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How are you? 

No, really, how are you? How have you been doing recently?  

Amid the constant tumult of the last year, asking after people’s wellbeing has moved from being a light greeting to a more meaningful conversation.   

Starting a national conversation 

From government, the media, employers and communities, there has been a quiet undercurrent of concern for our wellbeing. There is now a national conversation, not just about what has happened during the pandemic, but how we have felt about it – the anxiety in the face of disruption and uncertainty, the anger if something is perceived as mishandled, the loneliness of isolation from our friends and family.  

In the history-making context we are living in, the pandemic has given many people the permission to say that they are not OK. More than ever, how our mental health and wellbeing is affected by our circumstances and the events we are living through is a matter for national conversation.   

How are young people doing? 

Unfortunately, for many in their teens and 20s the answer to ‘how are you?’ is ‘not good’. As the immediate danger of the virus to older people’s health is thankfully diminishing, focus is shifting to groups who have had their health suffer in a different way. What is being shown in survey after survey is that, compared to older age groups, young people’s wellbeing is suffering.   

In many ways, this is not surprising. The decisions taken by government to protect us all from the virus had particularly hard consequences for younger people. The Health Foundation’s COVID-19 impact inquiry has young people as one of its spotlight groups. It charts the context that the pandemic imposed on young people: closure of schools, colleges and universities, coupled with increased unemployment and an uncertain future.  

For young people, along with the practical implications of this context, comes worry. Only 17% of young people felt happy that exams had been cancelled. The more common emotional response was uncertainty (51%) or worry (18%). 

And while we have seen many young people’s wellbeing bouncing back between lockdowns, for around 30% of young people, wellbeing has remained consistently low. 

This reflects circumstances as well as context. The pandemic had unequal impacts, with the resources young people were able to draw on making a material difference to the circumstances in which they were weathering the storm.   

An unequal impact 

The COVID-19 impact inquiry has been working with the McPin Foundation to illustrate how different young people, facing different challenges, are coping differently. It is not surprising to find that it’s those facing particular challenges – those who have been in care, disabled young people and others – who have seen the most impact on their mental health and wellbeing.   

But even before the pandemic we knew that the context and circumstances around young people – the situations in which they grow, learn and play – matter for their health. Our Young People’s Future Health Inquiry reported at the end of 2019. It emphasised the importance of emotional support, financial and practical support, skills and qualifications and personal connections to long-term health.  

The wider context particular to this generation of young people is also discussed in our latest podcast: Inside the teen mind: what’s happening to mental health? Our Chief Executive, Jennifer Dixon, talks to Jean Twenge, an American psychology professor who researches generational differences, and to Yvonne Kelly, Professor of Lifecourse Epidemiology at University College London. They discuss the broader social and technological context facing today’s young people, and the implications that has for their wellbeing. 

Understanding the link with context and circumstances 

Building an understanding of these wider issues of context and circumstances will remain important, particularly as we move into recovery from the pandemic.  

The Health Foundation has funded five policy posts across a range of organisations to build the policy agenda and amplify the voices of young people. These posts are looking at the wider determinants (the situations in which they grow, learn and play) that affect young people’s health.   

A launch report from one of the projects, led by Rukmen Sehmi at Resolution Foundation, has just been published. It suggests that in terms of both employment and mental health the last year is an acceleration of longer term trends. Pre-crisis, young people were more likely to be in an insecure job, and substantially more likely to have a mental health problem than ten years before. The impact that context and circumstances have on families, and the knock-on impact that this then has on the emotional support they are able to provide to their young people, will also be the focus of our research open call coming later in the summer. 

Taking action on the wider determinants 

Policymaking that understands how health, including mental health, is related to context is desperately needed. While mental health services for young people can help those who are most unwell, these interventions come at the end of a chain of events where young people’s mental health has not been prioritised or protected. Interventions across education, employment, family policy, income support and other areas can provide young people with the opportunities to build their own lives after this crisis – and protect their wellbeing in the process.  


Martina Kane is Policy and Engagement Manager in the Healthy Lives team at the Health Foundation. 

This content originally featured in our email newsletter, which explores perspectives and expert opinion on a different health or health care topic each month.

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