What's Really Driving the Youth Mental Health Crisis?

Diagnoses of mental health disorders among young people have soared across the globe in the last fifteen years with experts placing the blame on the insidious role of social media and smartphones. Here in Cayman it is no different, but research shows that the crisis goes beyond just technology...

Social Media, Smartphones and a Rapidly Changing World

In Cayman and across the developing world, one topic dominates all others when thinking about our young people – mental health. Our youth are growing up in a complex and rapidly changing world. Social media and smartphones have fundamentally changed childhood; some even believing they have rewired the brains of children. Their young lives were turned upside down by a pandemic which interrupted their education, isolated them from their support network and for some, destabilised their family and community. Young people are anxious about the future with reports of a climate catastrophe on the horizon and they face a jobs market that many predict will be blown apart by Artificial Intelligence.

This increasingly uncertain and individualistic world is having a profound impact on them. Studies show a decline in happiness among young people beginning around 2010, and anxiety and depression are on the rise. Globally, the World Health Organization estimates that one in seven young people aged 10-19 years old are experiencing a mental health condition. On top of this are the ordinary struggles and challenges of adolescence; one of the most transformative experiences of our lives involving enormous changes to the mind and body that can be very challenging emotionally.

Cayman Parent wanted to find out more about how young people are feeling—their worries, their anxieties—and what we can do as parents, carers and friends to help them navigate this challenging world.

Youth Mental Health in Cayman

In 2024, the Cayman Islands Student Drug Use Survey (CISDUS) found that more than one in ten students surveyed were experiencing symptoms consistent with depression, and a similar proportion were experiencing symptoms of anxiety; rates that are considerably higher than the global average. The survey also found that a quarter of young people in Years 6-12 had 'considered' suicide and a quarter had self-harmed.

Compared to five years ago, many more students are seeking help from school counsellors for mental health problems. Monique Anderson, a school counsellor at John Gray High School, is typically seeing between 30-50 students per week and provides short-term counselling support for students with varying degrees of mental health challenges.

In 2023, Alex’s Place (the Adolescent Behavioural Health Centre, at the Anthony S. Eden Hospital, formerly George Town Hospital) supported 148 young people with their mental health, and in 2024 that figure rose to 269. While some of this rise is due to a greater awareness of the recently opened service, Dr Chantal Basson, Clinical Psychologist at Alex’s Place, believes that the rise in patients also signals a worsening of the mental health problem. The most common conditions being treated are anxiety and depression.

More girls were treated at Alex’s Place than boys, accounting for 64% in 2024, although this does not mean that boys are faring better than girls. “Boys are struggling just as much as girls, but for cultural reasons surrounding masculinity and what it means to be a man, they are often slower to come forward and ask for help”, says Dr Shari Smith, Clinical Psychologist who works with young people in her private practice Life Options. Dr Shari also runs the twice monthly Alex Panton Foundation Teen Talk online support group for ages 13-17.

In 2023, seven young people were treated at Alex’s Place for suicidal ideation and six attempts at suicide were made by patients. In 2024, these figures rose to 67 and 34 respectively.

Causes of Mental Health Disorders

What causes a person to develop a mental health condition is not fully understood but it is thought that the causal factors fall into three broad categories:

Biological: including genetics, how the brain works, physical health, diet, sleep, exercise and use of drugs or alcohol.

Psychological: including personality traits, attitudes and beliefs, cognitive biases, social skills, emotions and temperament.

Social: including environment, experiences and relationships since birth.

“Mental illness is a complex intersection between genes and environment”, says Dr Shannon Seymour of the Wellness Centre. Mental health disorders often run in families suggesting a genetic underpinning, although scientists are yet to identify the multiple genes that likely contribute towards mental ill health.

Clinical Psychologist, Dr Erica Lam, highlights Cayman’s high rates of adverse childhood experiences, which may shine some light on why we also see higher per-capita rates of mental health disorders than the global average.

Adverse experiences during childhood are thought to play a contributing role in the development of mental health disorders. Adverse childhood experiences (ACEs) include emotional, physical or sexual abuse, challenges in the home including domestic violence, substance abuse, mental illness, parental separation or divorce, incarceration of a family member and neglect, both emotional and physical. Such experiences can have a lasting and negative impact on a person’s wellbeing throughout their life. They can manifest as difficulty regulating emotions and behaviour, and forming healthy friendships and relationships. In 2024, the Cayman Islands Student Drug Use Survey (CISDUS) found that more than one in three students aged 11-17 had experienced three or more ACEs in their lives, three times higher than the global average.

The quality of the relationships formed with parents and caregivers in the early years are also important for future emotional wellbeing. A secure attachment between child and caregiver is where a child’s physical and emotional needs are met in a loving, predictable and consistent manner, helping the child to feel secure and supported to regulate their emotions in a way that is beneficial for their neurological, physiological and psychosocial development.

Negative attachments can have a profound impact on a child’s brain development, potentially leading to behavioural issues, difficulties in forming successful relationships and mental health issues.

It is important to note that negative attachments can form within loving families. A loving parent living in poverty, overwhelmed by the need to provide for their family, perhaps who themselves lack the skills to regulate their own emotions and behaviours may be unable to provide a consistent, predictable and loving response to their child, despite their best intentions.

The Youth Perspective

Relationships

Many young people are experiencing challenges in their relationships both at home and school. At home, youngsters say they feel dismissed by their parents and older members of their family. As a result, they feel unable to open up about how they feel. Some young people report being called names by their parents, being labelled 'dumb' or 'lazy', being compared to siblings, peers or other generations, and being blamed for problems unrelated to them.

Adding to this is friction, resulting from the daily difficulties of parenting in the modern world, many feel as if they are being pulled in multiple directions at any one time. They want to listen and understand but know they must avoid the temptation to fix everything; they know technology is a part of life but would like to set boundaries; they set rules but worry about how best to enforce them; they want to be close to their children but also remain in control. Modern parenting is a minefield and unsurprisingly it is the source of considerable conflict in the home.

Peer-to-peer relationships are another source of distress for young people. Teens say that their relationships with friends are characterised by high levels of drama and a lack of trust. Girls feel that their relationships with boys are negatively affected by unrealistic ideals of women’s bodies, and some girls feel pressured into having sex.

A Hostile School Environment

Bullying is a problem in Cayman’s schools with almost half of students saying they have been bullied at some point in their lives. Young people report feeling unsafe or uncomfortable reporting bullying at school as they believe that very little is done about it. The perception that nothing is done about bullying is particularly concerning since people who are bullied are at greater risk of mental ill health. Cyberbullying is also a problem in Cayman, a type of bullying which is more difficult for teachers and parents to spot.

Academic Pressure

Anxiety about achieving good grades and a fear of failure is a significant source of worry for students. While sometimes this pressure comes from parents or wider family members, Dr Shari Smith notes that sometimes the pressure is internal. Considering the environment in which children are growing up, this is hardly surprising. Cayman is a high-wealth environment with one of the highest cost of living in the world, so it is hardly surprising that young people feel extreme, unhealthy and unsustainable levels of academic pressure.

Social Isolation

Despite the ease of modern communication and the abundance of social networking apps at our fingertips, young people are experiencing high levels of social isolation. They want to go out, meet their friends and socialise but say they lack teen-friendly spaces and affordable activities, particularly in the evening. The closure of the Blackpearl Skate Park in 2024 was a significant blow to Cayman’s youth. Also, following several incidents of anti-social behaviour in 2025, adults were asked not to leave their children unsupervised in Camana Bay after the shops closed. This removed another safe space for young people to go and spend time together.

In addition, some young people lack an emotional support structure; adults to whom they can talk and seek advice. Monique Anderson, counsellor at John Gray High School, notes that many of the young people that she sees are navigating big issues like divorce, bullying, trauma and acceptance alone, exacerbating their sense of isolation.

Cultural Issues

Cayman’s conservative culture and real or perceived homophobia is creating a difficult landscape to navigate for young people who are gay, lesbian or gender non-conforming. Young people say that older generations are not accepting of difference and are fearful of rejection and discrimination by their family and community. A similar cultural pressure is reported by boys who feel an expectation to live up to a traditional ideal of masculinity, one which leaves little space for boys and young men talking openly about their feelings and displaying their emotions.

Evidence from studies carried out internationally points to a link between cultural pressures relating to sexuality and masculinity and the risk of poor mental health. Such pressures are likely to lead people to internalise or suppress their feelings, damaging their sense of self-worth and self-esteem. Indeed, the 2024 CISDUS found that young people who identified their gender as non-binary (someone who does not feel or describe themselves as strictly male or female) were more likely to experience suicide ideation and poor mental health.

Smartphones and Social Media

These twin issues are causing many problems for young people. Social media is exposing users to unrealistic and unhealthy standards of 'beauty' and is negatively affecting their body image. Exposure to carefully curated posts, including highly edited gym selfies and holiday snaps depicting perfection and happiness, places a lot of pressure on young people, who feel a similar pressure to present a perfect life or wonder why their life is so different to others', something Jason Dunkley of The Counselling Centre calls ‘comparative living’. Online bullying is highlighted as a problem as is sextortion, a type of online blackmail whereby someone threatens to share intimate pictures, videos and information. Young people say that social media and smartphones are addictive and say that they want to spend less time on their phones, reporting that their phone use affects their sleep and mental health.

How can we help?

One of the most important things we can do to support our young people is to take the time to sit down, listen and validate their experiences. Young people "need to feel seen, heard, and valued", says school counsellor Monique Anderson. It can help to try to remember what it felt like to be their age; teenage heartbreak and friendship drama may be typical experiences for teenagers but that doesn’t make them any less challenging to deal with. The job of a trusted adult is to accept the truth of a child’s feelings, not to dismiss them as trivial or suggest it was harder in days gone by. By validating their experience, we reduce the likelihood that they will internalise their feelings, which can drive loneliness and exacerbate distress.

Experiencing feelings of sadness and worry for the first time can be unsettling but the reality is we all have days when we feel unhappy, lack motivation, feel anxious or even depressed. These are normal human emotions that we all experience from time to time. A significant aspect of the work of all the mental health professionals Cayman Parent spoke to involves helping young people to normalise and manage big and difficult emotions. “We help young people learn first how to de-stress and then how to manage stress in their lives”, says Dr Shari Smith.

Parents, carers and trusted adults can support children to deal with the ups and downs of life. Dr Shannon Seymour of The Wellness Centre highlights the need to tell children that it is okay to not feel okay and to help build what she calls 'capacity' in young people. "As a parent or caring adult, your role isn’t to pretend life’s challenges don’t exist, or to assume your child can’t handle them. It’s to recognise the hardships but also to send the message: ‘You’re not alone in this. It’s hard, yes, but you have what it takes, and I’ll be right here beside you’", she says.

Dr Seymour also notes that while young people have access to emotional literacy programmes such as those run by the Alex Panton Foundation, "We are not equipping parents with the same intensity of resources." Providing parents with the tools and strategies they need to help their children through a culturally appropriate programme of support would be beneficial to young people, enabling them to talk about their feelings before they become overwhelmed or require professional support.

Cayman's mental health infrastructure has expanded greatly in recent years to meet the growing demand in our community. However, mental health support is currently limited to those who can afford it. Many insurers offer only limited cover for mental health treatment which is then maxed out very quickly. To bridge the gap, the Alex Panton Foundation provides charitable support to access professional help, but say that the long-term solution lies in 'mental health insurance reform' allowing people to access premiums that provide mental health support at affordable prices.

What remains missing from Cayman's mental health infrastructure is a dedicated youth in-patient facility. The professionals Cayman Parent spoke to were unanimous that the current situation in which children and teens receive in-patient mental health treatment alongside adult patients is inappropriate and must change.

Much of the academic literature in recent years has focused on the all-important first three years of a child’s life—when 80% of brain development takes place—which are critical to future development and long-term wellbeing. Good infant mental health is built in these first three years and requires caregivers to provide a baby with loving and responsive care which provides for their physical and emotional needs in a stress-free environment.

Many health services around the world provide care and support for babies' most significant relationships, typically their parents. Programmes support parents during pregnancy and beyond, providing them with the information and tools they need to build a secure and safe attachment with their baby and to create the loving, nurturing and responsive environment that will build the foundations of good mental health into the future.

Research shows that investment in mental health services is strongly correlated with improved outcomes for indiviuals, families and wider society and as a country we have a lot to be positive about. Significant investment has been made in recent years by government and the private sector to improve the mental health infrastructure. We are fortunate to have grassroots organisations such as Boyz2Men and RISE that play an important role in mentoring at-risk boys and girls to help them steer their lives in a more positive direction. The Alex Panton Foundation works tirelessly to support young people, raise awareness of mental health and advocate for social change.

Ultimately, we all have a role to play in building a more inclusive country based on respect and acceptance, regardless of race, gender, sexual orientation, socioeconomic status or any other characteristric. As a country, we have come a long way in the last twenty years, breaking down barriers and ending the stigma associated with mental health but the work never ends.

Talk about feelings and emotions regularly. Rather than just saying your day was good, talk to your child about the different emotions you felt throughout the day and how you handled them. This teaches them that feelings are normal, it gives them the vocabulary to explain their own emotions, and provides them with tools to regulate themselves.

Include them in decision making. Find ways to include them in simple decisions like what's for dinner, what they wear or which movie to watch. This makes them feel valued and important. It teaches them that they have a voice and gives them confidence to use it.

Stay involved in their life and encourage their interests. Show curiosity in what they do and what is important to them, and encourage them to explore their interests. Not only will this boost their confidence and self-esteem, it will also make it easier for parents to notice arising concerns.

Reach out to a professional. Even though parents play an important part in the mental health of their children, they cannot replace professional help. Mental health practitioners are here to assist and support in every way. Early identification and early intervention can make an incredible difference at a young age, don't be afraid to reach out for help!

Don't forget that parents need support too. Supporting a child with mental health difficulties can be stressful, exhausting and overwhelming. Parents are more helpful to their children when they take care of themselves. Professional help can provide an outlet for parents to release their emotions and gain skills to better support their children.