Review

Character

Comment

Digital

6 May 2024

1 min read

Re-enchanting the anxious generation

The future doesn’t have to be horrible.

Krish Kandiah

Krish is a social entrepreneur partnering across civil society, faith communities, government and philanthropy, He founded The Sanctuary Foundation.

Two teenager lean against a rail, arms crossed, and laugh together.

LaShawn Dobbs on Unsplash.

I meet many anxious people as I wait for meetings in the Palace Westminster, but one in particular stands out. As I was queueing to get through security, a breathless American man rushed over asking if he was in the right place to meet the Minister of State for Universities. Once I had reassured him that he was, and he had caught his breath, I asked him where he was from and what he did for a job. He told me he was a social psychologist from New York.

Funnily enough, the night before, I had been reading a book by a social psychologist from New York. I asked the man if he had come across the author, Jonathan Haidt. He replied with a smile: “I am Jonathan Haidt.”

I chuckle when I remember that chance encounter, especially considering the title of his latest book – The Anxious Generation. The book tackles a much more serious topic than queueing nerves. It claims to show, in the words of the subtitle: “How the Great Rewiring of Childhood is Causing an Epidemic of Mental Illness”.

The Anxious Generation is a tightly argued plea to parents and educators for a radical change in the way that young people are allowed to engage with digital technology in general and social media in particular.

It follows the line of thought he began in his book The Coddling of the American Mind which argued that ‘helicopter parenting’ has led to such a fragility in young adults that universities are no longer places of open and free dialogue, but somewhere young people feel the need to be protected from ideas they disagree with. That problem was what Haidt was preparing to discuss with the Minister when we met outside Parliament.

“Embracing all this is a desire to maintain and hand on to our children an earth that offers genuine possibilities of flourishing.”

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The Anxious Generation makes a compelling case for the way we are failing a generation of children. It likens the social media world to another planet that we are all happily sending our children off to without first learning about or checking any of the risks linked with the potentially toxic environment. It concludes that as much as we are overprotecting our children in the physical world, we are under-protecting them in the digital world, thereby complicit in the resulting tidal wave of mental health disorders.

Haidt writes:

“Are screen-based experiences less valuable than real-life flesh-and-blood experiences? When we’re talking about children whose brains evolved to expect certain kinds of experiences at certain ages, yes. A resounding yes.”

Haidt argues that what children need is less screen time and more unsupervised play. Some might call this the re-enchantment of childhood– a rediscovery of wonder, and simple emotional connections with freedom, food, imagination, curiosity, those around them and the great outdoors. Perhaps there is healthy therapy to be found in this re-enchantment through the sharing of art, poetry, and fantasy. Maybe a rediscovery of faith and hope can help to bring healing.

Mary Grey, Emeritus Professor of Theology at the University of Wales in Lampeter, describes re-enchantment like this:

“The market’s language of desire must be replaced by reflecting what we really long for, like satisfying relationships and intimacy, meaningful communities where our values are shared, with working conditions that do not create an unbearable level of stress, enough income to cover basic and leisure needs, and planning for the future. Embracing all this is a desire to maintain and hand on to our children an earth that offers genuine possibilities of flourishing. … This is not an invitation to exchange reality for Magic Kingdoms, but to become embodied kinships of women, men, children and earth creatures in a re-imagined and transformed world of sustainable earth communities of healing and hope.”

The re-enchantment of childhood is an attractive theory. I often find myself comparing my children’s childhood with that of my own. I’m sure I played more in the garden than they do, climbed more trees, cycled more round the block, round the town, and later round the county in my spare time. I remember as a teenager getting on a bus to travel from Brighton to Durham without either parents or phones. Around the same time, I travelled to Tbilisi, Georgia with just a backpack, a map, a couple of friends and quite a lot of self-confidence. I wish that my children could experience some of the pleasures that come with fixing a bike or looking up at the stars or browsing the library to find answers, instead of just googling.

Yet, at the same time, if my children were making their way to Durham or Tbilisi today, I would certainly make sure they had plenty of charge on their phone and all the necessary mobile data roaming rights, and I would probably WhatsApp them regularly until they arrived safely at their destination.

Haidt presents a perfect story, one that explains all the evidence. He doesn’t mention anything that might challenge it, or anything that the doesn’t quite fit.

Haidt’s book touches a nerve. Not just because of my own contradictory feelings as a parent, but because of the shocking statistics that reflect the wider state of our nation’s children. With waiting lists for Child and Adolescent Mental Health Services at a record high, a 47 per cent increase in young people being treated for eating disorders compared to pre-pandemic, and an enormous leap in prevalence of probable mental disorder from one in nine children (in England aged 8-25 years old in 2017) to one in five (similar cohort in 2023), the mental health of the next generation is rightly highly concerning.

The blame has been levelled in many different directions: COVID lockdowns, school league tables, excessive homework, helicopter parenting, screen time, and general disenchantment in society at large. Some even say the increase is directly related to the increase in public discussion and awareness about mental health disorders.

For Haidt it is social media that is public mental health enemy number one. However, he does admit he is not a specialist in children’s mental health, child psychology or clinical psychology. This has led to some criticism about his conclusions. Professor Candice L. Odgers, the Associate Dean for research into psychological science and informatics at the University of California challenges head on the central argument of Haidt’s book. She claims:

“...the book’s repeated suggestion that digital technologies are rewiring our children’s brains and causing an epidemic of mental illness is not supported by science. Worse, the bold proposal that social media is to blame might distract us from effectively responding to the real causes of the current mental health crisis in young people.”

Similarly Henna Cundill, a researcher with the centre for autism and theology at the University of Aberdeen, wrote last week in an article for Seen and Unseen:

“From a scientific perspective, the argument is a barrage of statistics, arranged to the tune of ‘correlation equals causation’. “

Cundill and Professor Odgers are right to be sceptical. Sometimes we let our commitment to a story shape the way that we read the evidence. If there’s one thing I remember from A- level statistics it is that causation and correlation should not be confused. In his bid to add urgency and cogency to his argument, Haidt presents a perfect story, one that explains all the evidence. He doesn’t mention anything that might challenge it, or anything that the doesn’t quite fit. It is not a scientific treatise - which is both the book’s strength and its weakness.

Nevertheless, many of the recommendations Haidt suggests are wise and helpful. Even Professor Odgers, to some extent, agrees.

“Many of Haidt’s solutions for parents, adolescents, educators and big technology firms are reasonable, including stricter content-moderation policies and requiring companies to take user age into account when designing platforms and algorithms. Others, such as age-based restrictions and bans on mobile devices, are unlikely to be effective in practice — or worse, could backfire given what we know about adolescent behaviour.”

Therein lies the issue. Because of the lack of evidence for the causes, all we are left with – even from the experts – is what may or may not be likely to be effective in practice.

I wonder if this paucity of robust scientific evidence stems from the fact that the issues facing the next generation are even more complex than we could ever imagine.

The truth is that hype, hysteria and horror are more likely to gain traction than humdrum and happy medium.

Every generation is different from the last. My own youth in the UK in the late 1980s when I became part of the video games and micro-computers subculture was just as much a mystery to my parents and teachers. My generation’s problems were blamed on everything from the microwave to Mrs Thatcher to the milk that we drank following the disaster at Chernobyl.

It seems to me too simplistic to demonise the technology. It’s an easy sell, after all. In fact, whenever there is a major technical shift, horror stories are created by those who believe the dangers outweigh the benefits. Mary Shelley’s Frankenstein seems to be a reaction to the industrial revolution. The nuclear threat led to movies about Godzilla and 60-foot-tall Amazonian women. The advent of the internet brought us the Terminator films.

The truth is that hype, hysteria and horror are more likely to gain traction than humdrum and happy medium. Yet, despite the many and serious problems, the rise of new technologies, even social media, also have much to offer, and they are not going away soon. Instead of demonising new technology as the problem, perhaps we need to find ways to turn it into the solution.

And perhaps there are glimmers of hope. I like the fact that my children are connected to the wider world, that they know people and languages from more diverse places than I ever did. I like that they know what is going on in the world way before the 9 o’clock news. I like the fact that they are on the cutting edge of advancements I will never experience in my lifetime. I like the fact that they can get their homework checked by AI, that they don’t need to phone me up every time they want to try a new recipe, that we can grumble together about the football match in real time even when we are on different sides of the world. I like that they can browse the Bible or listen to podcasts about history while they are waiting at a bus stop. I like the fact that they have libraries of books at their fingertips, that they can disappear into fantasy worlds with a swipe and don’t have to spend hours at the job centre when they need to find work. And I love the fact that my children and their friends are rediscovering board games, crochet, embroidery and hiking and taking them to a whole new level because they are learning these crafts from experts around the world.

I sincerely appreciate that Jonathan Haidt cares about the real and desperate problem of youth mental health. His book adds weight to the pleas of those of us advocating for urgent investment into this area. It reminds us of the world beyond the digital borders and it gives us hope that the re-enchantment of childhood is not impossible.

However, the solution to these complex issues cannot be found in nostalgia alone. We cannot turn back the clock, nor should we want to. The past had problems of its own.

I would love someone to write a book that looks forward, that equips young people to live in the worlds of today and tomorrow. If, by some strange coincidence, Jonathan Haidt is reading this article and is in the process of writing that book, I do hope I will bump into him again to thank him.

Article

Change

26 July 2024

6 min read

Are we forgetting how to care?

The profound act at the heart of nursing.

Helen Cowan

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A nurse bends beside a bed and talks to a patient

Marie Curie.

Recently, at a nursing leadership programme in Oxford, attendees focused on the fundamentals of care. Have we forgotten how to care? What can we re-learn from those who pioneered an ordinary yet profound act that affects millions?"

Anam Cara is an old Gaelic term for ‘soul friend’, a person with whom you can share your innermost self, your mind and your heart. It is a term that Tom Hill, former chief executive at Helen House Hospice in Oxford, used to describe the relationship between his staff and the thousands of children and their families who passed through their ‘big red door’ in its first twenty-five years. The hospice (or ‘loving respice’ as it became known) had been founded by Sister Frances Dominica in 1982.

Other care in this country can also trace its religious roots. Between 1048 and 1070 in Jerusalem, the Order of St. John was founded for the purpose of helping pilgrims (“our Lords, The Sick”) who had become lost, weary, or beset by other difficulties while on their way to the Holy Land. Today, in the United Kingdom, the British Association of the Order has extended care to older people first in almshouses and later in care homes. A trustee for ten years was John Monckton, a man of ‘considerable talent, enormous integrity and deep religious conviction’; his tragic murder in 2004 led to the creation of the John Monckton Memorial Prize, which recognised and rightly celebrated commitment to care by care workers.

Today, across the world, seen and unseen, nurses, carers and families continue to provide compassionate care. “Assisting individuals, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge” is the very essence of nursing, captured by ‘architect of nursing’, researcher and author Virginia Henderson in 1966. Meeting more than basic needs such as breathing, eating, drinking and eliminating bodily waste (which are of essential importance), Henderson recognised the role of the nurse in enabling humans to communicate with others, worship according to their faith, satisfy curiosity and sense accomplishment.

In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care?

An uncomfortable truth brought out in healthcare reports such as the Final Report of the Special Commission of Inquiry (The Garling Report) 2008, and the Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (The Francis Report) 2013 is though that this type of nursing is too often done badly or even missed, leading to pressure injury, medication errors, hospital-acquired infection, falls, unplanned readmission, critical incidents and mortality. According to nurse scientist and scholar Professor Debra Jackson, “missed care occurs much more frequently than we might think”. She cites a systematic review in which ‘care left undone’ on the last shift ranged from 75 per cent in England, to 93 per cent in Germany, with an overall estimate of 88 per cent across 12 European countries’.

In one offensively-titled paper, “Shitty nursing - the new normal?” (in which the authors apologise for the title but not the questions raised), real-life pen portraits are drawn of patients lying for hours on hospital trolleys, immobile through infection or injury, ignored by staff. Whilst acknowledging contextual factors for poor care, such as a shortage of nurses and resources, the authors argue that circumstances cannot be the sole cause of missed nursing care.

A report published by the University of Adelaide, School of Nursing, has called for nurses to ‘reclaim and redefine’ the fundamentals of care. It asks whether the cause of the problem (of missed nursing care) lies “deep in the psyche of the nursing profession itself?” “Has something happened to the way modern nursing views and values caring?” it continues. “Indeed, is nursing in danger of losing its claim to care? In the desire for modernisation and professionalisation, have we lost sight of the core values and activities central to patient care? Or is this a broader social pattern where individuals are less inclined to show kindness, compassion, and care for others even if it is a necessary requirement of the job?”

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness.

Writing in the British Medical Journal, Professor of critical care medicine Peter Brindley and Consultant in intensive care Matt Morgan wonder whether doctors also “too often default to high-tech and low-touch” when patients are dying – a time “when community and connection matter most”. They powerfully begin with a mother’s comment: “Humans are gardens to tend – not machines to fix.”

Professor Sir Al Aynsley-Green, the first National Clinical Director for Children in Government and former Children’s Commissioner for England, and past president of the British Medical Association, suggests that we as a society need a “momentum for compassion”. Struck by the extremes of compassion witnessed during his wife’s treatment in the last years of her life, Sir Al wants to see a cultural transformation in healthcare: for compassion to be a key operating principle in NHS and care settings, led by the Chief Nurse’s Office; for every organisation to promote the importance of compassion at the professional level; for the views of patients and families to be sought regularly; for much earlier and better focus on compassion in undergraduate and postgraduate teaching programmes for all staff; for compassion to be inspected against by the Care Quality Commission; and for a willingness to encourage staff at all levels to expose poor practice as well as celebrating excellent care.

Compassion, he emphasises, is more than empathy - and way "less fluffy" but much more measurable than kindness. “It’s putting yourself into somebody else’s shoes – and doing something about it.” Recently appointed the UK’s first Visiting Professor in Compassionate Care at Northampton University, at the age of 80, Sir Al certainly is doing something about it. He has made it his new purpose in life to “embed compassion into every aspect of care”.

Like Sir Al, Queen Elizabeth II, the UK’s longest serving monarch, espoused compassion, in word and deed. Living a life of compassionate service, the Queen made clear that her Christian faith was her guiding principle. She speaks of Jesus Christ as ‘an inspiration,’ a ‘role model’ and ‘an anchor’. “Many will have been inspired by Jesus’ simple but powerful teaching,” she said in her Christmas Broadcast, 2000. “Love God and love thy neighbour as thyself – in other words, treat others as you would like them to treat you. His great emphasis was to give spirituality a practical purpose.”

When nurses do unto others as they would have done unto themselves, and act as role model to colleagues, not only do patient experiences of care and their outcomes improve – but so does job satisfaction for nurses: a critical factor in nurse recruitment and retention – the biggest workforce challenge faced by healthcare organisations. Across the UK, there are currently more than 40,000 nursing vacancies, and thousands of burnt-out nurses are leaving the profession early. Whether nurses decide to stay or go is driven in part by their daily experience at work. The late Kate Granger, Consultant in medicine for older people, inspired Compassionate Care Awards in her name, envisioning that such a legacy would drive up standards in care - and surely also help retain nurses, through restoring a sense of pride, achievement and fulfilment to the nursing workforce.