Read the full transcript of author Erica Komisar’s talk titled “The Keys To Raising Resilient Children” at ARC Forum event 2024.
Listen to the audio version here:
TRANSCRIPT:
Thank you to Baroness Philippa Stroud and the Lobkowicz family and all of ARC for inviting me here to speak today on the mental health crisis in children and adolescents and how we can turn this trend around to raise healthy, happy and resilient children. As a social worker and psychoanalyst in practice for the last 34 years and the author of books on parenting, I’m always asked, is this crisis real? Are our children really having a hard time or is it just media hype? After all, past generations have been faced with wars, poverty, social change and have managed it, so why is this different?
The answer is yes, it’s very real and it’s immensely different, both because of the kinds of stressors they face but more importantly because we haven’t given them the solid emotional foundation which would enable them to cope with these stressors. To show you just how real this crisis is, let me share with you some statistics that are more related to your area here.
In Germany, one in four children will suffer from mental illness, 25% almost. Mental illness in children is up 254% from 2009 to 2017. In Austria, one in five, in America, one in five, in Switzerland, one in three. Austria is up to 24% in suicidality in 14 to 20-year-olds. In fact, suicide is now the leading cause of premature death in the EU for ages 15 to 19. In the US, we tripled our suicidality figures in youth from 2007 to now. Inpatient beds for mental health reached 83 million in 2021.
Putting a strain on healthcare systems in Europe, in Switzerland, mental illness became the top cause of hospitalization of 10 to 24-year-olds in 2021. Let’s talk the financial cost of this crisis. According to a 2024 study, mental health costs in the US are at $282 billion per year, about 1.7% of the American annual spending budget. According to the EU, mental illness costs over $600 billion per year, the equivalent of 4% of the GDP.
The Impact of Institutional Daycare
What does institutional daycare of children under the age of three have to do with these figures? What is the term daycare to describe institutional care throughout this speech? In Germany, 35.5% of children under the age of three are in institutional care. Over the past two decades, childcare in Germany has shifted from a more informal or in-home care to institutional care. In Austria and Switzerland, 30% of children under the age of three are in institutional care.
How is paid leave and the ability of parents to stay home impacting the mental health of children? Austria and Germany have paid leave of no more than a year, and there is a pressure, with all northern European countries now, to split the leave between the mother and father, between the two parents, rather than letting the primary attachment figure stay home. In Switzerland, after 14 weeks of paid leave, children are placed in daycare.
Declining Birth Rates and Desire for Children
Let’s talk about birth rates and the lack of desire in youth to have children, you saw from this film. Our kids don’t want to have kids. In Germany, 1.46 births per woman is down from 2009, in Austria, 1.41, and Switzerland, 1.39 per woman. In the U.S., the Harris Interactive and Archbridge Institute did a survey and found that 63% of women without children and 50% of men said they had no desire to have a child, 46% of men wished to wed, and only 40% of women, 42% of those surveyed, said the reason was their desire to maintain personal independence. So, it’s a cultural shift.
Narcissism is on the rise. Either young people see having children as a burden or impingement on their time, their me time, and don’t want to make any sacrifices to have children, or if they have them, they don’t want to care for them and want to put them in institutional care as soon as possible. And not caring for them is making our children break down in rapid numbers and leading to future generations of not only disinterest in having and caring for children, but in turn, leading to more mental and emotional instability and illness in children.
Everybody wants a simple, quick-fix answer and something external for the mental health epidemic. When it’s, in fact, very complex and multivariable, there are many trendy books out now and theories to address this crisis. As a result of one cause, such as social media or indulgence of children and too much love and praise of them, or lack of independence of children, there are others that treat it as if it’s an organic condition to be addressed with drugs and cognitive manipulation. These excuses and approaches all fall short. The truth of the matter is that we have failed our children. We as the adults are responsible for this crisis and only we can undo it. The fraying of the social fabric and the deprioritization of caring for our own children has landed us in the mess we find ourselves in now.
We need a systemic sea change in the way we raise our children and how we think about their development. To address this crisis effectively, we need to examine it and make changes that impact the mental health of children at its origins and not just intervene with symptom relief and excuses in the present. Only then can we truly find solutions that work for now and future generations.
We have over the past 75 years prioritized adults’ desires rather than focusing on the needs of children. You can’t pick up a newspaper or magazine without seeing an article about how burdensome raising children can be, how parents’ lives are impinged by the care of their own children. We’ve glorified work outside the home, economic success, high achievement, and tried to negate and dismiss the unique role that mothers and fathers play in their children’s mental health.
Causes of the Mental Health Crisis
In my ARC paper, I discuss many causes of this mental health crisis and some of them, such as social media, you already know about and Jonathan Haidt writes well about, so I’ll focus on the ones that are lesser known and, in my opinion, very important, which have to do with the foundation on which mental health is built.
I’ll share with you some of the causes of this crisis now.
One, children are born neurologically fragile, not resilient. Based on their vulnerability, they need attachment security as a foundation for future mental health. Zero to three is a critical period of brain development where mothers serve a unique biological function of regulating children’s emotions from moment to moment, buffering them from stress and providing them with a feeling of safety and security through their emotional and physical presence.
It’s only after that three-year period that children can begin to internalize a feeling of security, which helps them to cope with adversity in the future and is the basis of personality development. In other parts of the world, children are worn on their mother’s bodies for the first year and then kept close by for another two years. There are many theories now that suggest that babies are born nine months too early and that mothers are the central nervous system to babies in the first year.
We’re pushing women out into the workforce as quickly as possible to raise them up economically, but we are impoverishing them and their families emotionally. Daycare is part of an agenda to get as many women into the workforce as quickly as possible, and it is bad for children. It raises their stress hormones, leads to behavioral problems and aggression as well as anxiety, ADHD, and depression. Many countries in the world, including my own, do not recognize the essential biological needs of children.
Let me tell you a quick story. Jane and George came to see me because their son, Max, 18 months, was aggressive with other children in daycare. He was hitting and biting and often distracted and had been labeled a problem in the classroom. Jane and George, who both have intense careers, insisted they couldn’t survive on one income and spent an average of 90 minutes per day with Max.
I observed Max in his daycare. The first thing I observed that when his mother dropped him off, he was inconsolable at separation. The teachers and parents colluded to believe that “Max will be just fine once you leave. Max will be just fine.”
I found that Max was not just fine. I found him to be the most vulnerable and sensitive boy who would alternate between the fight and flight mode of defense. The hitting and biting is fight. The distractibility is flight. It is our evolutionary way to protect ourselves when we feel in danger. Max was too young to be separated from Jane and to be in a group environment with five children to one caregiver. He clearly felt frightened and under attack and his protective response was to attack other children.
Once I established with the parents that Max shouldn’t be in group care and that the stress of being separated too early from his mother was causing Max to go into fight and flight, I warned them that if he stayed in his current path, he could end up suffering long-term stress disorders such as anxiety, depression, ADHD, or worse, a personality disorder that can lead to self-harm.
His parents adjusted their economic reality to accommodate having one parent home. Within a few weeks, Max’s behavior changed. He no longer was overtly aggressive. And although he wouldn’t let his mother out of his sight for some time, his behavioral issues subsided. Jane and George were fortunate, very fortunate, to be able to accommodate their financial reality. But other families are not so fortunate.
Two, children need their parents’ presence physically and emotionally as much as possible throughout childhood, not just zero to three. Adolescence, nine to 25, is what we call the second critical period of brain development where children, again, are vulnerable and need their parents to help them to process their experiences and feelings. So more is more. The more we can be there physically and emotionally in the first, in the two critical periods of brain development, zero to three in adolescence, the greater the chance your children will become mentally healthy and resilient to stress in the future.
Three, children need mentally healthy parents. They need parents who are self-aware, sensitive and empathic, can regulate their own emotions and are resilient to stress, and do not see their children as the problem. Parents need to look deeply at themselves and their own past losses and traumas and take responsibility for their children’s mental health, rather than blaming something outside of themselves.
Four, children need stability and community. Whether it comes from the ideal of two loving married parents or alternative family structures, extended family, grandparents, aunts, uncles, cousins, are critical to children’s mental health. I know this is a radical thing to say, that children need both a mother and father whenever possible. Because they serve different biological roles and functions in nurturing. But it is an inconvenient truth.
Mothers and fathers produce different nurturing hormones, which impact their nurturing behaviors. Mothers produce a lot of oxytocin when they give birth, breastfeed and care for their young. It makes their behavior more sensitive and empathic, necessary for attachment security. When fathers nurture, they also produce oxytocin. It comes from a different part of the brain, and it makes them more what we call playful tactile stimulators. They throw the baby up in the air, they tickle the baby, they run around and chase the baby. They help with separation.
Mothers help to regulate emotions such as sadness, distress, and fear, whereas fathers help to regulate aggression and excitement. Fathers have more of a hormone called vasopressin, which is called the protective aggressive hormone, which makes fathers, well, protective against predators or those who would harm their children. So fathers and mothers are both important. They’re not the same. They serve different functions. Faith-based communities are also important, very important. According to a Harvard study, children who grow up in families who attended faith-based services and had faith did better in terms of their long-term mental health. We have lost a lot of that today.
Five, children need a childhood where technology use is regulated. Technology and particularly the smartphone and social media have a negative impact on children’s mental health. As I said earlier, there has been a great deal written about this topic. I’ll not dwell here. If you have questions, come up to me after, I’ll be happy to answer the brain science behind it.
Solutions to Create a Bright Future
So what is needed to turn this epidemic around and create that bright future with resilient children? There are many solutions and there’s a role for many sectors of society to play, which I do discuss in my ARC paper.
I’m going to focus on a few of the most important solutions today.
The Role of Parents
Parents play the most important role. They need to take responsibility for their children’s mental health rather than blaming outside forces. Parents’ mental health is critical to the mental health of children. Parents need to seek help for themselves with therapists, parent guidance experts, faith-based leaders. If children are going to be healthy, parents have to be healthy.
Parents need to make the choices necessary to make sacrifices, as Jordan said, to raise their own children when they can. And when they need to use childcare, reorient their childcare options to prioritize your own time with your children.
Support from Governments and Employers
Governments and employers need to give parents the choice to raise their own children. That means the primary attachment figure, usually the mother, needs to have the financial and social support necessary to stay home in those first three years to care for their own children whenever possible. We cannot say as a society that we support families or families are first or feign concern over this mental health crisis without providing paid leave and family stipends to be used by families in the first three years to choose what is best for their own families. Institutional daycare is destructive and harmful to children under the age of three.
It also means that we need to change the cultural narrative we have created, which looks down upon mothers and mothering and idolizes materialism and high achievement in work outside the home as more important. This is going to require a permanent cultural shift, not just a superficial one.
Marriage and two-parent families need to be promoted as the best way to raise children whenever possible. There will always be alternative family structures, which we need to accept. But that shouldn’t stop us as a society from talking about what is ideal for children. And what is ideal is having a loving mother and father.
Communities, particularly faith-based communities, need to become not only centers of emotional and spiritual support, but also centers of prevention, learning, and treatment for mental illness. Parents feel isolated today, often without anywhere to turn for help in their children or suffering. Parenting classes, parents’ groups, after-school programs and mental health evaluation in support of children, as well as home visitors who can come from the community to help women who have just had new babies.
Young women and men have to be educated at home and in school on the importance of family and relationships first, and careers second. We have to model it. If we don’t model it as parents, it won’t happen. Freud said we all need love and meaningful work. Love always came first. We’ve spent the last 75 years telling young people that work outside the home is more important and that family is an afterthought, and that we need to change this narrative now.
We need to talk about the importance of education and careers before children and the need to ratchet down our careers or take breaks when you’re caring for your young children. Mothers need to have more part-time entrepreneurial and work-at-home options so they can work on their own terms with flexibility and control. They need to have more off-ramping and on-ramping structures so they can reenter the workforce when their children are ready.
Play-Based Education
Play-based education. This is something that’s also gone by the wayside. In children under the age of six, it’s critical to their future mental health. Jordan talks a lot about play. I’m going to talk about play in the early years. We’ve become a society that promotes cognitive development or left-brain development before right-brain development, before a child has even developed the social-emotional abilities to be able to cope with reading, writing, and arithmetic.
Children need play-based education under the age of six. They need it to learn to tolerate the frustration that’s involved with learning, to problem-solve, and to get along with others in the early years before they’re indoctrinated into left-brain cognitive development. Right-brain development must always come before left-brain development if we want our children to be mentally healthy.
Realigning the Healthcare System
We need to realign our health care system to reflect the needs of children. Pediatricians and health care providers need to educate parents about the importance of breastfeeding, being physically and emotionally as present from zero to three, attachment security, and the dangers of institutional care. They need to stop colluding with parents and society to focus on the child as the problem and focus on parents and the family dynamics, as well as moving away from quick fix symptom relief and medication as solutions to mental health issues.
Psychiatry should be a last resort when a child is showing signs of anxiety, depression, ADHD, or behavioral problems, unless there is a severe crisis or they fear the safety of that child. Making the correct referrals in a timely manner to parenting coaches, play therapists, and psychodynamic therapists is key to stemming the tide of this crisis. Mental health services are few and far between in most places in the world. Making them affordable, accessible, and appropriate is critical if we’re going to stem the tide.
Mental health care has become symptom relief and plugging the dike, rather than a more holistic and in-depth process of understanding family dynamics, relational trauma, and underlying psychosocial stressors in the family. We have to reorient ourselves to treating families, rather than just silencing children’s pain. It causes me that we are silencing our children’s pain.
We need stronger governments to protect children from social media, exposure to drug and alcohol abuse. Public and private partnerships can be effective, as we can see in social media, and what’s about to happen, I hope, in social media, but without a strong government to create laws which protect children, the cart is pulling the horse.
To conclude, our children are our future. We can reverse this narrative that our children are doomed to generations of mental illness and emotional fragility, but this will require that we all work together and take responsibility for our individual parts in this, in creating a brighter future for our children. The goal of raising healthy, resilient children is bipartisan, apolitical, and indivisible, and one that is achievable and attainable. In the wise words of C. S. Lewis, “our children are not a distraction from more important work. They are the most important work.” Thank you.
