Why Are So Many Children and Young People Struggling with Their Mental Health?

Over the past decade, the UK has seen a significant increase in the number of children and young people experiencing anxiety, depression, emotional distress and behavioural difficulties. While greater awareness has encouraged more families to seek help, most clinicians, teachers and parents would agree that increased awareness alone cannot explain the scale of what we are seeing.

The question we should perhaps be asking is not "Why are children becoming mentally ill?" but "What has changed in childhood?"

There is no single answer. Rather, the rise appears to reflect the convergence of biological, psychological, social and cultural factors that are placing unprecedented demands on young minds.

Childhood Has Changed

Today's children are growing up in a world that is faster, noisier and more uncertain than at any other time in history.

Many children experience lives filled with constant stimulation but relatively little opportunity for genuine emotional connection. Smartphones, social media, online gaming and 24-hour entertainment have transformed childhood. While technology brings enormous benefits, it also creates continuous comparison, pressure to perform, cyberbullying, disrupted sleep and a reduced capacity for quiet reflection.

Children are also spending less time outdoors, engaging in imaginative play and developing independence. Free play, once recognised as one of childhood's greatest protective factors, has steadily declined, replaced by structured activities, academic pressures and increased screen time.

At the same time, families themselves are often under considerable strain. Financial pressures, long working hours, housing insecurity and the lasting effects of the COVID-19 pandemic have left many parents emotionally depleted. Children are remarkably sensitive to the emotional climate around them, and chronic stress within the family can have profound effects on development.

The Biology of Toxic Stress

In The Deepest Well (published in the UK as Toxic Childhood Stress), paediatrician Dr. Nadine Burke Harris explains how prolonged childhood stress can literally shape the developing brain and body.

When children are exposed to ongoing adversity, such as abuse, neglect, domestic conflict, parental mental illness, addiction or chronic insecurity, the body's stress response system can become permanently activated.

Instead of switching on only when danger is present, the stress response remains in a constant state of high alert.

Over time this affects brain development, immune function, hormone regulation and even physical health. Children living with toxic stress may struggle with concentration, emotional regulation, impulsivity, relationships and learning, not because they are "difficult" children, but because their nervous systems have adapted to survive in environments that feel unsafe.

Burke Harris reminds us that behaviour is often biology in disguise. What appears to be defiance or laziness may actually be the consequence of a nervous system doing exactly what it evolved to do: protect itself.

The Importance of Being Truly Seen

Alice Miller, in The Drama of Being a Child, offered a profound psychological insight decades before neuroscience confirmed many of her observations.

Miller believed that children have one fundamental emotional need: to be accepted for who they truly are.

When children feel that love depends upon being good, successful, quiet or emotionally convenient, they often suppress parts of themselves in order to maintain attachment with their caregivers. Over time they lose touch with their authentic emotions and learn to prioritise pleasing others over understanding themselves.

This adaptation may help them survive childhood, but it can create anxiety, depression, perfectionism, low self-esteem and difficulties in relationships later in life.

Miller challenged professionals to look beneath behaviour and symptoms and instead ask:

"What has this child had to sacrifice in order to belong?"

Her work reminds us that emotional neglect is not always dramatic or intentional. Sometimes it simply occurs when adults are too overwhelmed to notice the emotional world of the child in front of them.

Are We Medicalising Childhood?

Richard House and Del Loewenthal, in Childhood, Wellbeing: A Therapeutic Ethos, offer a different but equally important perspective.

They argue that modern society increasingly interprets ordinary human distress through a medical lens. Childhood has become increasingly monitored, measured and diagnosed. Normal sadness, frustration, fear and emotional struggle can sometimes be viewed as symptoms requiring treatment rather than understandable responses to difficult circumstances. Richard House and Del Loewenthal's argument is not that diagnoses are inherently wrong, but that there is a risk of over-pathologising normal emotional experience and overlooking the social, relational and educational environments that contribute to children's distress.

This does not mean mental illness is not real as it undoubtedly is.

Rather, House and Loewenthal encourage us to be cautious about locating all problems within the child while overlooking the wider social environment.

If children are growing up in increasingly stressful, disconnected and performance-driven cultures, perhaps rising distress tells us something about society as much as it tells us about individual children.

Instead of asking, "How do we fix this child?" they encourage us to ask, "What kind of environment allows children to flourish?"

The Modern Pressures Facing Young People

Children today face challenges that previous generations simply did not experience.

These include:

Constant exposure to social media and unrealistic comparisons.
Reduced face-to-face friendships and increasing loneliness.
Academic pressure from an increasingly competitive education system.
Fear about global issues including climate change, war and economic uncertainty.
Less unstructured play and independence.
Increased family stress linked to financial pressures.
Reduced opportunities for emotional connection within increasingly busy family lives.
Sleep disruption caused by screens and digital technology.
Greater exposure to online harm, bullying and unrealistic expectations.

Each of these factors alone may not cause mental illness. Together, however, they create a developmental environment unlike any previous generation has experienced.

Towards a More Therapeutic Society

Perhaps one of the most powerful themes linking Burke Harris, Miller, House and Loewenthal is the importance of relationships.

Children do not simply need interventions.

They need emotionally available adults.

They need to feel safe enough for their nervous systems to relax.

They need opportunities to play, explore, fail, recover and be accepted exactly as they are.

Mental health is not created solely inside consulting rooms. It develops within families, schools, communities and cultures that foster connection, belonging and emotional security.

As professionals, parents and educators, our role may be less about fixing children and more about creating the conditions in which healthy development can naturally occur.

Looking Forward

The rise in childhood mental health difficulties is unlikely to have a single explanation, nor will it have a single solution.

The work of Dr. Nadine Burke Harris reminds us that chronic stress leaves biological footprints. Alice Miller teaches us that emotional authenticity is essential for healthy psychological development. Richard House and Del Loewenthal challenge us to examine whether society has become too quick to diagnose individual children while overlooking the environments in which they are growing.

Perhaps these perspectives point us towards the same conclusion: children's mental health is shaped not only by what happens within them, but by the relationships, communities and cultures that surround them.

If we truly wish to reverse the current trend, we must move beyond treating symptoms alone and begin creating a society in which children feel safe, valued, connected and free to become themselves.

References

Burke Harris, N. (2018). The Deepest Well: Healing the Long-Term Effects of Childhood Adversity. Boston: Houghton Mifflin Harcourt. (Published in the UK as Toxic Childhood Stress.)

House, R., & Loewenthal, D. (Eds.). (2009). Childhood, Wellbeing: A Therapeutic Ethos. Ross-on-Wye: PCCS Books.

Miller, A. (1997). The Drama of Being a Child: The Search for the True Self. London: Virago Press. (Originally published in German in 1979.)

Felitti, V. J., Anda, R. F., Nordenberg, D., et al. (1998). "Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study." American Journal of Preventive Medicine, 14(4), 245–258.

Shonkoff, J. P., Garner, A. S., & the Committee on Psychosocial Aspects of Child and Family Health. (2012). "The Lifelong Effects of Early Childhood Adversity and Toxic Stress." Pediatrics, 129(1), e232–e246.

Center on the Developing Child at Harvard University. (2021). Toxic Stress. https://developingchild.harvard.edu/science/key-concepts/toxic-stress/

NHS England. (2023). Mental Health of Children and Young People in England. https://www.england.nhs.uk/mental-health/children-and-young-people/

NHS Digital. (2023). Mental Health of Children and Young People in England: Wave Follow-up Reports.

Public Health England. (2021). Promoting Children and Young People's Emotional Health and Wellbeing.