One in six report severe mental health difficulties by age 17
16% of teenagers report high levels of psychological distress by age 17, finds a new study led by UCL researchers based on data collected in 2018-19. The findings also show 24% of young people report self-harming and 7% report self-harming with suicidal intent at age 17.
The research, which is being published in a briefing paper by the Centre for Longitudinal Studies (CLS) at the UCL Social Research Institute, working in partnership with the National Children's Bureau, provides evidence of widespread mental health difficulties among the UK’s Generation Z before the COVID-19 pandemic struck.
Using new data from the Millennium Cohort Study (MCS), a nationally representative study of teenagers born in 2000-02, this research also reveals stark inequalities in levels of psychological distress, with females, White teenagers, those from disadvantaged backgrounds and sexual minority teens all more likely to experience mental ill-health.
The authors analysed information collected from more than 10,000 young people who have all been taking part in the MCS since they were born. In 2018-19 when study members were aged 17, they answered a series of questions about their mental health over the preceding month, whether they had self-harmed in the last year, and if they had ever self-harmed with suicidal intent.
Overall, 22% of females and 10% of males had high levels of psychological distress, including symptoms of depression and anxiety.
More than a quarter of 17-year-old females (28%) and a fifth of males (20%) reported self-harming in the previous year. Rates of self-harming had increased from 15% to 24% since study members were last surveyed at age 14. The increase was particularly marked for males, with rates more than doubling from 9% at age 14 to 20% at age 17, while females experienced an increase from 23% to 28% over the same period. One in 10 females (10%) and one in 25 (4%) males said they had self-harmed with suicidal intent.
Poor mental health and self-harm were more prevalent among White teenagers, compared to young people from other ethnic groups. However, rates of self-harm with suicidal intent were similar across all ethnic groups.
Young people from more disadvantaged families, in the lowest 40% of the income distribution, were twice as likely to report having attempted suicide compared to their more advantaged counterparts. The proportion experiencing psychological distress was also higher among those from lower income families. Notably, there was no difference in prevalence of self-harming among youths from different socioeconomic backgrounds.
At age 17, study members reported on their sexual identity for the first time. Compared to their heterosexual peers, LGB+ teenagers were twice as likely to have serious mental distress (41% vs 16%) and to have self-harmed (56% vs 24%), and were three times more likely to have self-harmed with suicidal intent (22% vs 7%). These findings are in line with previous studies which show that sexual minority youths are particularly vulnerable to mental health difficulties.
Report author Dr Praveetha Patalay (UCL Centre for Longitudinal Studies) said: “These findings underline the urgent mental health support needed by this generation. Supporting young people who are suffering from mental ill-health should be made a priority, and more needs to be done to prevent such high levels of difficulties emerging for future generations.”
“Age 17 marks an important age before many key life transitions, including the ending of compulsory education and moving away from the parental home. With the ending of support from Child and Adolescent Mental Health Services (CAMHS) around this critical age, many young people fall through the gaps between CAMHS and adult mental health services, potentially further worsening outcomes at the precise time when support is most required.”
Report co-author Professor Emla Fitzsimons (UCL Centre for Longitudinal Studies) added: “This is the first evidence to emerge on the prevalence of attempted suicide among 17-year-olds across the UK, and the finding that one in 15 had self-harmed with suicidal intent is alarming. The COVID-19 pandemic has since occurred, and the additional pressure this brings to bear on a generation already facing major mental health issues is hugely concerning.”
During the COVID-19 national lockdown in May 2020, when study members were aged 19, they were asked to answer the same series of questions on their experience of psychological distress as at age 17, to see how the pandemic was impacting them. With responses collected from 2,200 MCS participants, overall rates of poor mental health had increased slightly from 18.2% to 18.9% in this group, and were much higher among females than males at age 19 too. However, this increase in mental ill-health between ages 17 and 19 might reflect change that may naturally occur at this stage of life, as well as change attributable to the pandemic.
Anna Feuchtwang, Chief Executive of the National Children’s Bureau, said: “The levels of anguish indicated in this report show the desperate situation that many 17-year-olds face, even before the COVID-19 pandemic.
“These findings remind us that we should all be vigilant for young people in mental distress, listen to their concerns and signpost them to the sources of specialist support available. These conversations can help young people to cope and find a way through.”
“Policymakers too must play their part. We are calling on them to provide an additional package of support for young people making the already difficult transition to adulthood in these unsettling times. The government must take action to ensure every young person is able to keep the level of support they need when they turn 18, as they move from CAMHS to adult mental health services.”
The study was funded by the Economic and Social Research Council (ESRC).
P Patalay, E Fitzsimons. ‘Mental ill health in the UK at age 17 – Prevalence of and inequalities in psychological distress, self-harm and attempted suicide,’ will be published on the CLS website at 00.01hrs on Friday 20 November 2020. Advance copies of the briefing paper are available to journalists on request.
If you have been affected by the issues raised in this report and need support:
- Children and young people affected by mental health issues can find support, information and details about their local NHS mental health services at www.youngminds.org.uk/find-help or call Childline on 0800 1111.
- For adults, whether you're concerned about yourself or a loved one, you can find local NHS urgent mental health helplines and a list of mental health charities, organisations and support groups offering expert advice, on the NHS website at: www.nhs.uk/conditions/stress-anxiety-depression/mental-health-helplines/ or call Samaritans on 116 123.
Media coverage of suicide and self-harm
None of the partners will be putting forward case studies for media work. We urge journalists to refrain from using case studies altogether and to make sure coverage is responsible by following the Samaritans’ guidelines on reporting issues related to self-harm and suicide: Media Guidelines for Reporting Suicide, Guidance for covering self-harm in the media and Guidance for covering youth suicides, clusters and self-harm.
Study methodology notes
Measures of mental ill-health at age 17
Psychological distress: Participants responded to the Kessler-6 item measure of psychological distress. The measure asks respondents how often in the last 30 days they felt: so depressed that nothing could cheer you up, hopeless, restless or fidgety, everything was an effort, worthless, and nervous; with response options ranging from all of the time to none of the time. Total scores can range from 0-24, with higher scores indicating greater distress. A score equal to or above 13 is indicative of high levels of psychological distress or possible clinical diagnosis.
This question was also repeated at age 19, where a subset of around 2,200 participants responded to a short online survey in May 2020 to gather information about their experiences during the COVID-19 UK national lockdown. They were not asked questions about self-harm or attempted suicide.
Self-harm: The survey also captured whether cohort members had self-harmed in the previous 12 months, with the question, “During the last year, have you hurt yourself on purpose in any of the following ways?”: cut or stabbed, burned, bruised or pinched, overdosed, pulled out hair, other. In this report we present 12-month prevalence of self-harming (yes or no).
Attempted suicide: Cohort members responded yes or no to the following question “Have you ever hurt yourself on purpose in an attempt to end your life?”
Data presented in this report are from all responses to these questions at age 17. Prevalences have been weighted to provide nationally representative estimates.
Ethnicity: At age 17, 82% of young people were of White ethnicity, 3.1% Mixed race, 9.6% Asian, 3.8% Black and 1.6% other ethnicities.
Family income: This was based on household income at age 14, equivalised to account for household size using the modified OECD scales, and divided into quintiles; poverty is below 60% of the median income.
Sexual identity: At age 17, around 10.6% of young people identified as non-heterosexual, with 6.5% identifying as bisexual, 2.5% as gay or lesbian and 1.6% as other.
The Millennium Cohort Study (MCS) is following 19,517 young people born across the UK in 2000-01, building a uniquely detailed portrait of the children of the new century. The last survey of parents and children took place in 2018-19 when the study members were age 17. Data from the Age 17 Survey is now available. The MCS is funded by the Economic and Social Research Council and a consortium of government departments, and managed by the UCL Centre for Longitudinal Studies at the UCL Social Research Institute. Visit https://www.cls.ucl.ac.uk/cls-studies/millennium-cohort-study/
The UCL Centre for Longitudinal Studies (CLS) is a resource centre based at the UCL Social Research Institute. CLS is home to four national longitudinal cohort studies, which follow the lives of tens of thousands of people. The Centre is funded by the Economic and Social Research Council (ESRC). www.cls.ucl.ac.uk
The UCL Social Research Institute (SRI) is one of the leading centres in the UK for multidisciplinary teaching and research in the social sciences. Based at the UCL Institute of Education, and with more than 180 academic, research and professional staff, it works to advance knowledge and to inform policy in areas including gender, families, education, employment, migration, inequalities, health and child/adult wellbeing. https://www.ucl.ac.uk/ioe/departments-and-centres/departments/ucl-social-research-institute.
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The Economic and Social Research Council (ESRC). The ESRC, which funds the UCL Centre for Longitudinal Studies, is part of UK Research and Innovation, a non-departmental public body funded by a grant-in-aid from the UK government. For more information visit www.ukri.org.
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