#15. Play Deficit as Cause of Decline in Children’s Mental Health

Multiple lines of evidence indicate that play deprivation is a major cause of the mental health crisis among young people.

In this letter I summarize the contents of an article that anthropologist David Lancy, developmental psychologist David Bjorklund, and I published in the Journal of Pediatrics. For the full account, including citations to research supporting each point, see the article here. Throughout this letter, I use the term “children” to refer to everyone under 18 years old unless otherwise specified.

We began the article with two very well-established and disturbing facts.

Two Very Well-Established and Disturbing Facts

Children’s freedom to play and explore has declined greatly over the last half century.

The first fact is that over the past 5 decades or more we have seen, in the United States, a continuous and overall huge decline in children’s freedom to play or engage in any activities independent of direct adult monitoring and control. With every decade children have become less free to play, roam, and explore alone or with other children away from adults, less free to occupy public spaces without an adult guard, and less free to have a part-time job where they can demonstrate their capacity for responsible self-control. Among the causes of this change are a large increase in societal fears that children are in danger if not constantly guarded, a large increase in the time that children must spend in school and at schoolwork at home, and a large increase in the societal view that children’s time is best spent in adult-directed school-like activities, such as formal sports and lessons, even when not in school.

.

Children’s mental health has declined greatly over the last half century.

The second undisputed fact is that over these same decades, rates of anxiety, depression, and suicide among young people have increased enormously. Using data from standard clinical questionnaires administered to school-aged children over the decades, researchers have estimated that the rates of what we now call major depressive disorder and generalized anxiety disorder increased by roughly 5- to 8-fold during the second half of the 20^th century, and other measures indicate that they have continued to increase during the first two decades of the 21^st century.

Perhaps the most compelling and disturbing evidence comes from research on suicides and suicidal thoughts. Data compiled by the Centers for Disease Control and Prevention indicate that the rate of suicide among children younger than age 15 rose 3.5-fold between 1950 and 2005 and by another 2.4-fold between 2005 and 2020. By 2019, suicide was the second leading cause of death for children from age 10 through 15, behind only unintentional injury (including traffic fatalities). Moreover, the 2019 Youth Risk Behavior Surveillance System survey revealed that during the previous year 18.8% of US high school students seriously considered attempting suicide, 15.7% made a suicide plan, 8.9% attempted suicide one or more times, and 2.5% made a suicide attempt requiring medical treatment.

Such findings led the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children’s Hospital Association to issue, in 2021, a joint statement to the Biden administration urging that child and adolescent mental health be declared a “national emergency.”

Reasons to Believe that the Decline in Freedom is a Major Cause of the Decline in Mental Health

You would think it would be obvious that taking away free play and other freedoms to act independently would make children anxious, depressed, and in some cases suicidal, but we adults are remarkably skilled at burying our heads in the sand on this issue. If you read the popular press, you would think the problem is screens and social media, or almost anything else other than the fact that we have more or less locked children up around the clock. So, here is some of the evidence we spelled out in the Journal of Pediatrics article.

Immediate effects of play and other independent activity on mental well-being.

Research, proving what should be obvious, shows that play is a direct source of children’s happiness. When children are asked to depict or describe activities that make them happy, they depict or describe scenes of play. There is also research showing that when children are allowed a little more play—such as when schools offer a little more recess—the kids become happier. Research also reveals that children consider play to be activity that they themselves initiate and control. If an adult is directing it, it’s not play. The joy of play is the joy of freedom from adult control. Other research reveals that the rates of emotional breakdowns and suicides among school-aged children decline markedly every summer when schools shut down and rise again when schools open. During the summer children have at least some more opportunity for independent activity than they do during the school year. There is also evidence that teens who have part-time jobs are happier than those who don’t, because of the sense of independence and confidence they gain from the job.

Long-term effects of play and other independent activity on mental well-being.

Beyond promoting immediate mental well-being, play and other independent activities build mental capacities and attitudes that foster future well-being. Research shows that people of all ages who have a strong internal locus of control (internal LOC), that is, a strong sense of being able to solve their own problems and take charge of their own lives, are much less likely to suffer from anxiety and depression than those with a weaker internal LOC. Obviously, however, to develop a strong internal LOC a person needs considerable experience of actually being in control, which is not possible if you are continuously being monitored and controlled by others.

Other research has assessed relationships between the amount of time children have to direct their own activities and psychological characteristics predictive of future mental health. Such research has revealed significant positive correlations between the amount of self-structured time (largely involving free play) young children have and (1) scores on tests of executive functioning (ability to create and follow through on a plan to solve a set of problems); (2) indices of emotional control and social ability; and (3) scores, 2 years later, on a measure of self-regulation.

Moreover, two retrospective studies with adults have shown that those who recall more instances of independent play when they were children are, by various indices, happier and more successful in adulthood than those who recall less such independence. And research with college students reveals that those with over-controlling parents (as assessed with questionnaires) fare more poorly psychologically than those whose parents are less controlling. These and other correlational studies all point in the same direction. Opportunities to take more control of your own life when young predict better future well-being.

Play is the primary vehicle through which children satisfy psychological needs essential to mental health.

Dozens of research studies, conducted with people of a wide range of ages, have led to the conclusion that mental health for all of us depends on our ability to satisfy three basic psychological needs—the needs for autonomy, competence, and relatedness. The logic underlying this is straightforward. To feel in charge of our life, to feel we can meet the bumps in the roads of life with equanimity, we must feel free to choose our own paths (autonomy); feel sufficiently skilled to pursue those paths (competence); and have friends and colleagues for support, including emotional support (relatedness).

How do children satisfy these psychological needs? They do so through play and other self-chosen, self-controlled activities. Play and other self-directed activities are, by definition, autonomous; such activities build skills (competence) in endeavors that children care about and that prepare them for adulthood (see Letter #5); and such activities are the primary means by which children make friends (relatedness).

By depriving children of play and other independent activities we are depriving them of the experiences they need to grow up with the confidence and ability to run their own lives.

Final Thoughts

So, what can you, I, and others do about this? Too many people are focusing on drugs and therapy, as if something is wrong with the kids that needs correction, and not enough of us are thinking about prevention. Prevention would involve bringing normal childhood back to children. Children are designed to play and explore and thereby becoming increasingly independent as they grow older. Their instincts tell them that something is seriously wrong if they don’t have such independence. Letter #14 outlines some ways to bring more play into children’s lives in today’s overprotective world, but we also need to work for change in the larger societal constraints on children’s lives.

If you wish to see more of the research evidence behind what I have described here, including reference citations, you can do so by examining our article in the Journal of Pediatrics.

I invite you to add your comments and questions in the comments section below. If you aren’t already subscribed to this Substack series, please subscribe now, and let others who might be interested know about it. By subscribing, you will receive an email notification of each new letter.