麻豆传媒

TEENAGERS are experiencing a mental health crisis. I am not just talking about the in mental health problems that have been reported in them over the past decade or so. I am talking about what UK schools are being asked to do in response.

Many secondary schools in the UK 鈥� which educate those aged 11 up to 18 鈥� now teach mental health skills, such as mindfulness or techniques from cognitive behaviour therapy (CBT). In a 鈥渦niversal鈥� approach, these lessons are taught to all students, regardless of their level of need. The idea is to give all teenagers helpful coping skills, which will alleviate current mental health problems or prevent future difficulties from starting.

This sounds excellent on paper, but the trouble is, it doesn鈥檛 work very well in reality. Research that when universal lessons do reduce symptoms of mental health problems, the effect is small: on average, teenagers who receive these classes only score slightly lower on questionnaires measuring anxiety or depression than those who don鈥檛 receive them.

More concerningly, the lessons might actually increase symptoms. A study published a few weeks ago, involving 8376 students in 84 UK schools, that some teenagers who received 10 mindfulness lessons reported more symptoms of depression than those who just had their usual lessons. (Specifically, it was teenagers with existing mental health symptoms who were affected in this way; for others, there was no increase or decrease in depressive symptoms after mindfulness.) Other studies that teaching teenagers CBT skills at school led to a small increase in depression and anxiety symptoms. In fact, when teenagers are asked what they think about mental health lessons, some they find them helpful, but others say the focus on negative thoughts made them feel more stressed and unhappy.

Such findings shouldn鈥檛 be surprising. The whole premise of these classes is that students should notice their negative thoughts and feelings, label them and then carry out exercises to try to accept or change them. But it can be really difficult to change how you think and feel, especially without one-to-one support. School mental health lessons may be inadvertently teaching teenagers to ruminate on negative thoughts and feelings without giving them any real ability to manage these experiences, which could increase their distress.

It is well-established that psychological therapy doesn鈥檛 help everyone and can even lead to mental health problems in some people. Since school mental health lessons are based on principles from psychological therapy, it is a reasonable and urgent hypothesis that they might have a harmful effect too, at least for some individuals.

There are other issues with universal approaches. By definition, they ignore the immense variety of personalities, needs and circumstances that exist within a class of students 鈥� and yet understanding this variation may be key to helping each individual. In addition, lessons about coping skills don鈥檛 address the root causes of mental health problems and instead tell the individual to manage their distress themselves, which can be unfair and unrealistic.

The question is what we do instead, because there are many teenagers who badly need mental health support and aren鈥檛 getting it. Two options may be more fruitful than universal approaches. First, more funds and effort could be channelled into one-to-one support, either via the National Health Service or experts working within schools. Second, more efforts could be made upstream, to reduce the issues, such as bullying and financial insecurity, that make teenagers so vulnerable to mental health problems in the first place.

We need to do a lot. But we also need to press pause and think about what not to do, because teaching mental health skills to everyone, while appealing on paper, isn鈥檛 stemming the problem 鈥� and might even be making matters worse.

Lucy Foulkes is a psychologist specialising in adolescent mental health @lfoulkesy