Dr Nihara Krause, Consultant Clinical Psychologist, CEO and founder stem4.

On the 22nd May in Manchester a suicide bomber killed 22 people and injured around 60. Among the injured and dead were children, young people and families. This sort of attack makes us all feel vulnerable, but, for a number of reasons, it can have particularly negative effect on the mental health of children and young people.

The first is that the attack was on other young people. This makes the experience more personalised and relatable. As a young patient told me: “I recognised the sound of screaming that I heard in the news reports. It sounded like the screams my friends and I would make.”   The enjoyment of an innocent, ‘feel good’ concert with pink balloons and bunny ears contrasts starkly with the shock and horror of the consequences –mass terror, death and destruction.  This makes it more shocking. As if that weren’t enough, children and young people are made more vulnerable to mental ill health by the intense media coverage and social media discussion and analysis of the attack.  A psychological study that explored the impact of the 9/11 bombing in the US , for example, found that watching TV coverage of the disaster increased a number of stress symptoms in adults.

Following the Manchester bombing, young people have been very active across social media. There was continuous discussion and sharing of articles on Facebook groups, together with ‘safe’ alerts. The safe alert is, no doubt, a helpful message when there is a disaster such as a flood or earthquake, but some young people were posting safe messages from around the world, heightening fears among other young people about global safety. This highlights how tricky it is to find a balance between the positive effects of social media communication and the negative effects of media-related contagion.

Increased levels of poor mental health might become manifest among people living in the city where an attack has taken place – and this effect might prove long-term among those vulnerable to poor mental health. Both Manchester Universities and their campuses are close to where the bombing occurred. Given that young people are more vulnerable to mental ill health in general, this is something to keep in mind.

Earlier this year my charity, stem4, carried out a survey of 500 young people, investigating their most common stresses and worries. One in ten reported anxiety about world affairs. Many children and young people report this anxiety to me when I work with secondary schools. There is also some evidence to indicate that Millennials show higher rates of anxiety than any other generation. All of this means that young people are more vigilant anyway and what’s happened will only increase their fears.

As mental ill health becomes part of life for a greater number of young people, an atrocity like the one in Manchester should cause us all to dig deep into our inner resources, so that we can support those not resilient enough to deal with its impact on their own.

Resilience is a concept that originally emerged from the trauma of war and, according to the American Psychiatric Association (2013): “Resilience is the process of adapting well in the face of adversity, trauma, tragedy, threat or significant sources of stress.” It is somewhat harder to define exactly what resilience is, since the literature confirms that resilience is not one single thing. In an effort at consolidation, my MINDYOUR5 programme for mental wellbeing – now established in a number of different school – focuses on the five main components needed to build resilience. To boost resilience, they should be practised daily.

One of these components is the identification, expression and regulation of emotions. Space should be given to expressions of fear, anger, grief and sadness – and adults should provide support by acknowledging that these emotions are positive. It is important for adults to share in young people’s feelings, helping them to model their ability to express and manage their emotions healthily. Connectivity is another enormously valuable factor in resilience. The community has already set a great example with vigils, offers of accommodation to stranded strangers, or just a friendly arm round someone’s shoulder. Families, schools, colleges and universities all have a role to play.

Social media provides another form of connectivity, but children and young people also need to learn how to discern positive messages and protect themselves from overload and contagion. This requires education – and the traditional media need to be sensitive to the fact that there are no age restrictions when it comes to accessing news.

In the face of a crisis or a perceived threat, we need to help children and teenagers think differently by putting things into perspective, making clear to them that it is not the norm for young people to be targeted and that every precaution is being taken to keep them and their loved ones safe. Adults should provide a balanced and positive view of the world amidst so much negativity. Children and young people will be affected by what has happened and will show this in a variety of ways. We need to know when these signs are a potential indication of mental ill health and when they are a sign of natural human reaction. We can build resilience through support and connection, talking and problem-solving. For young people who have experienced other trauma or have a mental illness, more support might be needed and this should be sought through their GP.

As adults, we need to be active in helping children and young people to build their resources. They can become more courageous by learning to face fear. By helping them to deal positively with adversity, we can help them to lead happy and fulfilled lives.