It is a telling comment on the contradictions of our development experience that in some of the most developed countries as well as developing countries recording the highest levels of economic growth, very high levels of depression have been recorded and particularly among adolescents and youth. It is often said by adults that most of their efforts at economic betterment are aimed at improving prospects of their children but if adolescents and youth are leading an increasingly depressed, insecure or uncertain life then questions need to be raised about where society is headed. According to a recent issue of the Economist, the number of American children and teenagers admitted to children’s hospitals for reporting suicidal thoughts has more than doubled over the last decade. The suicide rate in the 15-19 years age group increased by 31 per cent for boys and more than doubled for girls between 2007 and 2015. Suicide has become the second leading cause of death amongst college youth in USA.
According to the national survey on drug use and health in the USA, in 2015 an estimated 3 million adolescents aged 12 to 17 (12.5 per cent of the age group) had at least one major depressive episode in the past year. California’s biggest school district, Los Angeles Unified tallied 255 incidents of suicide openness, self-harm and suicide attempts between 2010 and 2011, but in 2014 this jumped to 5,000. More than 30, 000 students reported prolonged feelings of hopelessness and sadness. 9.1 per cent of middle students and 8.4 per cent of high school students in the district actually attempted suicide.
The American College Health Association surveyed 100,000 college students at 53 American campuses and found that 84 per cent of them feel unable to cope, 79 per cent are exhausted, 60 per cent feel very sad and more than half are experiencing overwhelming anxiety.
Another significant aspect of these trends is that girls are becoming much more vulnerable to depression compared to boys. According to the department of health and human services, the rate for depression among girls was more than double that of boys (19.5 per cent of girls, 5.8 per cent of boys).
In the context of UK, the Independent reported (27 February 2016) that rates of depression and anxiety among teenagers had increased by 70 per cent in the past 25 years. The number of children and young people turning up at hospitals with a psychiatric condition has more than doubled since 2009 and in the past three years, hospital admissions for teenagers with eating disorders have also almost doubled. In a 2016 study 93 per cent of teachers reported seeing increased rates of mental illness among children and teenagers, and 90 per cent said the issues were getting more serious.
A study titled ‘Mental Health among Youth in Sweden’ by Mona Sommer (Nordic Center for Welfare and Social Issues) has compiled a lot of available data. The number of girls (15-19 years) who were treated in hospitals for depression increased eight times within 25 years. In a study of over a thousand Swedish young people in school years 7 and 8, 21 per cent of girls and 16 per cent of boys reported that they had harmed themselves more than five times in the past six months. Between 1991 and 2014 the sales of anti- depressants in Sweden increased by 13690 per cent for girls aged 15 to 19, while that for boys increased by 6710 per cent.
Very worrying depression rates have also been reported from several developing countries. On 6 April 2017, the WHO released a report titled ‘Mental Health Status of Adolescents in South East Asia- Evidence for Action’. This report covers 10 countries in the region including India. Adolescents in this report are defined as children and youth included in the 10-19 age groups. These constitute 18.8 per cent of the population of these 10 countries, and number 362 million. Those in the 13-17 age group number 181 million, comprising about 9.4 per cent of the population.
In these 10 countries, suicide is the second leading cause of death in the 15-19 age group. The suicide rate per 100,000 population in this age-group varies from 3.6 in Indonesia to 25.8 in Nepal and 35.5 in India (the highest amongst the 10 countries). The percentage of adolescents that reported attempted suicides at least once in the past year ranged from 3.9 per cent in Indonesia to 13.3 per cent in Thailand, while the average for all countries was 6.4 per cent. The percentage of students who reported feeling lonely most of the times or always in the past 12 months was 8.4. Alcohol use at this tender age was as high as 23 per cent in Thailand and Bhutan.
In this study overall depression rate was found to be very high for India. Even though the data for India in this report covers only a section of students for whom details were available, nevertheless it indicates disturbing trends. As many as 25 per cent of students were found to be suffering from depression as defined in the study. Eight per cent suffered from anxiety and 10 per cent said that they have no close friends.
As evidence about the seriousness of youth depression has accumulated from all over the world, several studies have tried to identify causes and possible remedial actions. However, several of these studies tend to focus on only one or two of the more obvious aspects of a many sided and deeply rooted problem.
A number of studies have highlighted aspects related to social media. While some studies mentioned overuse of social media, others quote stressed teenagers as saying that it is a strain to be always available for social media. A very large number of adolescents complain about bullying on social media and receiving insulting as well as intimidating messages. In this context a study by Professor Jean Twenge of San Diego State University is often mentioned.
Using data collected between 2010 and 2015 for more than 500, 000 adolescents in the USA, this study found that adolescents who spent three hours or more a day on smart phones or other electronic devices were 34 per cent more likely to suffer at least one suicide-related outcome, including feeling hopeless or seriously considering suicide compared to adolescents who use such devices two hours a day or less. Among adolescents who use electronic devices five or more hours a day, 48 per cent had at least one suicide-related outcome.
Other studies have quoted teenagers who said that their school or college studies and extracurricular activities imposed a lot of burden on them. Their perception of the exaggerated ambitions of their parents as well as their own ambitions influenced by competitive environs often raised education-related stress to levels with which they could not cope. Students took up courses on the basis of ambition rather than genuine interest and youths took up jobs on this basis so that at a tender age work became a cause of stress, not joy.
Another factor cited is the significant erosion of the family support system which affects many adolescents and youth. In many families, both parents may have very busy work schedules. On the one hand, they may not have the quality time needed by their children while on the other, the inclination and ability of parents to handle complex stresses of the youth are open to question. Hence the bond of trust which gives adolescents the confidence to share their stresses does not develop. Adolescents of present generation feel lonelier than their predecessors.
Early initiation of sexual activities before physical and emotional maturity has been reached has also been mentioned in some studies as a factor behind this problem. This has been found to have particularly strong impact on girls.
These various factors have been emphasised in different studies which have recommended remedial action based on their identification of a particular factor. In addition, increasing access to mental health services for adolescents is emphasised time and again not only in the context of developing countries but even in those developed countries where access is amongst the highest in the world.
While all these recommendations have their importance in specific contexts these by themselves cannot provide the way out of the existing gloom. Looking in isolation at one or two factors may lead to missing the wood for the trees. The real solutions can emerge only if the problem as well as solutions are related to a much wider context.
The wider social context has to be seen at two levels. On the one hand, as explained above, a lot of avoidable pressures have built up very rapidly. On the other hand, society’s base of an ethics-based value system has been allowed to erode rapidly. It was this ethical value system which provided stability and guidance to choose between right and wrong, an ability which could be passed from parents to children and from teachers to students.
In the changed circumstances many adults feel that they do not have the moral capacity to fulfill the role of mentor and guide while the young themselves suffer from the absence of value-based guidance at a time they need this most. The great vacuum created by erosion of ethical value systems sometimes gets hidden behind the glitter of attractive-looking technological changes, but the reality is that the collapse of the value system creates such serious problems that no technological change can solve.
So remedial action is needed at two levels. Firstly, needless and avoidable pressures should be re-examined so that what is not necessary but at the same time is harmful can be discarded. Secondly, the greatest attention should be given to creating a strong, ethics-based value system in our society. This involves basic changes in the social system.
The writers are freelance journalists with a special interest in social and development issues.