UK teenager trends – suddenly they’re on the level

The difficulties governments face when responding to good longitudinal research are highlighted by new, more optimistic findings on the state of adolescent well-being and mental health just published by the UK Nuffield Foundation.

Five years ago the Foundation’s Time Trends in Adolescent Mental Health study identified an increase in teenage problems alarming enough to induce the Government to commit itself to a fundamental reform of children's mental health services.

The findings pointed to a dramatic rise across a series of measures, relating to anxiety, depression and conduct problems among 11-15 year-olds since 1974.

The latest Time Trends report adds the years between 1999 and 2004 to the analysis. In that period no further rise in the level of emotional problems was detected and there was a small decrease in the level of “passive” conduct problems such as lying and disobedience.

The continuing research is being undertaken by Stephan Collishaw from Cardiff University and Barbara Maughan from the Institute of Psychiatry using data from Office of National Statistics survey.

Both researchers were part of the team which reported in 2004, when the main findings were attributed confidently to real changes in adolescent behavior and experience rather than to any increasing tendency to rate UK teenagers as problematic.

At the time, the UK results were contrasted with findings from equivalent research in the US which showed that a comparable decline had tailed off during the 1990s, and from Holland, where there had been no decline at all.

Complicating the new picture further, more recent findings from the Netherlands study by Professor Frank Verhulst’s team at Erasmus University, Rotterdam, which extend the data to 2003, suggest small increases in internalizing problems. That trend was strongest between 1993 and 2003, they say.

UK policy makers are left to consider whether the response in 2004 would or should have been any different had the better evidence for the years after 1999 been available, and, in the light of that experience, to calculate how best to respond to the newly-uncovered improvement – acknowledging that it could not have had anything to do with policy changes made since 2004.

The main Nuffield findings are:

• There was no change in the amount of emotional problems such as anxiety or depression between 1999 and 2004 (these problems rose by 70% in the preceding 25 years from 1974 to 1999).
• Parent reports of conduct problems such as lying, stealing, disobedience and fighting decreased slightly between 1999 and 2004 (these problems doubled between 1974 and 1999).
• Researchers looked at nine different measures of mental health problems in 1999 and 2004, as identified by parents, teachers and teenagers. Of these nine measures, eight had decreased or stayed the same. The exception was the level of emotional problems reported by teachers, which increased slightly.

The authors conclude: “Although teenage mental health problems did not increase between 1999 and 2004, the dramatic rise in these problems prior to 1999 means that today’s teenagers are still more likely to experience emotional and conduct problems than teenagers in the 1970s and 1980s".

Of the new trend Stephan Collishaw said:
“The level of mental health problems amongst UK teenagers, which increased at an alarming rate over the 25 years from 1974 to 1999, has now reached a plateau. What is not yet clear is whether the slight decrease in levels of some problems is the start of a trend in the opposite direction.”

• Ann Hagell’s Nuffield Foundation briefing paper,Time trends in adolescent well-being can be downloaded from the Foundation’s website [1].