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Press Release

Embargoed 00:01 Wed 28th Nov 2018 AD4E


Are 1 in 8 children and young people really

‘mentally disordered’?

On November 22nd 2018, NHS Digital released a widely

publicised reporti on children and young people’s mental
Mental health organisations
health, which found that one in eight children and young
challenge the language of
people aged between five and nineteen, meet the criteria
illness and disorder
for at least one psychiatric condition such as depressive
disorder, anxiety disorder or bipolar disorder.

Consultant clinical psychologist Dr Lucy Johnstone appeared on Sky News that evening endorsing many
of the findings, but cautioning against the use of the language of illness and disorder to describe what
can be seen as children and young people’s understandable responses to life circumstances.

Watch the interview here:

The report gave much evidence that many of these children and young people are facing difficult events
such as parental separation and bullying, and come from families that are struggling emotionally and
financially. Dr Johnstone said that in these contexts it may make little sense to call children’s reactions
‘illnesses’ or ‘disorders’, and indeed doing so may add to their sense of shame, stigma and failure.

Mental health organisations A Disorder for Everyone (AD4E) and Safely Held Spaces (SHS) both point out
that there is little evidence that these very real and difficult experiences are best understood as
disorders and illnesses caused primarily by chemical imbalances or genetics.

They can instead be seen as the result of different interacting factors: there is a great deal of researchii
showing that these experiences of mental and emotional distress are related to life events such as
trauma, loss, neglect and abuse, as well as wider social factors such as unemployment, discrimination,
poverty and inequality.

The key question then, when we encounter children and young people’s mental and emotional distress,
might rather be What happened to you? and not What’s wrong with you?

Few people are aware that our current diagnostic categories have been described as ‘not valid’ and
‘unscientific’ by members of the very committees that drew them up. iii A coalition of professionals from
all backgrounds, along with people who have used psychiatric services, has for some time been calling
for alternatives.

While recognising that diagnosis is useful for some people, and will continue to be necessary for some
practical purposes, they argue that language like mental and emotional distress, low mood and hearing
voices is preferable to medical terms like mental illness, symptom and disorder and opens up the
possibility of a wider range of understandings.

Dr Lucy Johnstone says:

‘These children and young people are obviously in great distress. But are they
suffering from medical illnesses which need diagnosing? Or do we need to look at
their life circumstances for explanations of their difficulties?

‘Children are a barometer of our society - we cannot go on waiting until every child
in the country is labelled with a disorder and on a clinic waiting list’

‘Diagnosis tends to obscure the root causes of this epidemic of distress in our
children and young people. So an important start, as we are seeking to do here, is to
challenge the language of illness and disorder, so we can recognise this distress as
understandable in the context of children’s lives.’

‘We need to direct far more effort and resources towards tackling the root causes,
or else we are simply mopping the floor while the tap is running. A recent United
Nations reportiv found unprecedented levels of hardship and distress in poorer
families, up to and including suicide, which was impacting particularly strongly on
children. In this report NHS Digital has identified some of the inevitable
consequences of this for children’s wellbeing.’

Professor Allen Frances, Professor and Chairman Emeritus of the Department of Psychiatry and
Behavioral Sciences, Duke University School of Medicine. Chair of the Diagnostic and Statistical Manual
of Mental Disorders (DSM)Task Force and principal investigator on the DSM-IV says:

‘In my opinion, the DSM-5 process has been secretive, closed and sloppy – with
confidentiality restraints, constantly missed deadlines, botched field testing, the
cancellation of an important quality control step, and a rush to publication. A
petition for independent scientific review endorsed by 56 mental health
organisations was ignored. There is no reason to believe that DSM-5 is safe or
scientifically sound.’

Dr Thomas Insel, former chair of NIMH, the world’s largest funding body for mental health research:
‘The weakness is its lack of validity... That is why the National Institute for Mental
Health will be re-orienting its research away from DSM categories.’

Available for interview or comment:

Dr Lucy Johnstone
Consultant Clinical Psychologist

Dr Katie Hunt
Clinical Child Psychologist and Paediatric Clinical Neuropsychologist

To arrange interviews or comment please contact :

James Scurry Jo Watson
07850 172 206 07769 158 565

References and further reading

i One in eight of five to 19 year olds had a mental disorder in 2017 major new survey finds

ii The Chemical Imbalance Theory of Depression: still promoted but still unfounded

There are no ‘schizophrenia genes’: here’s why

Adverse Childhood Experiences Resources

iii One manual shouldn’t dictate US mental health research

iv United Nations report on extreme poverty and human rights

For more information please visit: