Everybody is talking about adolescent boys and the fact that they do not express their emotions. In a recent interview, Prince Harry says that he really regrets not opening up sooner about how his mother's death affected him:
You can be as tough as you want on the exterior, and you can be someone who never shows any emotion, but inside there's all sorts of stuff going on.
A recent article in the Guardian discusses whether the teenagers' view of masculinity, centred around not showing emotion and not asking for help, is leading to increased depression, suicide and violence. However, boys don't start their lives as unemotional human beings. Male infants are as emotionally expressive than female infants, but a boys' emotional expressiveness decreases as they age. The school environment may be the key.
Ashvin, my co-author in this blog, summarises it flawlessly: at school, emotions equal weakness. And, since the enjoyment of school is almost totally governed by whether a student is perceived as weak or strong by their peers, any public displays of emotion, whether crying, anxiety, or even extreme happiness, are to be avoided. Thus, suppression of feelings is essential to having a good time at school.
Gender differences in emotional expression may be particularly evident in the school environment, where adolescents are with peers and respond to differing expectations of boys and girls: boys don't cry, while sugar and spice and everything nice, that's what little girls are made of. Society's requirement that boys must hide their emotions has been extensively discussed since the 90's. Research has also shown that suppressing emotional expression increases the likelihood of compromised socioemotional functioning and the risk of developing psychopathology.
Keeping emotions under wraps at all times is therefore boys' most-practiced skill, as a way of coping in their social milieu. But sometimes, unforeseen events do occur. Becoming much more aggressive and unpredictable at school, or even engaging in violent behaviour, may be the only way for an adolescent boy to express the despair for a family illness or for other personal suffering: the sheer rawness and unfamiliarity of these feelings lead to dramatic manifestation of emotions, which can no longer remain suppressed.
Interestingly, the problem is not only about the affected boys learning to express emotions and to ask for help: it is also about other boys learning how to handle emotions and how to give help. Ashvin recalls situations where he, and his peers, should have talked to a friend in difficulty, but did not know how. Communicating and talking through emotions is such a societal taboo amongst boys, that it was easy to leave the affected boy to his own devices, as not one of his friends knew how to even begin to talk to him about what he was going through.
So what could be done differently? From a student's perspective, it starts by removing the stigma attached to having mental health difficulties or even to showing basic emotions. We need to move away from the idea that, in order to be considered as having a 'mental health problem,' one needs to be suicidal, severely depressed or have completely lost touch with reality; instead we need to realise that any episode of persistent worry, stress, or sadness, could be a mental health issue. This cannot happen overnight, but one place that it must start is in schools.
Schools are aware of this problem. The Good Schools Guide website reminds parents, who are approaching the website in search of school reviews and articles on education, that 1 in 10 teenagers suffers from a recognised mental health issue, and 1 in three teenagers reports feeling 'sad' or 'down' more than once a week. The website suggests that parents should find a school where children are loved and valued for their individuality and where the pastoral care is outstanding. Indeed, good pastoral care provision is essential for uncovering the causes of disruptive behaviour, and it gives the boy an outlet outside of the home environment to explore his problems in a safe space.
However, this may be not enough. Mental health must be incorporated into the school curriculum, but not simply through conventional, sit-down Personal, Social, Health and Economic lessons (PSHE). Rather than the daunting prospect of having to book formal appointments with a relatively unknown school counsellor, more interactive, informal discussions and workshops in smaller groups could be far more productive. Perhaps, a 'Mental Health Committee' could be responsible for organising these initiatives, bringing also families on board, and inviting independent speakers to joint events with parents and pupils. The input into the curriculum must be spread throughout the school years, as there is no saying when a young person may be struggling with mental health issues.
A recent report by the UK Department of Education on mental health and behaviour in schools highlights cases of good practice, with schools offering a curriculum promoting mental health and well-being, sessions for individuals or groups dealing with issues such as anger management and family break-up, and peer mentoring programmes where older students receive training and conduct one to one meetings with younger students under the supervision of an adult learning mentor.
So what about us - researchers in mental health? A new emphasis on public engagement is bringing additional resources to do outreach work in schools. My group has been involved in delivering Mind the Mind workshops by the European Federation of Psychology Student's Associations, aimed at educating young people about the stigma associated with mental disorders, and in the Takeover Challenge initiative, where young people are invited to our NIHR Maudsley Biomedical Research Centre to learn about mental health and to exchange ideas with researchers.
Let's hope that more schools and more mental health organisations join forces, and that the Government provides more funding for these kinds of initiatives.