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Review of "Young People and Mental Health"

By Peter Aggleton, June Hurry, and Ian Warwick (Editors)
John Wiley & Sons, 2000
Review by Christian Perring, Ph.D. on Jun 18th 2004
Young People and Mental Health

This collection of twelve papers by researchers based in the UK address a variety of mental health concerns for young people.  They are grouped into three sections: specific mental health problems; special groups and special needs; and special contexts and settings.  The authors come from backgrounds in psychiatry, psychology, social work and education.  They address drug and alcohol use, eating disorders, antisocial behavior, suicide and self-harm, lesbian and gay issues, learning difficulties, institutionalization, homelessness, and bullying.  The articles are serious and scholarly, citing many references and setting out the current state of knowledge on these issues, but they are also written clearly and should be accessible to non-specialists who are ready with the slightly dry academic style. 

These papers present standard information about symptoms and trends in the mental health of children and adolescents, and spell out briefly the treatments that succeed best.  The most interesting of the papers here tend to go against the trend of seeing the emotional and behavioral problems of young people as the result of individual mental disorder.  Instead, they contextualize them with regard to specific social and family causes.  In "Young People and Drugs," John Davies points out that the "War on Drugs" has been a failure, and that with its emphasis on total refusal of drugs, it has probably overlooked distinctions between safe and unsafe patterns of drug use.  With an underground market in street drugs and and uncertain ingredients, the danger is considerably increased.  One study found that some drugs sold as ecstasy in fact contained high doses of ketamine, which has much more serious side effects.  Another important point made by Davies is that the language of addiction and alcoholism may be unhelpful, and it may be better to see difficulties in controlling drug and alcohol intake as related to context, with a preferable outcome as being controlled use rather than abstinence.  The refusal to acknowledge the possibility that drug and alcohol use can be pleasurable and sometimes even helpful has driven a discourse of drug use as fatalistically dangerous.  Once drug users start thinking in this fatalistic way, they can find it harder to control their own intake, and the fatalism becomes a self-fulfilling prophesy. 

In the chapter on sexuality and mental health promotion, Ian Warwick, Christine Oliver and Peter Aggleton explain that gay and lesbian youth are at higher risk for many mental illnesses, but that these are related to their treatment at school and by their parents.  They are often bullied by their peers and rejected by their families.  Dealing with these problems is thus as much a social issue as it is psychological.  Another area where the social and the psychological are profoundly intertwined is homelessness.  Davina Lilley reports that it is estimated that there are a million homeless under the age of 21 in Europe, and in the USA, there are up to 1.3 million young homeless.  About a third of young people who leave home say it is due to physical abuse, and one in ten say it is because of sexual abuse.  She sets out the high rates of mental illness among the homeless young: to what extent the illness is the cause or the effect of living conditions varies from case to case. 

While there is a chapter on the emotional disorders of young people, it is striking that categories such as bipolar mood disorder and schizophrenia do not get much attention in this book.  It leads one to speculate that there may be a growing divergence between the USA and Europe in the diagnosis of chronic mental illness in the young, and it would be interesting to see some discussion of reasons for the increasing rates of diagnosis of these disorders in the USA.

Young People and Mental Health is a well-researched assessment of the mental health problems of young people in the UK.  Naturally, some of its claims will be controversial, and it tends to pay only passing attention to the growing issue of the wisdom of prescribing psychotropic medications to children.  Nevertheless, it is a valuable resource for those interested in the trends in the psychological welfare of children and adolescents. 

 

© 2004 Christian Perring. All rights reserved.

 

Christian Perring, Ph.D., is Academic Chair of the Arts & Humanities Division and Chair of the Philosophy Department at Dowling College, Long Island. He is also editor of Metapsychology Online Review.  His main research is on philosophical issues in medicine, psychiatry and psychology.

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