His Brain has Just Gone Haywire: the Development of Children and Young People's Concepts of Mental Illness

Abstract

This thesis examines children and young people's ideas about mental illness. Frequently, previous research in this area has suffered from methodological flaws or a limited theoretical framework. Qualitative methodology was utilised in this thesis in order to both gather the range of ideas that children have about mental illness, and to propose a theoretical model to explain the development of these ideas. In the first study, 63 children (comprising 4 age groups: 6 - 7, 9 - 10, 12 - 13, and 16 - 18 years old) participated in focus group discussions. Groups were presented with 3 illustrated vignettes, each depicting a story about an adult with a mental health problem (schizophrenia, agoraphobia, or depression). A thematic analysis was used to examine the ideas that children expressed in these discussions. Analysis found that children have a wide range of ways of explaining the characters' behaviours. Children and young people's ideas were grouped into 5 main categories: 'medical explanations', 'psychiatric explanations', 'abnormal behaviour explanations', 'psychological explanations', and' event explanations'. Following this, a second study was conducted to focus on children's ideas about causes and treatments for mental illness. 36 children (ages 9 - 10, 12 - 13, and 16 - 18) were interviewed individually. Participants were presented the same 3 vignettes and asked to create a story that explains why each character has their problem and how their problem is resolved. Grounded theory methods were used to analyse the stories, with 6 primary categories and 1 secondary category ('psychological explanations') emerging. All stories included a cause from one of the 6 primary categories, and sometimes that primary category also led to a thinking problem (from the secondary category). Resolutions to the stories either came from the same primary category as the suggested cause, or alternatively, treatment came from one of the treatments included in the secondary category ('think or act differently', 'counselling', or 'support from others'). The primary categories were 'event' (problem was due to an external event happening, and resolution comes from an external event occurring); 'physiological' (the problem is seen as a medical problem, and treatment came from doctors); 'neurological / psychiatric' (characters have problems with their brains or a diagnostic label, resolutions include psychiatric medication, hospitalisation, and negative outcomes);'drug' problems; 'spiritual' (discussion related to ghosts or religion); and 'responsibility' (the character had done something wrong, and must fix it to resolve their problem). Further analysis then compared the data from both studies with previous theoretical literature. It is argued that as children grow older they develop a concept of mental illness, which they can then use when discussing vignettes or understanding abnormal behaviour. This domain-specific development occurs throughout late childhood and adolescence as children incorporate information they have learned from families, schools, and media, and build on pre-existing domains (in particular, naive psychology and naive biology). Evidence from the current study is used to support this proposed model, and implications for future research, school curriculum, and helping children with mentally ill relatives are discussed.