Dr Christina Carlisi on how to protect the mental health of children and adolescents

It’s not easy being a teenager; understanding who we are, who we want to be and our place in the world around us has always been a cause of stress and anxiety for many people growing up.

But worryingly, research suggests that things may be getting worse for today’s teens. The NHS reports that one in six young people in England (aged 5 to 16) experienced a mental health problem in 2020, up from one in nine in 2017. But what has caused this decline in good mental health and what can be done to protect the mental health of young people today?

We spoke to Dr Christina Carlisi (UCL Division of Psychology and Language Sciences) to find out more.

“Adolescence is a period of intense social and emotional development,” Dr Carlisi explains, “It’s when young people are becoming more independent, stepping out on their own, forging new relationships and really having to navigate this complex world on their own for the first time. During this development, young people are flooded with all different types of social and emotional information, for example, feedback from peers and social media or stresses from school and exams. Research has shown that the unique ways in which adolescents internalise and respond to this type of social and emotional information might be linked to their likelihood of experiencing mental health problems like anxiety and depression.”

Individuals who struggle with anxiety, for example, may experience a ‘negative affective bias’. This means that when they encounter some type of social information, such as not getting a text back from their best friend, they are more likely to interpret this in a negative light.

“So they might think this is because the friend is mad at them, when in reality, it’s just because they were busy,” Dr Carlisi says.

Existing research suggests that there are a number of factors that contribute to some children and adolescents being more vulnerable to anxiety and depression. For example, it has been found that young people in the lowest income bracket are 4.5 times more likely to experience severe mental health problems than those in the highest income bracket. Experiencing childhood trauma can also double a young person’s risk of experiencing mental health problems.

Dr Carlisi says: “Research has shown that there are myriad factors, both environmental and biological, that make young people more vulnerable to anxiety and depression. For example, coming from a socioeconomically disadvantaged background, or certain family and social environments might make one more likely to develop these problems in adolescence, but we also know that having a parent with anxiety or depression (i.e. our genetics) makes one more at risk of these problems as well. On the biology side, we are trying to understand whether or how these genetic and environmental factors impact brain development, and how this relates to mental health symptoms.”

Dr Carlisi’s latest research focuses on understanding why some young people may be at a higher risk for developing problems like anxiety and depression, and why some people are more or less likely to respond to different types of treatments for these problems.

“We use MRI brain scanning to try and answer these questions, exploring whether there are certain biological factors or signatures in the way adolescents’ brains respond to social and emotional information in their worlds that might tell us something about their risk for mental ill health and treatment response.”

Participants have responded well to their involvement in the study so far.

“I’m continually surprised by the enthusiasm young people have for this type of research,” Dr Carlisi says, “People love to participate in our studies, and I’ve learned so much beyond just the science about the things that matter most to young people when it comes to their mental health, and the sorts of things we as researchers need to prioritise when it comes to our research. So, making sure we’re asking the right questions, making sure we keep all of the things adolescents share with us completely confidential, and making sure our research materials and information are digestible and interesting to young people. Because without this, we’re really missing the point in engaging the key stakeholders in our work.”

While we await the results of Dr Carlisi’s study, there is plenty that can be done at policy level and at home to protect children’s mental health. According to the mental health charity Young Minds, only a third of children and young people with a diagnosable mental health condition get access to NHS care and treatment.

Dr Carlisi says: “One of the biggest challenges with young people’s mental health is access to support. We are failing young people with long waiting lists and limited resources, and we need better access to mental health and public services – especially in schools. This can include a whole range of support from school-based counselling to mental health screening and education to early intervention programs. But without funding, this just isn’t feasible. So, more funding for school-based services.

“The government can also make a huge impact in providing support to families. We’ve spoken a lot about the importance of the home environment and parental support, and this is made so much easier if families are given adequate education and resources to support young people’s mental health. And at a policy level, this starts from day one. Parents need to be given decent parental leave periods, allowing parents to support their children’s emotional well-being from the very start.”

A growing concern among politicians and parents alike is the impact of social media on young people’s mental health. According to the World Health Organization, 11% of adolescents show signs of problematic social media behaviour.

I think at this point we're under no illusions that social media is here to stay, it’s not going anywhere and can actually be a really positive thing for young people in some contexts,” Dr Carlisi says, “It's not really practical or feasible to say ‘let's just ban it completely’.

“But lawmakers could certainly be doing more to regulate and monitor harmful online content, legislating around cyberbullying and holding social media companies accountable when it comes to the young people who use these platforms most.”

The testing ground for building social and emotional skills is the home environment. Parents are key to helping their children lay a strong foundation and providing them with a safe environment in which to explore the skills that they will need to lead a happy and healthy life.

“First, creating a supportive environment and promoting positive relationships is key,” says Dr Carlisi, “We know that relationships and support structures help young people feel scaffolded and teach them the skills they need to thrive in social interactions, and this can definitely start in the home. Young people thrive on having a sense of purpose, and a supportive relationship with the parents can help foster this.

“Parents are also crucial role models for young people – we all experience struggles at some point, but parents can model healthy coping strategies, again giving their children the skills they need to overcome similar challenges in the future.  

“And lastly, something that’s a hot topic at the moment is monitoring social media use. I wholeheartedly believe that social media can be a good thing for young people and plays a critical role in our current world in social development. However, there are certainly downsides, and a healthy attitude towards social media use (and non-use) may help protect from some of the harms of this type of digital technology.”

Image credit: Canva

Biography

Dr Christina Carlisi completed her PhD at the Institute of Psychiatry, Psychology and Neuroscience, King’s College London, investigating the shared and disorder specific neurobiological mechanisms underlying attention and decision-making in adolescents with obsessive-compulsive disorder (OCD) and Autism. Prior to this, she worked as a research assistant in the Section of Development and Affective Neuroscience at the National Institute of Mental Health, NIH in Bethesda, MD, USA. 

Christina came to UCL as a Wellcome Trust Postdoctoral Fellow in the Developmental Risk and Resilience Unit at UCL with Professor Essi Viding, collaborating with Profs Ahmad Hariri and Terrie Moffitt at Duke University. She now leads the Cognitive and Affective Neurodevelopment Lab (CANDL) as a Prudence Trust Senior Research Fellow in the Department of Clinical, Educational and Health Psychology.