Professor Peter Fonagy, who heads an independent review into mental health, attention deficit hyperactivity disorder (ADHD) and autism, has rejected claims that young people are a ‘snowflake generation’, saying the evidence shows a real increase in psychological distress since the 1990s.
The review found that mental health difficulties have genuinely risen among children and young people. Approximately one in four people aged 16 to 24 now struggle with mental health issues. Anxiety, depression, self-harm and eating disorders are becoming increasingly prevalent.
Demand for care has risen alongside those findings. Referrals to children’s mental health services in England exceed one million, with anxiety the leading reason for referral. Emergency department visits by children in a mental health crisis surged 36% between 2019 and 2025.
Fonagy said the pattern affects boys and girls, although it becomes particularly pronounced among girls from around age 12. The reasons for that disparity remain unclear.
The review drew on more than 100 experts and families with lived experience of mental health problems. Its conclusion challenges the view that rising reports of distress mainly reflect changing attitudes or a lower tolerance for hardship.
Fonagy identified economic uncertainty, unstable employment and social media pressures as factors contributing to young people’s mental distress. He also said the pandemic worsened existing problems by disrupting young people’s lives.
Educational pressure is another concern. Children have been described as ‘constantly pressured’ by demands around attendance and examinations. A systematic review found that 48 of 52 studies reported a link between academic stress or pressure and at least one adverse mental health outcome, including anxiety, depression, self-harm or suicidal thoughts.
A British study also found that greater academic pressure at age 15 was associated with higher risks of depression, self-harm and reported suicide attempts later. For each additional point on the researchers’ academic-pressure scale, the likelihood of depression at age 16 increased by 25%.
Social media may add to these pressures, according to Fonagy. He linked increasing loneliness since 2000 to greater phone and social media use, which he said had reduced face-to-face interaction and disrupted sleep patterns.
He also pointed to the persistence of online bullying. Young people can face harassment online after leaving school, unlike earlier generations who could return home and find solace in their rooms.
The evidence supports an association between several pressures and poorer mental health, though it does not settle which factor carries the greatest weight. Researchers continue to debate whether academic demands, digital technology, economic conditions, declining independence and reduced unstructured play are the main drivers of the increase.
There is also uncertainty over how far the growth in service demand reflects a higher prevalence of distress, improved identification of mental health problems, or greater willingness to seek help. The review’s central finding is that the rise since the 1990s is genuine, while the causes and the future course of the trend remain unresolved.
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