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

Jane Graham has been a school nurse for nearly 20 years – and during this time the nature of her work has completely changed. "When I started, the majority of the support we provided was for physical health, like asthma, allergic reactions and injuries," she says. "Now it's mental health."

She has seen a surge in schoolchildren struggling. "It really impacts pupils at secondary school, but some are as young as seven," she explains.

"We're seeing children with depression, anxiety and stress – and that's leading to panic attacks, self-harm and eating disorders. They're not making it to school or are so anxious they cannot attend classes."

GPs, youth workers and social workers I have spoken to shared similar stories, with many pointing out that mental health cases in the young are rising in ever greater numbers.

One in five children and young people between the ages of eight and 25 in England are now thought to have a mental health disorder, according to official figures. Unsurprisingly, the NHS is struggling to keep up.

In 2024 Dame Rachel de Souza, the children's commissioner for England, described the situation as "shocking" and said the system was in "crisis".

What's less clear is why this is happening now.

Plenty of explanations have been offered by experts: the pandemic, the cost of living and the advent of social media have all placed additional pressures on the generation now starting out.

But some experts in the field of mental health have raised another question: that is, is there really a mental health crisis or are young people simply not resilient enough?

In other words, are they lacking the capacity to withstand or recover quickly from day-to-day difficulties that generations before them faced too?

This question is a polarising one. The word resilience could be interpreted by some as disparaging, or even toxic, in a similar vein as the term "snowflake generation".

But one of the country's leading experts in child and adolescent psychiatry, Prof Andrea Danese, from King’s College London, believes that resilience needs to be taken seriously.

While greater awareness of mental health "has generally been a positive thing", according to Prof Danese, who is general secretary for the European Society of Child and Adolescent Psychiatry, he says that he is concerned that it may also have "inadvertently contributed to over-pathologising distress in young people".

Distress should not automatically be seen as a sign of mental ill-health, he continues.

"Facing challenges and distress is normal and important in terms of individual growth," he says. "That's how young people develop emotional resilience – they learn coping skills in the face of many small challenges and build self-confidence about their ability to cope. The narratives we build matter."

Ms Graham, the school nurse, is also of the opinion that many children who she has seen struggling - particularly those with more low level mental health problems - would benefit from becoming more resilient.

She believes that if they were equipped with better coping skills, young people would likely be better placed to deal with the challenges they may be facing before they develop into a full-blown crisis – and this in turn would help ease the pressure on services to focus on those who are at high risk of harm.

"We need to do much better at teaching resilience in schools and how to stay mentally healthy," she says. "But the way we treat children, such as primary school sports days where everyone is declared a winner, doesn't help."

In popular culture, the concept of resilience was popularised in the 1970s, in the wake of research by psychologist Emmy Werner, who studied children in Hawaii from lower-income backgrounds.

More recently it has been the subject of several bestselling books, including Option B: Facing Adversity, Building Resilience and Finding Joy, co-authored by Sheryl Sandberg, who was previously chief operating officer at Meta.

Research by academics carried out in Poland suggests that higher levels of resilience improve life satisfaction and act as a buffer against mental health problems among young people.

Two studies involving young people aged between 13 and 18 found those with greater resilience were more 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 is in agreement on the issue of resilience - or the questions around the potential downsides of greater mental health awareness.

Dr Shari McDaid, head of policy and evidence (Scotland and Northern Ireland) at the Mental Health Foundation, argues that any suggestion that increased awareness is to blame for rising rates of mental health problems is "misleading".

She points out that for someone to qualify for treatment for mental ill-health, they must meet a clinical threshold and the support they receive must have been judged to be of benefit.

Rather, greater awareness has led to better "mental health literacy", in her view, which in turn has given people the tools to recognise and manage day-to-day emotions.

"What we need to do is work harder at preventing young people's mental distress from escalating into disorder - and we can do this through a whole-of-society approach that creates mentally healthy communities, schools and workplaces, as well as by fostering young people's personal resilience," she says.

"The two approaches go hand in hand."

Dr McDaid argues that the current generation of children and young adults face a unique set of challenges, pointing out they were the toddlers and infants of the 2008 financial crisis and have also lived through the divides around Brexit as well as the Covid-19 pandemic during their formative years.

"We know 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 benefits, Dr McDaid points out that cyber-bullying and body image pressures, which can be exacerbated on social media, cause additional stress.

"There has always been unrealistic images… but social media has complicated things further," she adds.

Social psychologist Jonathan Haidt argues that advents in the digital world have led to a "great rewiring of childhood", in which children are spending less time socialising in person and more time glued to their screens. In his book The Anxious Generation, he suggests that this affects self-esteem and personal connections, which are crucial to good mental health.

But Prof Danese says that social media usage alone cannot "wholly explain" why mental health problems have become widespread.

It is, he argues, more likely to "amplify" problems rather than cause them. "The causes [of the rise in mental health problems] are complex and I'm not sure we fully understand them."

And it is the cumulative effect of a great many challenges, rather than one in isolation, that creates a perfect storm.

As one young person puts it: "From social media platforms that make us more isolated and anxious, to underfunded mental health services that are on the brink of collapse and a global climate crisis that puts our future at risk - it's no wonder that young people are struggling to stay positive."

Adele Zeynep Walton is 25 years old and has written extensively about the negative impact of the online era on her generation's mental health, including in her book, Logging Off: The Human Cost of Our Digital World.

"While individual resilience can be a great tool to protect us from the severity of the challenges we face and help us bounce back from the struggles of everyday life, to say it can fix the problems facing young people today is like putting a plaster on a gaping wound," she argues.

Instead, she believes the answer lies in tackling the addictive and toxic nature of social media platforms and investing in community spaces - as well as listening to young people themselves.

"What young people need is the recognition that the world we live in today makes it difficult to thrive as a young person and a genuine effort from those in power to tackle those barriers to wellbeing at the root."

Adam Jones, a policy and public affairs manager at mental health charity Young Minds, is also wary of the term resilience, which he argues can be used in a "stigmatising" way.

But he does share concerns that the current approach is "over-medicalised".

More than 600,000 young people aged 15 to 25 in England were prescribed anti-depressants in 2023-24, according to NHS England, and thousands more are believed to have been prescribed other drugs to treat conditions such as anxiety.

"Drug treatment can be useful for some, but clinical guidelines are clear that it should not be the first-line treatment for most," says Mr Jones.

Hamza Dar, a 26-year-old wellness influencer from Manchester who shares mental health advice with his followers on TikTok and Instagram under the name Humz D, agrees there needs to be changes in the way support is provided. He suggests, among other things, that children in schools should be taught strategies like meditation from year one.

Nonetheless, he argues, young people are already well aware of the importance of resilience.

"[It] has become a vital characteristic that every young person has had to embody just to navigate and survive in a world like this."

Prof Danese is quick to stress that he is not arguing young people do not need support. Instead, he suggests they perhaps just need a different sort of help to that which is currently on offer – alongside earlier identification of those at risk of developing the most serious mental health problems.

For Prof Danese, the true meaning of resilience isn't what it may at first appear. Emotional resilience, he says, isn't just about the individual coping by themselves, but about the backing they receive from friends, family and community too, whether through community centres, sporting opportunities and social events.

But some of these opportunities have been lost, he says, nodding to a withdrawal of funding in the past and the closure of some networks that can provide support to young people.

Mr Jones agrees, arguing young people should be offered greater access to activities that connect them with their community and build friendships. He also says there needs to be non-clinical support for issues such as housing and employment as well as more personalised therapies.

There are examples of projects offering this kind of joined-up help, often in partnerships between councils, charities and, sometimes, the NHS.

Mr Jones points to The Nest in south London and the Young Person's Advisory Service in Merseyside as two schemes that take a flexible approach, offering a diverse range of support, including employment training, budget and benefits advice.

The problem is that more generally, the current prevailing approach embedded across most of the NHS is not conducive to bringing networks together in this way.

"We need to rethink the mental health system for young people in its entirety," argues Mr Jones.

So, perhaps the question at the heart of the mental health crisis is less about whether young people are resilient enough - but whether they can access sufficient support to become so.

Additional reporting by Tara Mewawalla

Top image credit: Getty