Sunday, June 27, 2010

Richard Eckersley on the mental health crisis

The following article by Australia 21 Director and Fellow Richard Eckersley was published in The Canberra Times, 24 June 2010.  See the article as published here.

Cash grab hurting wellbeing

Cultural changes towards extrinsic goals – like financial success – are adding to pressures on young people, Richard Eckersley writes.

The resignation of the Federal Government’s top mental health adviser, John Mendoza, is just the latest episode in the unfolding mental health crisis in Australia. Professor Mendoza, the chair of the National Advisory Council on Mental Health, quit last week saying he was deeply disappointed at the Government’s lack of vision and commitment to mental health.

The crisis goes deeper than even many psychiatrists and psychologists, let alone governments and the public, realise. Addressing it requires more than increasing funding for mental health services. Our understanding of the causes of the situation remains a contentious matter among researchers, but there is growing evidence that they lie deep in the psychological impacts of the changing culture of Australia and other Western societies.

Most mental illness begins in adolescence and early adulthood and concerns about mental health care for young people are a prominent feature of the current debate, championed by the 2010 Australian of the Year, Professor Pat McGorry.

Earlier this year, American psychologist Jean Twenge and her colleagues published the findings of a remarkable study, in which they compared the results of the oddly named but widely used psychological test, the Minnesota Multiphasic Personality Inventory, or MMPI, going back to the 1930s.

The researchers found a steady decline in the mental health of college students between 1938 and 2007 and high-school students between 1951 and 2002. Five times as many college students now score high enough to indicate psychological problems as they did in 1938. The increases translate into a greater likelihood of characteristics such as moodiness, restlessness, dissatisfaction and instability; unrealistically positive self-appraisal, overactivity and low self-control; feeling isolated and misunderstood; sensitivity and sentimentality; and being narcissistic, self-centred and antisocial.

The findings are not conclusive. Critics point out that people might just be becoming more willing to endorse items indicating psychological problems (although Twenge says the MMPI allows researchers to test for this bias, which they did; the trends remain).

Another new study, conducted by British psychologist Stephan Collishaw and colleagues, found that English adolescents experienced considerably higher rates of emotional problems in 2006 than they did in 1986, especially girls. The greatest changes were for worry, irritability, fatigue, sleep disturbance, panic and feeling worn out or under strain; the more severe the reported symptoms, the larger the increase over the two decades.

A few months ago, I looked up the most recent results of national surveys conducted by the American College Health Association. The survey shows that large proportions of students report strong negative emotions for both the previous twelve months and the previous two weeks. For example, 47 per cent in the last twelve months (and 17 per cent in the last two weeks) had felt things were hopeless; 87 per cent (54 per cent) had felt overwhelmed by all they had to do; 82 per cent (50 per cent) had felt exhausted; 31 per cent (10 per cent) had felt so depressed that it was difficult to function; 49 per cent (19 per cent) had felt overwhelming anxiety; and 39 per cent (12 per cent) had felt overwhelming anger.

Although I have been steeped in data like these for over 20 years, I find the figures shocking, even hard to believe. I’ve asked colleagues here and in the United States and Britain what the findings mean. I think it is fair to say that we don’t know for sure. They are certainly not the whole story of young people’s lives.

Had they been asked, 80-90 per cent of the students would have said they were happy and satisfied with their lives; most would be leading seemingly normal lives: attending lectures, completing assignments, working, partying and dating. At the same time, I think these findings tell us something about being young today, including specific social problems such as youth violence and binge-drinking.

The disturbing picture is likely to be broadly true of Australians (we lack comparable data over time to assess trends here). What explains it? There are many possibilities, including changes in family life such as more family conflict and breakdown, increasing work-life pressures and changes in parenting. The growth of the media and communications technologies, the weakening influence of religion, more junk food and other changes in diet, and even chemical pollution might be involved.

Twenge and her colleagues considered – and rejected – the possibility that economic factors were responsible. Instead they favoured a cultural explanation – in particular, a shift from intrinsic to extrinsic values and goals. An intrinsic orientation means doing things for their own sake – because we want to do them. It is ‘self –transcending’ and is good for our wellbeing.

An extrinsic orientation means doing things in the hope or expectation of other rewards - status, money, appearance, recognition. It is ‘self-enhancing’ in the sense of being concerned with self-image. It is not good for our wellbeing. A focus on the external trappings of success and ‘the good life’ encourages unrealistic and misguided expectations and increases the pressure to perform and achieve, leading to stress, frustration, resentment and dissatisfaction.

One American student says in an Associated Press article on Twenge’s findings that she feels pressure to be financially successful, even when she doesn't want to be. ‘The unrealistic feelings that are ingrained in us from a young age — that we need to have massive amounts of money to be considered a success — not only lead us to a higher likelihood of feeling inadequate, anxious or depressed, but also make us think that the only value in getting an education is to make a lot of money, which is the wrong way to look at it.’

The results of regular surveys over more than forty years of how American college students rate the importance of various life goals confirm her observation. The biggest change has occurred in the two goals of ‘developing a meaningful philosophy of life’ and ‘being very well off financially’. Meaning declined sharply in importance during the 1970s and 1980s, while money rose to become the highest rated goal.

Youth problems today are more the result of existential and relational deprivation than material and economic deprivation. Our individualistic, consumer culture relentlessly and ruthlessly promotes extrinsic values and norms, making it harder for us to develop a grounded sense of who we are and what we want in life, and distracting us from what matters most to our wellbeing: our relationships with other people.

Australian novelist Ruth Park, in describing growing up in New Zealand during the Depression, says of young people then: ‘Whatever hardship came our way was all on the outside. Inside we knew, without doubt, that Life was aware of us and somehow had us in its care’. It strikes me as a good description of intrinsic worth and existential certainty and confidence.

Richard Eckersley is a director of Australia 21, an independent, non-profit research company and a visiting fellow at the Australian National University.

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