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10 January 2000

Have our kids gone mad?

The affluent society, say some experts, has led to mental illness in one in five children. Judy Hirs

By Judy Hirst

It’s 1.30pm on a cold, windswept day in Newham, east London. Darren, a mixed-race 12 year old, with bleached blond hair and a winning smile, is kicking a ball about with a mate before going off swimming with his school. Nothing extraordinary about that. Except that Darren – though far from unique – is no ordinary lad. Nor is this an ordinary school.

For a start, it has only seven pupils, all boys, all with severe behavioural problems. They are here, rattling around in a gulag of run-down Portakabins, because after years of trying to integrate these ranting, raving, frequently violent children into mainstream schooling, their teachers have had enough. In theory, Newham has an inclusive education policy second to none. It shut most of its special schools years ago and clamped down on exclusions. But since Greengate school – a joint venture between the local education authority and Barnardo’s – opened last year, local heads have been discreetly queuing up to send their problem pupils.

Darren has been here just two months, and according to his mum, her friend, his educational assessor and all the other adults and professionals who fuss over him, he has blossomed. From a boy who, in his own words, was “totally mental”, he has become almost likeable. He still has his off days, but for the first time in years he is enjoying school.

The proportion of children like Darren is on the increase. The Mental Health Foundation claims that one in five young people suffers from a mental health problem, ranging from attention deficit and hyperactivity disorders to obsessive-compulsive behaviour, phobias and depression.

Talk to any teacher or social worker and they will tell you that the number of EBDs – pupils with emotional and behavioural difficulties – is soaring.

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But how trustworthy are these claims about children getting madder by the minute? Most commentators talk airily about the breakdown of traditional social structures and the impact of rampant consumerism on families. Which, translated down to street level, means that children are screwed up because they didn’t get the right trainers or Pokemons for Christmas, or don’t live in squeaky clean 2.2 families.

Current orthodoxy on the issue supports this “richer but sadder” theory. But early findings from an Office for National Statistics survey confirm what we probably suspected all along: that poverty and social exclusion – rather than angst and ennui produced by an ever wealthier society – are vital in understanding much childhood mental illness.

The ONS survey – the first major one of its kind – shows that children from social class V (unskilled workers) are three times more likely to have a mental health problem than the offspring of social class I (professionals), and twice as likely as those in social class II (employers and managers). What’s more, 10 per cent of children from social class V have conduct disorders compared with 3 per cent from social class I. These differences are mirrored in the findings on family income. The researchers have also come up with a much more conservative estimate of childhood mental illness, putting the proportion at only one in ten. When the full report is published in April, it is likely to indicate little recent increase in diagnosable mental disorders.

Professor Robert Goodman, of the Institute of Psychiatry, who is heading the research, argues that the figures being bandied about on mental illness devalue the meaning of the term. “Of course children display ‘symptoms’ of disturbance all the time,” he says. “But most people sensibly wouldn’t call this mental ill health. The criteria we’re using is whether a disorder causes real distress or seriously interferes with the child’s life.”

Sebastian Kraemer, consultant psychiatrist at the Tavistock Institute, points out that the view that improved social conditions equals worsening mental health has major policy implications. “It’s really a fairly right-wing thesis that can be used to undermine welfare provision and hark back to a mythical golden age. In fact, the whole argument is deeply suspect. There has been no real rise in children’s mental disorders, just a better recognition of what might be wrong with the aggressive, odd or painfully shy child.”

Far from being mentally healthier, life for most children half a century ago was thoroughly repressed. “The fifties were terrible, with everything – abuse, violence – all locked away behind a facade of order and respectability,” says Kraemer. “It was like The Truman Show. Today things are more out in the open, though some children are likely to be less securely attached because of parental conflict and marital breakdown. But that doesn’t mean most children are worse off.”

The real risk, he argues, is that a generalised, ill-informed panic about out of control, anti-social young people will simply be used to knock single mothers, divorce and welfare dependency, instead of providing support for the families that most need it.

Support for children such as Darren. At Greengate school, the charismatic teacher in charge, Penny Poston, seeks to provide her young charges with the things that mainstream education and their families rarely offered them. “I treat them with respect . . . and explain about respecting other people. Like why picking your nose or sticking your hand down your trousers in McDonald’s is just not on.”

Greengate is essentially a therapeutic environment – one that these boys, whose home backgrounds are impoverished in every sense, including domestic violence, alcoholism and sexual abuse, need.

But Greengate can only take a maximum of 12 children. And in most areas, nothing like it exists. Certainly not for Sean, a Cardiff primary school boy, who thinks he’s a dog and insists on acting like a dog all day long. He’s on Ritalin, for some kind of attention deficit disorder, says his school head, Roger Brind.

Dealing with barking, biting boys, while trying to run a good school in a catchment area where up to 90 per cent of children get free school meals and half have special needs, is one of the things that recently drove Brind to a breakdown. Two million viewers watched him on BBC2’s Talking Cure programme being signed off for six months with stress-related illness. What they didn’t see was the dog-boy; or the child who witnessed his mother commit suicide two years ago and has been attacking himself and everyone around him ever since; or the 50 or so other EBD children at Brind’s school – many of them unwanted by other heads because of their impact on school results.

Brind is a firm supporter of inclusive education. But he is angry at policies that have dismantled special needs and school welfare provision, impoverished communities, set school against school, and expect teachers to do inclusion on the cheap. The government tacitly acknowledged that teachers are under unbearable pressure when it announced plans for “learning mentors” – sort of classroom-assistants-cum-social-workers – to go into some of the most troubled schools.

The kids, says Brind, need specialist counselling and therapeutic support. In a handful of places, some are getting it. Officially Greengate is meant to be a stepping stone towards reinclusion into mainstream schooling for boys such as Darren. For many of them, though, it’s unlikely and too late.

Roger Brind, back now at the chalkface, might well ask whether it’s the children or the government and the shrinks who are barking mad.

Children’s names have been changed