This collection of twelve papers by
researchers based in the UK address a variety of mental health concerns for
young people. They are grouped into three sections: specific mental health
problems; special groups and special needs; and special contexts and settings.
The authors come from backgrounds in psychiatry, psychology, social work and
education. They address drug and alcohol use, eating disorders, antisocial
behavior, suicide and self-harm, lesbian and gay issues, learning difficulties,
institutionalization, homelessness, and bullying. The articles are serious and
scholarly, citing many references and setting out the current state of knowledge
on these issues, but they are also written clearly and should be accessible to
non-specialists who are ready with the slightly dry academic style.
These papers present standard
information about symptoms and trends in the mental health of children and
adolescents, and spell out briefly the treatments that succeed best. The most
interesting of the papers here tend to go against the trend of seeing the
emotional and behavioral problems of young people as the result of individual
mental disorder. Instead, they contextualize them with regard to specific
social and family causes. In "Young People and Drugs," John Davies
points out that the "War on Drugs" has been a failure, and that with
its emphasis on total refusal of drugs, it has probably overlooked distinctions
between safe and unsafe patterns of drug use. With an underground market in
street drugs and and uncertain ingredients, the danger is considerably
increased. One study found that some drugs sold as ecstasy in fact contained
high doses of ketamine, which has much more serious side effects. Another
important point made by Davies is that the language of addiction and alcoholism
may be unhelpful, and it may be better to see difficulties in controlling drug
and alcohol intake as related to context, with a preferable outcome as being
controlled use rather than abstinence. The refusal to acknowledge the
possibility that drug and alcohol use can be pleasurable and sometimes even
helpful has driven a discourse of drug use as fatalistically dangerous. Once
drug users start thinking in this fatalistic way, they can find it harder to
control their own intake, and the fatalism becomes a self-fulfilling prophesy.
In the chapter on sexuality and
mental health promotion, Ian Warwick, Christine Oliver and Peter Aggleton
explain that gay and lesbian youth are at higher risk for many mental
illnesses, but that these are related to their treatment at school and by their
parents. They are often bullied by their peers and rejected by their families.
Dealing with these problems is thus as much a social issue as it is
psychological. Another area where the social and the psychological are
profoundly intertwined is homelessness. Davina Lilley reports that it is
estimated that there are a million homeless under the age of 21 in Europe, and
in the USA, there are up to 1.3 million young homeless. About a third of young
people who leave home say it is due to physical abuse, and one in ten say it is
because of sexual abuse. She sets out the high rates of mental illness among
the homeless young: to what extent the illness is the cause or the effect of
living conditions varies from case to case.
While there is a chapter on the
emotional disorders of young people, it is striking that categories such as
bipolar mood disorder and schizophrenia do not get much attention in this
book. It leads one to speculate that there may be a growing divergence between
the USA and Europe in the diagnosis of chronic mental illness in the young, and
it would be interesting to see some discussion of reasons for the increasing
rates of diagnosis of these disorders in the USA.
Young People and Mental Health is
a well-researched assessment of the mental health problems of young people in
the UK. Naturally, some of its claims will be controversial, and it tends to
pay only passing attention to the growing issue of the wisdom of prescribing
psychotropic medications to children. Nevertheless, it is a valuable resource
for those interested in the trends in the psychological welfare of children and
© 2004 Christian
Perring. All rights reserved.
Perring, Ph.D., is Academic Chair of the Arts & Humanities
Division and Chair of the Philosophy Department at Dowling College, Long Island. He is also
editor of Metapsychology Online Review. His main research is on
philosophical issues in medicine, psychiatry and psychology.