Mental health does not equal happiness. Those were not the words I expected to hear from Dr. Stan Kutcher, Chair in Adolescent Mental Health and the Director of the World Health Organization Collaborating Centre in Mental Health Policy and Training at Dalhousie University. Dr. Kutcher spent the day at Trafalgar Castle last week, working with a group of teachers and counsellors from independent schools across Ontario, and then in the evening, speaking to our community. His words and the directness of his delivery surprised me. But as he continued to talk and share insight as someone working in the trenches with families, educators, and the health care system, his words began to make sense and resonate clearly. The problems our children and teens are facing today, according to Kutcher, are particular to Western society. In order to find solutions, we first need to understand how our parenting, our present-day beliefs, and our modern-day culture are impacting children’s mental health and overall wellbeing. In other words, it’s less about taking a look at our children, and more about taking a look at ourselves.
At first glance, things are not looking good when it comes to child and adolescent mental health in Ontario. Between 2006 and 2014, the rate of outpatient physician visits for mental health concerns grew by 25%. Emergency room visits rose by 53%, and the rate of hospitalization for mental health and addiction issues increased by 56%. Our schools, our community service providers, our emergency rooms, our hospitals – every part of the system is stretched and struggling to keep up with growing mental health needs.
Admittedly, there is no quick fix. But according to Kutcher, simply improving our mental health literacy would go a long way to deescalating the panic and reducing some of the problem. It’s not enough to have mental health awareness. We also need to be literate in mental health, and that includes understanding four key components: knowing how to achieve and maintain good mental health, understanding mental health disorders and the treatments that are available, reducing stigma, and teaching people how to access help when needed.
One of the biggest challenges we face is the misconception that positive feelings denote good mental health while negative feelings indicate a problem or disorder. This strictly Western phenomenon, says Kutcher, is leaving parents (and by extension their children) susceptible to the idea that there’s something wrong with them if they’re sad, or disappointed, or upset. Instead of teaching them that life is often hard, that negative emotions are a normal response to difficult situations, and that adversity breeds resilience, we have begun pathologizing typical experiences by too quickly throwing out labels. “Instead of unhappy, disappointed, or discouraged, the word depression is used. Instead of worried, concerned, or nervous, the word anxiety is used,” says Kutcher. What children need is an opportunity to embrace life’s challenges and all the uncomfortable emotions that go along with them. They need to learn that strategies are available to help them deal with problems independently, that they are capable of coping, and that it gets easier every time they pick themselves up and dust themselves off. And most of all, according to Kutcher, they need to be allowed to deal with these difficulties with increasing independence.
Kutcher is not discounting that some children and adolescents do suffer from serious problems with mental health. His point is that the vast majority of our youngest generation do not fall into this category, and can best be supported when parents ensure that a few key things are in place. What are these important remedies? Exercise, nutrition, sleep, and technology-free time.
Exercise significantly supports physical and mental health. It helps focus and attention, relieves stress, and improves mood. Its benefits are indisputable, yet only 6% of school-aged girls achieve the recommended 60 minutes of moderate-to-vigorous daily exercise. The percentage drops even lower (3%) when we look at girls aged 12 to 17 years. Even with daily activity built into the school day, children are not maintaining the same levels of activity they did even ten years ago, and they’re paying a heavy price, both physically and mentally.
Nutrition is simple, according to Kutcher. Kids just need to eat healthy. There’s no magic pill or special diet needed other than a common sense focus on good food. Avoiding processed meals and reducing refined sugars are helpful, but the main take away is that nutrition is an easy thing to check off the list for children whose families have ample access to food at home. For families at the bottom of the socio-economic ladder, it may be a different story, and that’s where schools and other support networks need to step in to help.
Sleep is altogether another thing, and these days, it’s tied to technology. Simply put, the vast majority of children and teens are able to get a good night’s sleep when set up for success. Sleep disorders are exceptionally rare, and what looks like a problem with sleep is often a problem of too little exercise during the day and too much stimulation at night. Kutcher emphasizes that kids need to be off all devices and away from all screens for a minimum of sixty minutes prior to bedtime. They need 8 to 9 hours of sleep daily, so an early morning alarm clock means that an earlier bedtime is essential. He is frustrated by what he sees as an inability or refusal of some parents to remove technology from bedrooms. Laptops and cell phones left in a bedroom over night are, in his mind, an unnecessary temptation and a danger that contribute to later bedtimes and interrupted sleep patterns. Even teenagers, he argues, need limits and rules to teach them the importance of good sleep hygiene, yet often, they’re left to manage their own use of technology.
Technology-free time and guidelines around the use of technology go hand in hand with good mental health. Kutcher encouraged us, as a school, to hold firm with our rules limiting cell phones during the school day, and with putting in place cell-phone free experiences like we have at camp. He wasn’t surprised to learn that we receive push back, and not just from students, but from parents, too. He sees this resulting from a style of modern-day parenting where the need to be in constant communication with one’s child has become the norm for many parents. What would have been normal and healthy periods of radio silence in previous generations now result in immense worry or discomfort for parents and, as a result of learned behaviour, the child.
Kutcher believes that in our desire to give our children the best of everything – a life better than our own growing up – we’ve created a state of superfluous abundance that is causing mental malaise. For many children, walking to school at an early age is now unthinkable. A part-time job is unnecessary. Fewer teens are getting a driver’s licence at age sixteen, and more are being chaperoned to and from parties. Simply allowing a child to head out after school on a bike with friends and return home sometime before sunset would strike fear into the hearts of many parents. We’re extending the length of adolescence (a strictly Western phenomenon), and reducing the expectation of independence in our children. We’re trying to protect our children from any and all danger, and in so doing, impeding their normal developmental journey from childhood to adulthood.
According to Kutcher, we’ve also created the notion of a “safe space” – the idea that a child must always feel comfortable and emotionally protected, her every thought listened to and her every feeling validated. As a result, personal slights are too often seen as bullying, and adult intervention is perceived to be necessary. A problem with a teacher is taken up by parents rather than the student, even in the upper grades. Normal feelings of disappointment or upset or sadness are discussed (and analysed and reanalysed) to the point that moving on becomes difficult. The message the child receives is that they should be free from discomfort. In fact, being free from discomfort is seen as their right.
If you want to see how this phenomenon is playing out for this generation, just take a look at our post-secondary settings. The idea that professors are there to challenge thinking, to put students on the spot, to dismantle students’ arguments (sometimes forcefully) until they can think for themselves – these hallmarks of higher learning are under attack. Replacing them are notions of students’ emotional safety that precludes, in many instances, robust academic discourse and heated open debate. It’s as if we’re now saying that this new generation of children is too emotionally fragile to cope with feelings of discomfort or upset or unease or disagreement. And if that’s truly what we believe, then it’s no surprise that mental health problems are on the rise.
As I mentioned earlier, Kutcher is not saying that mental illness does not exist. Sadly, it does. It needs to be identified early and treated effectively. But Kutcher’s overall (and good news) message is that serious mental illness in children and adolescents is rare, so the majority of what we’re dealing with as parents and educators is not that. It’s something else. And dealing with it likely requires us to sit with our own possible discomfort as we allow our children to sit with theirs.
As a next step, I propose we heed Kutcher’s advice. Let’s parent in a way that reinforces the importance of physical health and wellness. Let’s increase the expectation that our children try to problem solve independently. Let’s give them the tools to manage set backs, failure and disappointment, and then step back and let them practice without us running interference. They may not feel as happy in the moment, but they’ll be healthier in the long run, and better equipped for life.
 The Mental Health of Children and Youth in Ontario: 2017 Scorecard. Institute for Clinical Evaluative Sciences, 2017.