Survey after survey indicates that growing numbers of people in their pre-teens, teens and 20s are reporting symptoms of conditions including anxiety and depression.
Only half of 18-to 24-year-olds rated their mental health as “good” or “very good”, while 17 per cent described it as “bad” or “very bad”, according to Central Statistics Office (CSO) research carried out in 2024.
In the same study, 18.7 per cent of people aged over 18 said they had been diagnosed with a specific neurodiverse condition, or suspected they were neurodiverse. Linked to this is a surge in people seeking medication to treat the symptoms of neurodivergence. The number of prescriptions for ADHD medication has increased by 87 per cent in the five years to 2024, according to the HSE.
Something is clearly happening. But is it a growing mental health crisis – or greater visibility and a shift in how we name and respond to distress and difference in childhood and adolescence?
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The increase in diagnoses, combined with the recent publication of the Halpin Report, which documented predominantly prescription-based treatment in North Kerry Child and Adolescent Mental Health Service (Camhs), raises the question of whether we have become too quick to respond to children in distress with a tablet.
The field of mental health is fraught with confusion and complexity. Parents who wish for their child or teenager to receive the understanding and support they need to progress and thrive in life are often wondering what to do and who to turn to.
This confusion is compounded by language that wasn’t in widespread use a decade ago – including terms such as “neurodivergence” and “neurotypical”. This language has become entangled in the already-complex and often-confused terminology of mental health and wellbeing.
But while the words “neurodiversity” and “mental health” are sometimes used in the same sentence, these are distinct concepts.
Neurodiversity refers to natural variations in how people function and process information and can include autism, ADHD and dyslexia. “Mental health” is used, somewhat paradoxically, to describe the range of social, emotional, psychological and psychiatric distress than can be experienced by anyone – including those with neurodiversity.
Adding to the confusion, diagnostic assessments for neurodevelopmental conditions such as autism or ADHD are managed in many parts of the country by Camhs, so families access mental health services in order to receive a neurodevelopmental assessment and diagnosis.
Those who can’t pay for a private assessment join an already-long waiting list for Camhs assessment, with wait times of one year or more for first appointment in many areas.
This has led to a significant increase in the number of children and young people with neurodevelopmental and mental health difficulties waiting for years at a time to be seen. In many cases, this compounds the distress.
But why do they need a diagnosis in the first place? And while medication in some cases is helpful, why has it become a frontline response?
Diagnosis in mental health is imprecise. There are no blood tests, brain scans or objective biological measures for most forms of distress. Diagnosis is based on self-report and subjective assessment and observation. And diagnostic criteria are heavily shaped by evolving social and cultural norms. There are no “hard lines”. This has led many to decry the expanding boundaries of psychiatric diagnosis in everyday life.
One fascinating example of the breadth and reach of diagnostic categories comes from the Dunedin longitudinal birth cohort study. This study follows 1,000 babies born in Dunedin, New Zealand, in 1972 and 1973, tracking their health, behaviour and life outcomes as they progressed through life.
By the time they reached their 40s, 86 per cent of them met the criteria for one major mental disorder, with 85 per cent meeting the criteria for more than one.
This suggests there is either a problem with the people in Dunedin – or a problem with the diagnostic assessment. In reality what it means may simply be that the criteria are broad enough that most adults could be diagnosed with some form of mental distress.
My work on the lived experience of young people with mental health difficulties reveals how a diagnosis can initially be helpful, providing a sense of relief and validation.
As a young woman, whom I’ll call Áine*, put it: “It validated that I wasn’t making this up, that this was actually a problem”. Ashley felt that a diagnosis meant “there’s a reason for it [her distress] and it’s not just my fault”.
However, many young people describe a sense – as another we’ll call Sarah said – that “once you have one diagnosis you end up with 10 – every time you go in you get a different one and you’re on different medications”.
What these experiences reveal is a desire to be heard, understood, acknowledged and validated in their distress. To be told “it’s not just my fault” if they are struggling and, ideally, that there are people and services available to help them to overcome their distress and move on in their lives.
It is entirely understandable in a world which young people describe as competitive, unrelenting and limited in opportunity that they, or their parents, would seek understanding, compassion, care and allowances.
Just this week undergraduate students I work with named issues such as the housing crisis, the cost-of-living crisis, geopolitical instability, war, the climate crisis and the impact of artificial intelligence (AI) on the graduate job market as affecting their sense of self-efficacy and optimism for the future. There is no pill that will address the effects of a profoundly unequal society.
All the while the larger drivers of this distress continue with limited attention or recourse. The World Health Organisation is clear that “risk factors for many common mental disorders are heavily associated with social inequalities”.
Ireland is now a country where the 10 per cent of households hold almost half of the wealth. Investment in essential child and youth services, obliterated following the 2008 banking bailout, has yet to return to pre-crash levels. Homelessness is at an all-time high and almost one-third of unhoused citizens are under the age of 20.
And so waiting lists get longer and the number of children with diagnoses increases as parents fight for limited resources, understanding and compassion for their child, be it under the umbrella of mental health or neurodiversity, in systems of scarcity and insufficient resourcing.
If we are serious about improving child and youth mental health we must not only provide timely access to understanding and support, but also tackle these inequalities. A society that tolerates child poverty, homelessness, educational and wealth inequality should not be surprised when its young people struggle to thrive.
Emma Farrell is an assistant professor in mental health in the department of psychology, Maynooth University. She is author of Making Sense of Mental Health: A Practical Approach through Lived Experience (The Liffey Press, 2022)
*Names have been changed to protect the speakers’ identities
