Gender and children and young people’s emotional and mental health: manifestations and responses
A rapid review of the evidence
Children and young people's mental health is one of the most challenging health issues of our times. It is estimated that half of all mental health problems emerge before the age of 14, with three quarters having appeared by the age of 24 (Kessler and others 2005). The serious consequences of emotional and behavioural problems for children and young people’s life outcomes in many domains, and even their life expectancy, are well-documented (Goodman and others 2011; Richards and others 2009). The use of effective, evidence-based interventions with children, young people and families can help to avert such consequences and save public money (Khan 2016).
In 2014, the Department of Health and NHS England established a taskforce to examine how to improve child and adolescent mental health and wellbeing, as part of a government commitment to achieve better access to mental health care for people of all ages by 2020 (DH 2014). The taskforce published its report, Future in Mind (DH and NHSE 2015), making clear proposals for whole-system change. Major transformation programmes for both child and adult mental health services are now underway (NHS England 2016a).
This rapid review presents evidence of clear gender differences in children and young people's emotional and mental health, in terms of:
1. the general picture of children and young people’s emotional and mental health
2. the prevalence of specific difficulties and issues among children and young people
3. children and young people’s coping strategies and help-seeking behaviours
4. responses to children and young people’s emotional and mental health needs from parents and carers, schools, and public services
5. service responses to the needs of some particular groups of children and young people.
This document aims to provide a snapshot of the most recent and salient evidence from published research and grey literature, as relevant to children and young people living in England in 2016. It addresses children and young people’s emotional and mental health difficulties as they manifest and are responded to, highlighting and exploring gender-related issues behind observed patterns across areas of mental health.
This is not a systematic review, and is not exhaustive. It is part of a small-scale project that aims to inform gender-responsive approaches to children and young people’s mental health by bringing evidence together with findings from engagement with young people and practice examples from services.
It is important to acknowledge that many of the issues covered in this review are contested and inextricably linked to the broader context in which differences in mental health arise. Social inequalities relating to gender, socioeconomic status, ethnicity, disability, sexual orientation and other factors intersect to impact on individuals throughout the life course in ways that affect their mental health: for example, socio-economically disadvantaged children and young people are up to three times more likely to have a mental health problem than their better-off peers (Reiss 2013). Gender differences are observable in relation to many of these social inequalities, as well as to various biological, developmental and sociocultural factors relevant to emotional and mental health (WHO 2011). Interrelationships between such factors, health behaviours, and mental and physical health outcomes are complex. There is also significant diversity in young people’s needs and experiences, and how effectively these are understood and addressed, according to a wide range of characteristics, experiences or circumstances.