#TeenMentalHealth Report Day 1: The things that are wrecking teenager's heads

In a special report, Claire O’Sullivan looks at teen mental health. A special Irish Examiner / ReachOut Ireland teen mental health survey was designed to capture the views of teenagers in Ireland in relation to youth mental health and the issues that affect them.

Two thirds of teenagers rate their mental health as bad 

  • 34% of 2,500 teens reported ‘good’ or ‘very good’ mental health
  • 62% say their mental health is ‘average’, ‘poor’, or ‘very poor’

Just one third of teenagers rate their mental health as good or very good — with boys reporting better mental health than girls.

Younger adolescents (13 and 14-year-olds) also reported overall better emotional health and wellbeing compared to those in mid and late adolescence.

Overall, 34% of the respondents reported ‘good’ or ‘very good’ personal mental health while 62% self-rated their mental health as ‘average’, ‘poor’, or ‘very poor’.

Only 7% of the 2,500 teenagers who took part in the Irish Examiner/Reachout Ireland survey described their mental health as very good, 27% as good, 32% rated it average, 21% as poor, and 9% as very poor.

Among teenage girls, 27.9% described their emotional wellbeing as good or very good while that figure was significantly higher among boys, who scored 46.5%. In contrast, 33.8% of girls described their mental health as poor or very poor while that figure stood at 20.6% among boys.

Dr Aileen Murtagh, a consultant child and adolescent psychiatrist at St Patrick’s Mental Health Services, wondered if boys under- reported in this survey as, based on her clinical experience, boys are more reluctant than girls to report poor mental health.

“We see more and more teenage girls presenting with mental health difficulties but boys remain slower to identify a problem and to ask for help. Teenage boys often present to our services in an atypical manner where they are displaying symptoms like irritability. Girls talk more about emotions and so tend to present earlier,” said Dr Murtagh.

Dr Murtagh said young people nowadays have more stressors in their lives — many of them stemming from social media and television. It didn’t surprise her that exams and school are young people’s primary concerns.

She said St Patrick’s “consistently” gets high levels of referrals from exam-year students.

“Each year, we see young people with exam-related stress and anxiety from November to June. And in recent years, we have noticed an increase in the run-up to the mock exams as well as the State exams themselves. We see referrals from Junior Cert as well as Leaving Cert students,” she said.

The following quotations are some of the experiences students shared with us during the survey:

Dr Murtagh, like Dr Emer Smyth from the ESRI, said she doesn’t think parents and teachers are driving this anxiety.

“Many of the young people are generating this stress themselves. They set standards very high, getting obsessed with results and the points race. We will see sleep difficulties, anxiety, panic attacks, and even self-harm in people setting very high standards for themselves,” said Dr Murtagh.

She added that despite their many friends on social media, young people are struggling with friendship.

“Friendships and boy/girl relationships come up a lot. Boy/girl relationships and the exploration of sexuality is a big concern. Many struggle with building relationships or friendships based on things like shared interests,” said Dr Murtagh.

Up to 43.6% of 13 and 14-year-olds described their mental health as good or very good while the equivalent figure dropped to 30.2% among 18- and 19-year-olds.

Asked a series of questions around how they are dealing with problems, how relaxed they have been feeling, optimism levels, and so on, just 2% of girls said they had been feeling relaxed all of the time compared to 7% of boys.

Just 22% of girls said they often dealt with problems well compared to 30% of boys. Some 34% of boys said they had been feeling optimistic frequently but the equivalent figure was 25% for girls.

Psychiatrist Aileen Murtagh.

Tunes are music to ears of stressed out teens

If teenagers want to destress, they most commonly turn to music, ReachOut Ireland/Irish Examiner research shows.

They listen to music, play musical instruments or sing.

Some 45% of the 2,045 boys and girls that answered this optional question suggested that music helped them.

Another 23% said exercise and sport made them feel better while 18% said talking with others got them through difficult times.

Another 16% said spending time with people, family and friends helped.

Another 10% said getting some sleep made them feel better while 9% said chilling out, watching TV, movies or Netflix were good stress relievers for them.

According to the CEO of ReachOut Ireland, Derek Chambers, the vast majority of teenagers had “healthy and positive ways of coping with stress”, while a small number described binge drinking, self harming, smoking and “hitting things” when life got tough.

According to ReachOut, the survey also revealed young people have a “reasonable” understanding about how to access and provide mental health information and support.

Up to 61% felt they had a good or very good understanding of how to help a friend who was going through a tough time. Another 60% said they personally would have a good or very good understanding of who to talk to if they were going through a tough time and 48% said they would have a good or very good understanding of where to find information “on getting through a tough time”.

A similar question was asked in ReachOut Ireland’s 2015 study of college students and higher percentages were recorded suggesting that as young people progress from school to college, they are more exposed to mental health information.

‘I’m sitting there thinking what do I want to do, and what am I expected to do’

The Irish Examiner / ReachOut Ireland teen mental health survey has shown there is huge pressure on students to 'pick the right college course' even if they haven't made up their mind about a future career.

There was a mixture of surprise, disbelief, and then more serious nodding of heads when we sat down with a group of fourth- and fifth-year pupils from Kinsale Community School in Cork to talk about the results of the teen mental health survey.

Out of the 2,500 boys and girls, aged 13-19, who responded to the survey, only 34% rated their emotional wellbeing as good or very good. Another 30% said it was poor or very poor, while 32% said it was average.

Fiona Deasy was thrown by the results. She “wouldn’t have thought” 30% of her classmates or school year could be feeling low or very low. She’d imagined her fellow fifth years as “happy out or plodding along”. However, the national survey results suggest otherwise.

“I was thinking of my year group and never would I have thought that 60 of those 100 would have described their mental health as only average, poor, or very poor. You walk through the corridor, you go to the area where we hang out, and they look like they’re all happy. They must obviously have a front up but answered honestly in that survey,” she said.

Donnacha O'Mahony, Kate MacCarthy, and Andrew O'Connell, three of the Kinsale Community School students who took part in a discussion about the ReachOut Ireland/Irish Examiner survey findings. Donnacha was shocked by the finding that only one third of teens rated their mental health as good, while Kate says body image and being popular are huge issues.

Donnacha O’Mahony from fourth year was more shocked.

“I kind of believe that we’re all positive and to find out a third [describe their mental health as poor or very poor] — that’s just unbelievable... and even a third of us being average is disappointing. I enjoy seeing people happy and that a third of us are unhappy, I kind of can’t believe it,” he said.

It didn’t surprise fourth year Jennifer McCarthy, however. She thinks that, compared to previous generations, teenagers nowadays don’t “have as much opportunity to just be themselves”.

“Our parents didn’t grow up on social media like we did and not everybody wants to be on social media and even if they don’t want to, they feel like they have to. People of this generation... they’re expected to just follow the crowd so I’m actually not surprised that there’s a third that are unhappy, she said.

The results show exams and school life were the biggest stressors among teens.

Body image and friends were also seen as a cause of stress by 72% and 69% of respondents. Among teenage girls, friends cause even more stress, the research shows.

‘It’s such a small place [school] and everything is exaggerated. If something happens, everyone knows,” said fifth-year pupil Georgia Gould.

“Especially as a girl, people talk, people talk a lot and that’s one of the reasons I think that girls’ [mental health] stats weren’t higher.

“Girls have this thing where they might be lovely to a girl’s face but next you hear them saying something else about you. It’s constant worry. It’s just the fact that we’re all in this school together and sometimes things are blown out of all proportion altogether. Sometimes you feel like you just want to get away [ to college].”

Fiona Deasy says some parents and schools are too focused on sending pupils to university when university might not be the best option for everyone.

“Some people want to go to college from day one but some people feel like they have to. They might struggle to even get low points but not going to college is not an option anymore,” she said.

The fourth years felt under enormous pressure to choose “the right Leaving Cert subjects” so they’d “be able to select the right college course” even though many didn’t know what they’d like to do after school.

“Teachers say ‘oh you need to know this by fifth year’ and parents say ‘oh you need to have your course [picked]’ but you might be 18 and not know what you want to do, but still you have to have chosen what subjects you want to do in fourth year,” said Andrew O’Connell.

Georgia Gould agreed: “You’re making a decision in transition year about what you’re going to do for the rest of your life and that is a lot of pressure.

“I’m sitting there thinking ‘what do I want to do?’ and then ‘what am I expected to do?’ and ‘what do my parents want me to do?’ and ‘what do my teachers want me to do?’” she said.

In an open-ended question at the end of the survey, many of the survey respondents spoke about the pressure “to be perfect and have a perfect life” on social media.

Donnacha O’Mahony said teenagers are judged in school by what gang they hang around with. “When you’re in school you’re sectioned off into groups really, the farmers stick with farmers and the sports crowd stick with the sports crowd,” he said. “Body image and social media is a big part of life in Kinsale,” countered Kate Mac Carthy, “and so [that result] definitely wouldn’t surprise me. Even coming into school, [it’s about] what you look like and what you wear.

“Body image and just being popular is huge. Your friends [who you hang around with] have a huge impact on the way that you’re looked at in school.”

The survey results also show that music and exercise are the most popular ways of destressing among the country’s teens. This was evident in Kinsale too.

“I know that whenever I’m upset or stressed, I can go straight up to the field, even running, just running lets it all out. Going up to the pitch and seeing a different bunch of people... going up seeing your football friends, it’s the best therapy you can get… you’re working together and you know that person is going to be there for you, even if it’s not mentally or emotionally, they’ll be there to get the ball, they’re with you,” said Georgia Gould.

“Im not sporty,” said Fiona “but would very much agree with Georgia that it’s so important to find something that you really love doing, something that you’re passionate about.

“For me it would be music, I’ve a load of different instruments at home and sometimes if homework or study just got a bit hectic I would just take 10 minutes and play something, leave the desk for a while, and it does clear the head. Anything that you love so much, it’s a really healthy thing.”

On Saturday, read about how Kinsale Community School is ahead of the curve when its comes teaching teenagers coping skills.

Pressure to excel in exams a worry for three quarters of teenagers, survey reveals

Nearly three quarters of teenagers described the pressure to excel in exams, to be popular in school, and have the “perfect body” as causes of stress in their lives.

Exams and school were chosen by 80% and 81% of teenagers as a cause of stress while 72% believed body image issues caused them difficulties.

Exams and school appear to worry girls more than boys.

Up to 86% of girls saw exams as a difficulty in their lives compared to 72% of boys.

Meanwhile, 84% of girls saw school as a difficulty compared to 71% of boys.

Over two thirds of teenagers described difficulties with friends as causing them problems while two out of three said difficulties with family troubled them.

Just over three quarters of the girls, 76%, cited friends as a cause of stress but this dropped to 55% amongst boys.

Nearly half said boy/girl relationships caused them stress, according to the ReachOut Ireland/Irish Examiner survey on teen mental health.

Money, social media and bullying were also highlighted as causes of strife by the 2,500 teenage boys and girls who took part in the research.

Nearly half (47%) of the teenagers cited money as causing difficulties for them while social media ranked slightly lower, coming in in eighth place in terms of causes of stress. Money became an increasing source of stress as the teenagers hit aged 18 and 19.

Up to 43% of the young people described social media as causing them difficulties in their lives but in a later open-ended question on mental health in Ireland, many referred to social media as a problem.

Bullying was cited by over a quarter of students, or 29% as a problem in their lives.

College was a cause of stress for 27% of the teenagers but just 31% of the respondents were likely of college going age, ie aged 18 and 19.

ESRI research professor, Dr Emer Smyth, said research has shown that “high expectations, exam-focussed learning, and a fear of making mistakes” all contribute to the pressure being felt by teenagers around exams and school.

“A lot of the pressure that the young people put themselves under is internal as they have a realisation that the Leaving Cert is high stakes.

“We would have found that the pressure is from within them and not so much from parents or teachers,” she said.

“Really, it’s a byproduct of an education system that is so exam focussed, a system that is a distortion of what learning should be about”.

ESRI research also found that school, homework, and studying was taking up so much of pupils’ time that they were reducing involvement in sport and other extracurricular activities which are proven to beat stress.

“A hot house is created then and that is not good but it does seem to be temporary and within two or three years, the stress is lower,” said Dr Smyth.

The ESRI had suggested a re-assessment of the education system and called for greater supports for teenagers in schools.

Other causes of stress that were independently raised by the teengaers include their own mental and physical health concerns such as depression and long term illness while sport was also noted eg ‘the pressure to perform day in day out’.

Work, the future and grief following a close death were also listed by respondents.

We must listen if we are to support our teens

Our survey takes account of the views of 2,500 teenagers and suggests we should stop celebrating talking about mental health and rethink how we talk about it.

In just three days, over 2,500 teenagers completed our online youth mental health survey.

If we are serious about supporting youth mental health in Ireland we need to listen to what they told us.

Nearly two-thirds (65%) of respondents were female, there was a good spread of ages from 13 to 19-years-old and 39% lived in a rural area.

When the teenagers were asked, “how would you rate your mental health at the moment?”, there was an even three-way split between those who replied good or very good, poor or very poor, and average.

Young males were more likely than females to rate their mental health as ‘good’ or ‘very good’ (45%). The younger teenagers were more likely to report good mental health than those in their late teens.

Again, the young males reported higher levels of wellbeing, as did younger teenagers (13 and 14-year-olds) compared with older teens.

When asked about things that have ever caused stress or difficulty, exams (selected by 81%) followed by school (selected by 80%) were the most common stressors.

The next most frequently selected issues were:

  • body image — 72%
  • friends — 69%
  • family — 63%
  • social media — 43%

Social media is a much discussed source of tension between parents and teenagers. Traditionally, body image issues are more associated with females and in our survey it was selected as a difficulty by 81% of females and 52% of the young males.

To get a deeper insight into the views of young people, an open question was included asking “is there anything else you would like to say?” and the issue of social media was frequently mentioned.

The views on social media were polarised, one negative comment was that “teenagers are forced to alter themselves and reach unrealistic expectations because they’re only seeing good things someone’s posting about their lives on Facebook or Instagram”.

Others spoke about how important social media feels in teenagers’ lives — “we hear all these stories about phones and social media being bad for our health but the truth is if I didn’t have a phone I wouldn’t be able to cope with life, it distracts us from a lot of our problems.”

Thinking about solutions and supports, the survey asked about “what helps?” (an open question). Over 2,000 answered this question and music was the most common response (by 40%), followed by exercise and sport (23%) and talking (18%).

A small number of teenagers reported negative coping strategies such as‘binge drinking and self-harm. There were some interesting gender differences around what helps.

Girls mentioned stress relievers such as crying, a bath and meditation more frequently than males who mentioned video games, football, and gym.

Respondents were also asked about their likelihood of using sources of support for mental health from a list of ten options.

Online search was selected by 58% and friends by 56%. The GP was selected by 13% of respondents and mental health service by only 9%.

As with other recent mental health surveys, very few respondents indicated they would use a telephone helpline (6%) reflecting the changing nature of help-seeking among young people today.

The richest survey insights came from the final open question, answered by 1,142 young people, one of whom suggested “the stigma around mental health is going away, it’s starting to be talked about openly a lot more but I feel like there needs to be more supports available to young people.”

Indeed, many young people were critical of mental health campaigns and celebrity testimony suggesting “it’s a big issue but it’s being trivialised by too many campaigns which are doing more harm than good”.

Maybe it is time to stop celebrating that we are talking about mental health and rethink how we talk about it.

Tomorrow

Teenagers tell us how social media is putting them under pressure to be “perfect”, how adults and teachers don’t take their mental health seriously and how many are scared to speak out in case they are called ‘attention seekers’.

Helpful contacts

  • www.reachout.com – offers comprehensive information on all aspects of mental health and how to get help.
  • www.childline.ie – provides support through online chat or helpline for those under 18.
  • www.yourmentalhealth.ie – provides information on mental health, support services near you and the everyday #littlethings that can make a difference to your mental health and wellbeing.
  • www.bodywhys.ie – offers online support for eating disorder issues, including an online group counselling service.
  • www.drugs.ie – offers drug and alcohol information and support including a ‘live helper’ service that lets you chat to a staff member online.
  • Parents concerned about a son or daughter can get reliable mental health information from reachoutparents.com

The Irish Examiner / ReachOut Ireland teen mental health survey was designed to capture the views of teenagers in Ireland in relation to youth mental health and the issues that affect them. The survey involved 2,500 interviews with teenagers between the ages of 13 and 19 in the Republic of Ireland. Promotion of, and recruitment for, the survey was conducted solely through social media (Twitter, Facebook and Instagram). Data collection took place from 28 February to 3 March 2017. Personal consent was sought from all participants and parental/guardian consent was sought for those under 18 years-old. All data is copyrighted by the Irish Examiner / ReachOut Ireland and should be attributed to this source where quoted.

© Irish Examiner Ltd. All rights reserved

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