Are we watching a childhood anxiety epidemic caused by education unfolding before our eyes?
To answer this, let’s first look at what, exactly, anxiety is and what causes children to experience it.
Anxiety is a feeling of worry or fear that manifests itself in negative thought patterns, interfering with concentration, focus and sleep. It can cause physical effects like a racing heartbeat, sweating and feelings of sickness or dizziness.
The likelihood of a person suffering chronic anxiety is partly down to genetics, argues Eleanor Leigh, a clinical psychologist at the University of Oxford’s Centre for Anxiety Disorders and Trauma.
“A third to a fifth of the variance in anxiety problems in the population can be explained by genetic inheritance,” says Leigh. “Children come into the world with behavioural temperaments to a greater or lesser extent, and that affects how they learn about their environment and whether they’re likely to develop anxiety problems.”
As well as nature, there’s also nurture. For example, overcritical and controlling parenting is associated with anxious behaviours in children. Major life events such as bereavement, accidents, abuse and sexual assault all add to the mix, as does bullying and the effects of an unsettled or unhappy home life.
Measuring the prevalence of anxiety is difficult. It’s possible to count the number of referrals from GPs to child and adolescent mental health services (Camhs) for severe anxiety, but these services are increasingly stretched. Much less is known about how many children are going undiagnosed or aren’t being referred onward for help. It’s hard to find data about the true scope of anxiety in the general population due to a lack of long-term research.
But certainly in surveys, more young people are reporting anxious feelings. So, what is causing this?
David Putwain, an educational psychologist at Liverpool John Moores University, says that exams are part of the problem. “Leaders and teachers see the government reforms that came to fruition in 2014 as being behind all this,” he says. GCSE students moved from a modular approach to big, terminal exams at the end of Year 11 in a three- or four-week period. “It would be wrong to say this is the entire cause, but it seems to be driving an increase in anxiety,” he adds.
Leigh, however, disagrees. “I think it’s the other way around,” she says. “We know that kids with anxiety disorders find exams hard already, so there’s going to be an extra burden on those already struggling. But we can’t say what impact frequent exams have on mental health outcomes for others.”
While there is not reliable evidence about the cause of anxiety, it’s clear that action is needed. Those who genuinely do have a problem need support, says Leigh.
“Look out for the quiet ones,” she suggests. “The children who don’t ever put their hand up, don’t ask questions, speak in a whisper, might lock themselves in the loo or have a lot of sick days with things like tummy aches.”
If that sounds like one of your pupils, do not confront them when others are watching, she warns. “If you do approach them, be sensitive,” urges Leigh. “Ask about it in a way that’s normalising - ‘Do these feelings ever come up for you?’ Give the message that it’s always OK to ask for help and advice without feeling forced to talk.” For more severe anxiety, a GP can refer a child to the local Camhs. Charities such as Childline, YoungMinds and Place2Be can also offer support.
Ultimately, whether you believe that we are in an anxiety epidemic caused by education or not, the effect of mental health problems on children’s wellbeing is too serious to ignore.
Kat Arney is a science writer, speaker and broadcaster
Commentary: ‘I want to go back in time to shout and wave my arms’
Tara Porter is a clinical psychologist in NHS child and adolescent mental health services and private practice. Her first book, You Don’t Understand Me: the young woman’s guide to life, is due to be published in April 2022 by Bonnier. She says:
One of Kat Arney’s primary questions was whether the anxiety we were seeing among young people amounted to an anxiety pandemic.
Reading the article again now, I’m reminded of the early days of the Covid-19 pandemic, when, let’s face it, most of the world’s governments failed to recognise the severity of the situation.
I now want to go back in time to shout and wave my arms at the learned academics in this article. Yes, of course we need more data; of course coincidence doesn’t prove causality. But can we please listen to the frontline workers about just how bad the problem is and respond before it is too late?
Sadly, anxiety rates have continued to rise since 2018. The recent NHS Digital survey Mental Health of Children and Young People in England 2021 found that the rate of probable mental health disorders in six- to 16-year-olds increased between 2017 and 2021 from one in nine (11.6 per cent) to one in six (17.4 per cent). And in its annual The Good Childhood Report, charity The Children’s Society says that young people are more unhappy with school than with any other aspect of their life.
Why? For me, the causality is multilayered and complex. When I sit in my clinics listening to children and adolescents, I am reminded of an assembly line. Children believe their success is all about collecting accomplishments and achievements, and I believe that all that pressure is making a generation mentally unwell.
Parenting styles and social media play a part. But we also have an education system in which we judge schools and teachers on the exam grades of their pupils, and start talking about GCSEs in Year 7, giving children the message that their whole future is determined by their performance in exams.
So, what’s the answer? It’s not about mindfulness groups or more school counsellors: those are Band-Aids on a gaping wound. If we are serious about making a change for the next generation, we need to work towards a society and education system that respects our future care workers and shelf stackers equally with our future academics and doctors; where children are allowed to “be” and don’t always have to be “doing”; where the success of an education is judged not on a child’s exam results but on whether they are a well-adjusted, mentally well, functioning member of society, valued for the work they do.
