More people are ill than ever before, so we are led to believe. About 40% report they have a long term illness, but this statistic does not just represent the degeneration of an ageing population, to a large extent it is composed of stress-related lifestyles of the young. Latest figures suggest that 50% of ill people have illness that defies medical explanation, which, like IBS, often starts during that period of separation that commences in adolescence and extends into the mid twenties or beyond, spanning the period of time when many young people are at university. Surveys have shown that 1 in 4 students seek professional help for a mental health problem, either anxiety or depression and often overlapping with unexplained physical illness.
So is life in 21st century more toxic than ever before? Or are young people more vulnerable and ill equipped for independent life? Or are we just over-medicalising everyday experience? These were the questions addressed at a special annual debate organised by The Sheffield University Counselling Service.
Anna Mullaney, welfare officer for The Students’ Union claimed that in Sheffield, 80% of students reported mental health disturbances. This might be because young people had been so overprotected that they were ill equipped to cope with the stresses and pressures of university life, but it might also be because the current environment for University was particularly difficult.
When I went to University in the nineteen sixties, I was among a privileged 30%. I knew I had a job waiting for me as soon as I left. The government funded my tuition fees and I had local authority support for my accommodation and sustenance. As the Prime Minister of the day proclaimed, ‘we had never had it so good!’ It was true. We were very fortunate. We lived in a world that seemed more secure than it is now. We had everything to play for.
Most young people expect to go to University these days. It is for many a rite of passage into adulthood. Nevertheless, it is much more competitive than ever before. There is not a guaranteed job at the end of it. Many university leavers start life as ‘graduates on benefits’. The bar has been raised. Employers are often looking for students with Masters degrees or Doctorates, but these are only awarded to the most competitive students. The pressure to succeed often means extra courses, assignments and appropriate extracurricular activities including involvement in student politics, administration and sport; anything that gives them that edge over their peers.
Student life is harder now. Most students have to take casual employment in bars or restaurants just to earn enough for the necessities of food, shelter and entertainment. Many find it more economic to live in a house together with other people, but this may afford them little privacy and little time for thought and study. There are also dangers; they may fall out with their housemates, feel coerced into drinking too much, taking drugs or experimenting with casual sex. The stereotype is they finish work late a night, party until the early hours and then get up for lectures the following morning.
Loneliness, poverty, the stress of assignments and exams, alcohol, drugs, sex; it’s such a toxic mix, it is amazing that so many students get through it unscathed. But the reality is that many don’t; what happens during ‘the time of their lives’ may leave them increasingly susceptible to illness and stress. So is university that dangerous or does it just seem so? Is the fact that more students are living at home these days related to the dangers of university life or to a lack of maturity and life experience?
The other speakers went to University in ‘the golden age’. Sir Simon Wessley, President of the Royal College of Psychiatrists, acknowledged the results of the mental health surveys of students and the stresses of university life, but questioned whether such stress should be considered abnormal or just part of growing up. ‘Change is always stressful’, he asserted, ‘and leaving home and going to university has always been a challenging transition. It is the way we deal with it that matters. The experience of stress and resolution of anxiety helps people learn and grow in confidence and enjoy life. Enjoyment always comes with overcoming risk.’
Wessley questioned whether we might not be in danger of pathologising everyday experience? Might, for example, depression be everyday sadness and disappointment; anxiety, life stress; bullying just a robust argument; autism or obsessive/compulsive disorder focus and hard work; attention/deficit hyperactivity disorder, the boredom of an intelligent child. There is obviously something in that, but by extension, IBS could be dismissed unfairly as everyday bowel disturbance; food allergy as everyday sickness and chronic fatigue as just tiredness condemning many to rejection and stigmatisation. Wessley has a certain reputation of making light of the illnesses that cause young people so much distress.
Quoting from a study of those soldiers deemed at risk from battle trauma, Wessley noted that the greater proportion showed resilience under fire and grew from the experience. Likewise, Fitness to Study surveys may rule many people out of university on basis of vulnerability and are likely to be wrong. Most students will do well. So should we put appropriate safeguards in place that still allow students to gain the experience that will enable them to develop into responsible members of society?
Ken McLaughlin, Professor of Social Care & Social Work at Manchester Metropolitan University was concerned that regarding social and political problems as psychological blames the individual rather than society. ‘It is often when people feel entrapped in a situation that is unfair or does not recognise them, that they get ill’, he claimed. ‘People who are unemployed may not so much need counselling or cognitive behavioural therapy (CBT); their cognitive processes may be quite rational. They just need help to find a job. It’s not necessarily work that is so toxic, it is lack of work. These days, Trades Unions seem more concerned with helping people cope with inequalities in the workplace than fighting them’.
‘The same might apply to initiatives that student unions put in place. Although CBT, mindfulness courses and resilience training may help the individual deal with their feelings, positive action may be more effective. The expression of frustration and anger is often a justifiable response society’s injustice. Should they not get in the real world and fight for better conditions? Too much illness may be caused by passivity and feelings of victimisation in the face of injustice.’
‘We need to address what it is about society that makes people feel bad. Situations that induce feelings of entrapment, impingement, rejection, isolation, loneliness, inequality, poverty and hopelessness often underpin illness and should not necessarily be seen as a failure on the part of the individual.’
McLaughlin also questioned the benefits of awareness campaigns for mental illness or unexplained physical illness. He wondered whether this might focus too much attention on the risks of illness instead of celebrating the risk and the excitement of life. ‘Does awareness just make us more conscious of being sick? Does putting a label on everyday feeling justify illness behaviour? Have we become so Health and Safety conscious that we worry ourselves sick about the risks of everyday life than just accepting them and enjoying the challenge? Awareness can just make us anxious. In labelling people as mentally ill, we may be producing a stigma, that isolates the individual, causing rejection and more tension.’
Professor Kathryn Ecclestone, from The University of Sheffield’s School of Education said that the university has trebled its expenditure on psychological support of students, but the student movement are now requesting trigger warnings on upsetting material in lectures and the provision of safe spaces for vulnerable students. She questioned how helpful that was. ‘Are we offering much needed support and recovery facilities or are we in danger of fostering dependency? Do self help groups keep people in the illness? Students are very suggestible; they have many worries about their lifestyle. They are still trying to find who they are. Instead of creating a space to talk about a perceived problem, could they be helped to work together and experience that frisson of risk and resolution that would help them to grow.’
The speakers all acknowledged that life can be difficult for students, but many of the difficulties that students encounter may be normal part of growing up. Instead of trying to protect students an treating them as potential victims, it would seem better to create an environment where they can balance work with activity, society with study, enjoyment with meaning and so discover the people they are.
That all seemed quite reasonable, but I was left with the uncomfortable feeling that some of the students in the audience might regard this conclusion unrealistic and feel a mite patronised.
For more information, why not go to The IBS Network website, log in or join and click on https://www.theibsnetwork.org/stress/