Changing Adolescence

Social Trends and Mental Health

Hagell, Ann

• Publisher: Policy Press
• Year: 2012
• ISBN:
  9781447308195
• Topic: Social Sciences
• Subtopic: Children's Studies in Sociology
• Index: Social Sciences

The general well-being of British adolescents has been the topic of considerable debate in recent years, but too often this is based on myth rather than fact. Are today's young people more stressed, anxious, distressed or antisocial than they used to be? What does research evidence tell us about the adolescent experience today and how it has changed over time? And how do trends in adolescent well-being since the 1970s relate to changes in education, leisure, communities and family life in that time? This unique volume brings together the main findings from the Nuffield Foundation's Changing Adolescence Programme and explores how social change may affect young people's behaviour, mental health and transitions toward adulthood. As well as critiquing research evidence, which will be of interest to a wide academic audience, the book will inform the wider debate on this subject among policy makers and service providers, voluntary organisations and campaign groups.

ONE

Introduction

Ann Hagell

Background

Adolescents’ lives are shaped by the social context in which they live. A number of key social institutions structure and dominate their lives, such as those of education, family and part-time employment. It is an intensely social time of life; friends, peers, classmates, parents, extended family, teachers and neighbourhood groups are all critical. Pressures and expectations arise from several directions at once, and although we are more healthy, wealthy and comfortable than at any time in the past, British teenagers are undoubtedly subject to a range of stresses.

The general well-being of British adolescents has been the topic of considerable debate in recent years, but are today’s young people any more stressed than previous generations? Are they any more depressed or anxious? Do we have useful and robust evidence on this? If so, what might have changed about the social context that might be particularly salient for their lives?

Indeed, evidence has suggested that the current level of behavioural and emotional problems in teenagers is higher than in the past. Our work in this area began in 2004 with the publication of a study funded by the Nuffield Foundation, which provided specific evidence on time trends across 1974, 1986 and 1999. Undertaken by Barbara Maughan, Stephan Collishaw, Robert Goodman and Andrew Pickles, the comparison of large-scale surveys of 15/16-year-olds at each point in time showed rises for problems such as depression, anxiety and conduct disorder (Collishaw et al, 2004). In fact, addition of a fourth wave of data collection from 2004 suggested that by this time the time trends may have been levelling off, providing cause for guarded optimism. As Stephan Collishaw’s chapter in this volume shows, this still, however, leaves young people of today with a general level of emotional and behavioural problems that is significantly higher than it was for 16-year-olds living through the 1970s and 1980s. And it still leaves us with questions about why this might be the case. That is what this volume is about.

Some key terms

For the purposes of exploring the research in this area of young people and social change, we have taken a deliberately broad definition of adolescence. Generally we mean it to include the second decade of life. This encompasses the last year of primary school and the preparation to move into secondary education. At the higher end it includes the move to further or higher education, or the beginning of employment. We have also used the term ‘young people’, and we mean this as interchangeable with our definition of ‘adolescence’. Some more formal definitions of ‘youth’ take an age range that goes up to the mid-20s or even higher, but the lower end of these ranges tend to be in the mid- to late teens, and we wanted to make sure we included at the very least all children at secondary school. A warning, however – it is possible to find a number of papers with ‘adolescence’ in the title that all address rather different age groups. In this area in particular, there is always a need to be explicit about samples and to make sure that like is being compared with like. And, as the essays in this volume will make clear, we do not regard adolescence as a homogeneous life stage, but see all sorts of ways of sub-dividing groups, by age and also by ‘pathway’ and by socioeconomic status.

How to refer to the geographical setting for this work has also been somewhat problematic. At the outset our intention was to take a look at ‘British adolescents’, or, for some purposes, ‘United Kingdom (UK) adolescents’ particularly with a view (if possible) to comparing them to their counterparts in other European or North American countries. However, very few research studies take ‘British’ or ‘the UK’ as their sampling frame, and this applies equally to official statistics given the vagaries of the British administrative and political boundaries. Most commonly the information contained in the following pages refers, strictly speaking, to ‘English and Welsh adolescents’, but this is a rather clumsy way to denote the groups of interest. Unless there is good information to suggest that Scottish or Northern Irish young people are significantly different, we have tended to stick to British, but the reader will note that we do chop and change a little in the text, depending on the original research samples from which findings are drawn. The aim is to be as accurate as possible without reducing readability.

Nuffield Foundation Changing Adolescence Programme

The Nuffield Foundation Changing Adolescence Programme was a portfolio of research on time trends in adolescent mental health, focusing on various aspects of social change and adolescent experiences in order to reveal some of the changes in adolescents’ lives today. The programme brought together the Foundation’s long-standing interests in young people, social institutions, mental health and educational transitions. Six research reviews were funded, taking different areas of social change and interrogating the evidence for links with emotional and behavioural problems in young people. The aim was to contribute to policy and practice debates in ways that could potentially improve outcomes for young people.

In this volume, we begin by outlining our main ‘outcome’ measure – changes in young people’s emotional and behavioural problems. The remainder of the volume presents a series of essays that draw on the research we funded and build on it, and that begin the process of thinking about what the implications might be. We take a particular look at the evidence on stress – have their lives become more stressful over our period of interest? We then take a rather selective look at two specific social institutions important to young people (school and families), followed by one key area where much social change has happened (use of alcohol and drugs), and we then explore some aspects of the broader social context in which they live (neighbourhoods and peers).

We would be the first to admit that this represents a rather idiosyncratic collection of questions and topics. It is a collision of the interests we brought to the topic, the strengths and weaknesses of the field, the resource limitations and the availability (or otherwise) of experts to work with us. The result should be regarded as illustrative of some of the relevant topics, rather than an exhaustive account of all aspects of social change. We are particularly indebted to the researchers who undertook the original scoping work for us, and in Appendix I we indicate the Foundation-funded work that we have drawn on. Some of this is starting to be published by the research teams themselves, and what we present here is the Foundation’s particular ‘take’ on that work, rather than a formal summary of the reviews themselves. What we hope is that the programme as a whole refocuses some attention on the interesting issue of the implications of social change for young people’s experiences, and encourages others to take up these issues further.

Changing context for adolescence in the UK, 1975-2005

If we turned the clock back to the mid-1970s, the start of our period of interest, what would life look like? Overviews of social change for UK society across this period do exist, and referral to, for example, Office for National Statistics (ONS) trend documents (for example, the ONS Social Change publication series), will provide more detailed information, although it is sometimes a challenge to pull out statistics that are relevant for our particular age group of interest. There are occasional publications in the ONS series that do focus on young people, although this includes younger children as well as adolescents (for example, ONS, 1994, 2002). Some elements of social change over recent decades are included in the compilations of Key data on adolescence (most recent edition, Coleman, Brooks and Threadgold, 2011), although the series is not specifically focused on time trends. Two particularly helpful recent overviews of social change specifically in relation to adolescence are also available: Coleman (2011) and Furlong and Cartmel (2007). Finally, an international perspective is given in a publication from the American Society for Research in Adolescence entitled The changing adolescent experience (Mortimer and Larson, 2002a).

Broad overviews highlight that the last three decades of the 20th century were a time of relative political stability in the UK. As far as impacts on children might be concerned, both positive and negative trends can be identified. Despite recurring economic recession, this was a period of rising living standards and expanding consumer power and acquisition. International standards on the rights of children, such as the United Nations (UN) Convention on the Rights of the Child 1989, reflected widespread concern about the need to protect children in a variety of different settings. Other developments of potential benefit to children within the UK across this period included the introduction of the minimum wage in the late 1990s, and political changes that brought a Children’s Commissioner and a Minister for Children (Bradshaw and Keung, 2011). However, child poverty rose during the beginning of our period before levelling out or falling by the 2000s (depending on which indicators are used).

Throughout these 30 years, from the mid-1970s to the mid-2000s, five main sets of changes are of particular significance to adolescence, and frame their experiences as described in the following chapters. More detail on all of these will arise throughout the text, and at this stage the intention is to provide a broad-brush perspective:

• Expansion in the higher educational system The collapse of the youth labour market through the 1980s has been widely documented (Furlong and Cartmel, 2007; Côté and Bynner, 2008), as has the accompanying expansion of the education system (Symonds and Hagell, 2011). The proportion of 16-year-olds heading directly into employment approximately halved between 1988 and 2004, and the proportion of 16-year-olds in full-time education rose across the same period (Furlong and Cartmel, 2007). This is an important context for all of the chapters in this volume, but particularly those relating to time use and educational transitions.
• Changes in living arrangements The average age of leaving home in the UK has been estimated to be around 23 years old (Iacovou, 2001), and this has risen in recent decades (ONS, 2009). This serves as an index for a number of important changes, such as the continued role of parents in everyday life, changes in financial support and arrangements, context for peer relations etc. The link between leaving home and establishing new family relationships weakened across our period of study, and more young people left home to go into higher education (Holdsworth, 2000; Berrington et al, 2009). This forms part of the background particularly for the chapters on relationships with parents, and also time use in the 16-18 year groups.
• Extension of adolescence As a result of the trends in staying on in education, leaving home later and delayed financial independence, there has been much written about the elongation of transition to adulthood, and many have noted the emergence of multiple, non-linear pathways to adult living (Furlong and Cartmel, 2007; Côté and Bynner, 2008; Coleman, 2011). This cuts across all of the chapters in this book and is a key part of the story of social change.
• Changes to family structure The proportion of children living in homes headed by a lone parent rose from approximately 12 per cent in the early 1980s to 20 per cent by 2001 (ONS, 2002), and across our time period adolescents increasingly lived in a wider variety of family structures as a result of changes in cohabitation, marriage and re-marriage. It has been estimated that in Europe 25 per cent of young people now live through the divorce of their parents (Coleman, 2011), leading to an increase in experiences of reconstituted families: stepfamilies, extended families, and so on. Coleman points out three likely implications – more stress (we return to this in Chapter Three), shifts in beliefs about relationships and marriage including separation of parenthood from marriage and new challenges for parenting of teenagers within these new and reconstituted family patterns (Coleman, 2011).
• Changes in sexual behaviour, relationship patterns The average age of puberty in the UK fell in the 100 years to 1970, but in fact by the period that the programme focused on, the fall had levelled out. Across this period the median age of menarche in British teenagers was around 13 years (Whincup et al, 2001). Any decrease is estimated to be in the order of a few months. Similar findings have arisen in USA samples (Anderson et al, 2003). However, it is possible that the age at which children began their first sexual relationships, and the nature of those relationships, may have changed. This crops up in the chapter on stress, and is important in considering peers and neighbourhoods.
• Globalisation Young people are subject to a much wider range of information about the wider world than they were three decades previously, fuelled in part by explosion in new media and communication structures and information technology. Awareness of what is going on well beyond the boundaries of the local area is now the norm, and with it has come the sense that we are part of a much larger society.
• Demographic shifts In the UK, the proportion of the population made up by young people under the age of 16 has not changed a great deal since the 1970s – it still stands at approximately 20 per cent (ONS, 2002). However, there have been demographic shifts in the proportions of young people from minority ethnic groups, now representing around 12 per cent of children in Great Britain (ONS, 2002). Important aspects of these changes include a growth in young people in mixed-race groups, and the potentially changing nature of ethnic identity as a result.

Overarching questions and themes

Although there was no doubt that society had changed over the years that Collishaw et al’s study covered, there was little concrete information available to us about time trends in some of the key areas where social institutions were shaping the lives of young people. One of the first aims of the programme was to interrogate the existing literature to firm up what we know – and do not know – about social change for this age group over this period. In each of the areas where we funded reviews, we also wanted to know how good the evidence was that each of these areas of life (parenting, education, peers etc) were related to emotional and behaviour outcomes for young people. That is, was there anything more than just correlational evidence that these domains of life mattered in some way?

The focus was clear and the questions were simple, although the tasks of pulling together and interrogating the evidence proved more challenging than anticipated. We were clear that we wanted to know specifically about adolescence, about social change and about social institutions and how they shape lives. Everything in the programme was viewed through the lenses of time trends. The underlying question is, is there any evidence that social change was responsible for the rise in emotional and behavioural problems that Stephan Collishaw demonstrates in the next chapter?

TWO

Time trends in young people’s emotional and behavioural problems, 1975-2005

Stephan Collishaw

Introduction

Trends in child and adolescent mental health can be seen as a barometer of the success of society’s efforts to improve children’s well-being and life chances. Improving the mental health of children was identified as a key strategic target in The Children’s Plan (DCSF, 2007a). In this context, evidence of long-term deterioration in the mental health and behavioural adjustment of young people (Rutter and Smith, 1995; Maughan et al, 2005), and unfavourable comparisons with child wellbeing in other countries (UNICEF, 2007), has provoked significant concern among policy makers and health professionals in the UK (see, for example, Layard and Dunn, 2009).

Child and adolescent mental health problems are common and often have long-lasting and far-reaching consequences for children’s lives. Large, well-designed epidemiological studies demonstrate that at any one time approximately one in ten of Britain’s 5- to 16-year-olds suffers from a clinically impairing psychiatric disorder (Meltzer et al, 2000; Green et al, 2005). Depression, anxiety, conduct disorder and attention deficit hyperactivity disorders (ADHDs) are all common, with wide-ranging associated functional impairments. They affect children and adolescents’educational progress, relationships with friends, family life and physical health.

The focus of this report is on trends in adolescent mental health (although comparisons are drawn where relevant with what is known about trends in younger children’s mental health). The reason for this focus is that adolescence is an important risk period for the onset of mental health problems. The prevalence of many mental health problems, including depression and anxiety, increases sharply during adolescence (see Figure 2.1).

Figure 2.1: ICD-10 Depression diagnoses by child age and gender, 1999 and 2004, British Child and Adolescent Mental Health Surveys

Data from the ONS British Child and Adolescent Mental Health Surveys 1999 and 2004 downloaded from the UK data archive; data for years combined using sample weights.

Moreover long-term prospective follow-up studies highlight strong continuities between adolescent and adult mental health. More than half of all early adult psychiatric disease is preceded by mental illness before the age of 18 (Kim-Cohen et al, 2003); conversely, adolescents with anxiety or depression are at substantially increased risk for adult psychiatric illness. Adolescent depression, for example, is highly recurrent, with 50-70 per ...

Table of contents

• Front Cover
• Title Page
• Copyright Page
• Contents
• List of tables and figures
• Acronyms and abbreviations
• Notes on contributors
• Acknowledgements
• Foreword by Professor Sir Michael Rutter
• Chapter 1: Introduction
• Chapter 2: Time trends in young people’s emotional and behavioural problems, 1975-2005
• Chapter 3: Stress and mental health in adolescence: interrelationship and time trends
• Chapter 4: Trends in adolescent time use in the United Kingdom
• Chapter 5: Trends in parenting: can they help explain time trends in problem behaviour?
• Chapter 6: Educational changes and possible links with adolescent well-being: 1970s to 2000s
• Chapter 7: Trends in adolescent substance use and their implications for understanding trends in mental health
• Chapter 8: Some thoughts on the broader context: neighbourhoods and peers
• Chapter 9: Reflections and implications
• References
• Appendix I: The Nuffield Foundation’s Changing Adolescence Programme
• Appendix 11: Reference list for primary data sources for graph data in Chapter Seven
• Notes