STRESS. Anxiety. Worry over schoolwork. Depression. Self harm. Sleep difficulties. With our children just returned to school after the summer holidays, studies suggest there is something going awry in the mental health of Scotland’s teenagers. Though on most measures they start secondary school seeming reasonably content, research shows that by the time they reach 15 years old, they, particularly the girls, are showing worrying indicators of mental health issues. The Health Behaviour in School-aged Children (HBSC) study by St Andrews University has found Scottish teens also feel more burdened by schoolwork pressure than teens in most other countries in Europe. Such is the concern over mental health that the Scottish Youth Parliament has published which, described, in its title, the issue as “Our generation’s epidemic”.

Back to school week has just passed. When we talked to young people, parents and experts, in this transition period, what was revealed was a portrait of Scotland’s teens in crisis beset by worries, unsure of where to turn for mental health help, troubled by exam stress, unable to switch off from social media, anxious about their own futures, distressed by the steady flow of violence and terror on the news, and by, what one parent called, “the globalisation of awfulness”. Anxiety is rife. As a mother of a 14-year-old girl said: “It’s a feeding frenzy of anxiety among these girls. My daughter is struggling. It’s as if there is a positive bidding war going on among them over who is the most anxious. Who has got a diagnosis? Who doesn’t have a diagnosis? Are you a fraud, are you not a fraud? It seems to me that more than ever it’s like Lord of the Flies out there. Tribes, cruelty. It’s identity stuff. It’s anxiety about who you are – and it feeds itself.”

Perhaps it was ever thus. The fact that young people are reporting more issues could be interpreted as a sign of increased mental health awareness. But, as Ross Whitehead, researcher on the University of St Andrews HBSC report notes, his findings suggest that there is more to it than that. Of 33 countries studied in the report he notes, Scotland was not the worst, but what stood out was that, among our 15-year-old girls “the slope of deterioration is steeper in Scotland than anywhere else”.

He suggests that, particularly for Scottish girls, a “perfect storm” has come together of rising body image concern, public health messages about weight and soaring use of social media. In his recent research, still yet to be peer reviewed, he found links between body image and the shocking increase there has been in mental health indicators in 15 year old girls. “The impact of body image on especially girls’ mental wellbeing is strong,” he says. “That’s something we’ve known for a while. But that relationship is strengthening. Body image is becoming more important for somebody’s mental health. And there’s especially a steep increase in that relationship over the last 5-10 years, particularly for girls.”

This he partially links with the rise of social media – since the effect on mental health seems to rise in line with its increased use. “Also,” he notes, “logically it makes sense, since social media facilitates the comparison of physical attributes between peers. The kind of images people put up are not particularly representative of what is real. They are very heavily self-selected, sometimes manipulated. If your perception is that this is how everyone else looks and you don’t match, you may feel inferior about it.”

Other researchers have revealed complementary findings. One study by Dr Heather Cleland Woods of Glasgow University investigated students at one Scottish school who were using social media during the night and linked this with sleep difficulties, anxiety and depression. As Woods described: “While overall social media use impacts on sleep quality, those who log on at night appear to be particularly affected…We have to think about how our kids use social media, in relation to time for switching off.” Both parents and teens we spoke to echoed this. One mother described how she had taken to removing her daughter’s phone overnight because she had been having Snapchats with friends at three or four in the morning.

Many young people acknowledge the impact of social media on mental health, though they say they find it hard to stay away from. As Caitlin-Jay Wyllie-Quinn, a 19-year-old mental health campaigner observes: “I feel social media is a big part of the problem. Everything’s based around the amount of likes and comments you get on posts. If you’re constantly comparing yourself with other people online, with filtered pictures that other people have posted, pictures that aren’t even real, there’s a pressure and expectation.”

But it is not only girls who are suffering. The mid-teen mental health issues appear in boys also, just not at such an extreme level. Ewan McCall, one of the compilers of the Scottish Youth Parliament report, believes that one of the problems, particularly for boys, is that they still feel a great deal of stigma around talking about mental health. “If you look at statistics there’s a far higher male suicide rate among young people than there is a female suicide rate. Guys struggle more to have an emotional outlet in the way girls have because of the whole culture of being macho and masculine.”

Meanwhile, young people also clearly identify school workload and pressure as a contributory factor. This is reflected both in the Scottish Youth Parliament research and also the St Andrews HBSC report. Perceived schoolwork pressure, says Dr Ross Whitehead, has increased significantly since 2006. Currently 80% of 15 year old girls and 59% of 15-year-old boys say they feel pressured by schoolwork, a statistic ”dramatically higher than most of the other European countries in the study”.

It is also possible that this spike in mental health issues is not even entirely to do with what is happening in their teens. Does the problem in fact start many years beforehand when Scotland’s children seem, on most measures, to be doing relatively fine? One of the buzz terms around how we prepare children for life’s problems is emotional resilience. Sue Palmer, literacy expert and founder of Upstart, a campaign to replace our current system with formal schooling that starts at seven years old, believes resilience is what we need to cultivate. Research, she notes, is revealing that one of the ways we can do this is through ensuring children get enough independent play when they are young. Her findings make interesting reading at a time when children are spending increasing amounts of time playing at home, rather than playing independently beyond the confines of where they live.

Given all this, how are Scottish young people being helped to cope? Mental wellbeing is at the heart of the curriculum for excellence, yet many believe it is only paid lip service to, since funding is scant and mental health services vary according to area and school. The Scottish Youth Parliament report notes that 74% of young people surveyed did not know what mental health information, support, and services were available in their areas.

Like the SYP, Caitlin-Jay Wyllie-Quinn, wants to see change. She recalls struggling to gain help when she was at school and is calling for a complete review of mental health services for young people. “The support’s not there with the Child and Adolescent Mental Health Service (CAMHS),” she says. “People aren’t serious enough. There’s so much talk about how children are vulnerable – you would think they would be given more support.”

The Sunday Herald contacted the Scottish government regarding mental health services for teens, but they did not respond.

Stories of anxiety from Generation Angst

Caitlin-Jay Wyllie-Quinn, 19

It was when I was about 13 years old, starting secondary school, that I felt my mental health problems started and at first it was due to bullying. I can honestly say that through the whole time at school, I received absolutely nothing in the way of real help. The only support that I got was there was a school counsellor, which I got through CAMHS, but that was not regular, I would see him maybe two or three weeks and then I would not see him for six months. Even that service has actually now been cut.

In all that time I didn’t have a diagnosis for what I was feeling. I couldn’t speak to teachers about my problems. My guidance teacher was awful. She told me that the reason why I was getting bullied was because I was too sensitive. I didn’t really know where else to go. At about 16 I had what I think was my first bout of depression. I got rejected by CAMHS. I was told I wasn’t going to be given any help. And I asked why and he said because I wasn’t a serious enough case for them to deal with. I was told this was because I wasn’t self-harming or suicidal. But no one had asked me about that. And at that point I was so low. At that point I would have said yes I was suicidal.

One of the problems is social media. For a lot of young people the first thing they do is go to their phone and there’s a lot of bad sites out there and a lot of bad information that can be seriously detrimental to young people’s health, particularly around eating disorders and body image. It’s so easily accessible to the point it’s scary.

Lucy (name changed), 15

School is very stressful at times. I guess it is partly how much work they give us all at once. Some of my friends are more together than others. Everyone is stressed, even the smart kids are really stressed about schoolwork. You have to do your work, but you also have all the social pressures as well. It’s bad enough when you’re at school, when you might have drama with friends. But it’s also with social media as well, you can’t escape it. You have to keep your account working the whole time, interact with all these people on all these different social media platforms.

Ewan McCall, 17

I was really stressed out for the exams in S5. One of the big problems is exams. The whole year is building up to these exams. And also a lot of people aren’t academic so they might feel they have failed just because they can’t memorise things well. I know a lot of very intelligent people for whom it’s just the sheer panic of how much time there is to do it in. I just got my exam results and did quite well - managed to get into university. I’m pretty happy about that. I did feel the exam pressure, though - especially in S5 and S4 because those are really the years where it was heaped on.

Young people are finding everyday life high pressure. With social media we’re constantly in contact with the rest of the world - and all the news that is out there. There is a constant bombardment of stories.