgency – for instance, by tracking symptoms of mental distress within schools before and after awareness campaigns.
And whether in the research setting or not, those who design and deliver such campaigns should be more open to the possibility that their efforts might do harm as well as good. You could say we need more awareness about awareness. Clare Wilson is i ’s science writer.
