The state of young people’s mental health

To coincide with World Mental Health Day, guest blogger, young person and professional Kat Cormack looks at the state of young people’s mental health in 2013 and examines access to treatment, perception of people with mental health issues and stigma.

So here we are on the week of World Mental Health Day 2013 and I can’t believe a year has passed already since the last one.

It’s also ten years since I started receiving mental health treatment and so now seems to me like a good time to take stock and see what is currently happening in children and young people’s mental health. I guess that makes this my “State of the mental health nation” speech.

Mental health, illness and everything in between is a massive area and I could talk to you about everything from ADHD to Z-drugs but then this would be less blog and more book: or five! So I’m going to focus on a few areas that I feel make for good indicators to assess the health of our mental health and services.

The last 10 years have been huge for me, seeing me going from a severely ill 14-year-old to a moderately ill but high functioning adult. In this time I have gone from being a student at school using CAMHS to someone who now works for the NHS and with YoungMinds (and occasionally uses Adult Mental Health Services).

I have also spent five years working with YoungMinds, the Royal College of Psychiatrists as well as completing an undergraduate degree in Psychology where my dissertation was based on young people’s experiences of transitions from CAMHS to adult services. This puts me in a somewhat unique situation (not unlike a tightrope at times) of being a professional, a “young person” and a service user all at once.

So where do we begin? I think two of the most salient indicators are access to treatment and perception of people with mental health issues. These are the two areas I will be covering in this blog.

Access to treatment

Asking for help with a mental health problem is daunting. I’m not going to lie. It takes courage to admit that things aren’t right and that you’re struggling and I commend everyone who takes this first step.

For most young people the first port of call is their GP, it was for me too. Ten years ago when I first asked for help my GP (newly qualified) had no idea about mental health having received no real training in the area. At the time I didn’t think much of it but looking back that’s pretty shocking given that such a high percentage of GP visits are related to mental health.

Fast forward 10 years and some progress has been made and I have met a lot of GPs who are very much up to speed with mental health and act accordingly. However many still have limited training and understanding and I have had my fair share of run-ins with GPs who are ignorant to the point of negligence. This needs to change. We cannot keep telling young people just to “talk to a teacher or your doctor” if they’re worried if we don’t then train these professionals to respond appropriately.

After seeing the GP for many young people they are referred to CAMHS. However we know that waiting lists are still unacceptably long with many young people waiting months (or even up to 18 months) for the support they so desperately need. This is not acceptable.

There is much talk of bringing about “parity of esteem”, to put it simply this means we need to start treating mental health as seriously as we treat physical health and that includes holding services to account to the same waiting times. You wouldn’t have to wait 18 months to get a broken leg fixed!

Another big problem we face in 2013 is the increasingly savage cuts to health and social care. Through an FOI request YoungMinds found that two thirds of local authorities have cut their budgets for children and young people’s mental health services since the coalition government came to power in 2010. One service suffered cuts of 41%. (Source: http://www.bbc.co.uk/newsbeat/21737173)

At a time when even more children and young people are experiencing mental health problems the last thing we can afford to do is cut services. Children and young people are not immune to the effects of the recession which have lead to a surge in family breakdown, youth unemployment and stress for young people. And as Tier 3 services like children’s centers are closed the burden increasingly falls even more heavily on CAMHS which was struggling as it was 10 years ago when I first came into contact with them.

With three in every classroom affected by a mental health problem we are letting down too many children and young people.

This is why I am happy to hear that many schools are beginning to ask more organisations like the wonderful BodyGossip to come in and talk to their students. I’m also glad that there is a lot more talk of teaching children resilience and even screening for mental health issues from the age of 7.

Perception of mental illness

Another area that I have watched with interest over the last decade is the way mental illness is viewed and the stigma associated with it.

Thankfully I can say that we’re making some progress with this. When I was at school we never ever heard about mental illness. Now we have amazing campaigns like Time to Change’s Stand Up Kid, YoungMinds in Schools, Student Minds, The Acseed initiative and Mental Wealth.

But we still have a long way to go. I may now be very open about my mental health, something I definitely didn’t feel able to do 10 years ago, but I am part of a minority. I am lucky enough to have the support of my family, friends and importantly my employer. This has not always been the case and I have suffered discrimination in the workplace because of my health as have many thousands of others. We need to create an environment in our country where it is okay to talk about how we feel.

I think that the recent ASDA/Tesco “mental patient” costume scandal is a very good example of some of the stigma we still face in society. Although having said that, the fact that this story hit the news as hard as it did is actually quite heartening. It wouldn’t have made mainstream news 10 years ago.

I also recently ran into the anti-psychiatry movement founded by Scientology, the ironically named Citizens Commission on Human Rights. As I stated in my blog here this was really shocking for me. I know people struggle with the idea that children can experience distress and mental illness but to run head first into people that don’t believe that mental illness exists at all?

There is definitely a lot of work still to be done to help educate people but I also know that there are lots of fantastic organisations, too many to name, fighting daily to reduce stigma and increase awareness.

So overall how is the state of children and young people’s mental health in 2013? I don’t think we can say clearly that it is “better” or “worse” than it was 10 years ago. There have been improvements, there have been set backs but perhaps, if I am dangerously optimistic, I would say things are gradually improving in some ways.

What we need now is for proper investment in children and young people’s mental health, and in mental health in general. For too long it has been a Cinderella service and we cannot continue this way. Research shows both that over half of adults with a mental health issue developed it by the age of 14 and that prevention and early intervention work and save both money, and more importantly lives, in the long run.

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Talking Taboos: Self Harm

There is a phenomena that lurks, mostly hidden away, and that affects more young people than i think anyone really dared, or wanted, to imagine. The number has been growing for years. In fact it affects one in twelve young people and yet is one of the most misunderstood and mistreated issues they face today.

The issue i’m talking about here if you hadn’t guessed is Self Harm.

At YoungMinds and the VIK project we have known for a very long time that self harm is a huge problem for many young people. We campaign to raise awareness about self harm and reduce some of the stigma that surrounds it and do this by giving training to professionals, speaking and writing publicly about our experiences and feeding into research. So when  YoungMinds were given the chance to do a major piece of research on self harm they jumped and together with CELLO they produced a year long piece of research entitled: “Talking Taboos”.

I was lucky enough to attend the launch of Talking Taboos at Portcullis House on the 23rd of October. The launch was a fantastic success with a wonderful audience that were full of questions for our panel of experts:

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The panel

 

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Lucie Russell, YoungMinds

The report, aimed at exploring society’s perceptions of self harm as well as young people’s experiences also goes on to give key recommendations to try and bring self harm out of the shadows and break down the barriers so many face in seeking help. In a world where there is so much fear around self injury it is great to see such clear, straightforward steps we can begin to take to improve this area.

The report showed a widespread lack of understanding and training around self harm for near enough all frontline staff in young people’s lives; from parents, to teachers to GP’s. However it also showed that so much of the time it is not a wilful ignorance.

 

97% of young people say that they believe self harm should be addressed in schools and 80% of teachers want clear, practical advice and materials that they can share with pupils.

 

Those are overwhelming numbers that cannot be ignored. There is a strong desire for knowledge and to open up a dialogue with young people and i would love to see more schools actively engaging with young people about mental health and emotional wellbeing at the very least.

We need to help GPs to understand too. Four out of five do not feel that they have the right language to speak to young people about self harm. That worries me.

We need a new era of openness and tolerance and not only that but empathy for our fellow men, women and children who are suffering silently because of ignorance and stigma.

Self harm is a widespread problem and just like mental illness it does not discriminate between genders, or races or even age ranges. We have all at some point or another i imagine done something that could be seen as self destructive and everyone has less than perfect coping mechanisms. It might take the form of smoking, or drinking too much, or self harming. Either way we need to stop obsessing about the fact it is happening and start asking “why?”.

 

 

 

The report can be read in full here: Talking Taboos

And for more information and advice on self harm i would strongly recommend checking out LifeSIGNS which is run by people with direct experience of self injury.

A few weeks ago i blogged about how you could  Celebrate World Mental Health Day in London. I was lucky enough to be able to do just that and found myself on the 10th of October at Camden’s Real Talk event titled “Mad, Bad or Sad”.

The event brought together more than 60 young people from Camden and a range of organisations for a dynamic, interactive debate on mental health at Camden Council. Young people were asked a range of questions such as “when you hear “mental health” what do you think?” and “would you tell your friends if you had a mental health problem in the past” and responded by voting with keypads; a really great way to use technology to involve people in open, honest debate.

The event was hosted by Brooke Kinsella (@brookekinsella), star of Eastenders and anti-knife crime campaigner and Luc Skyz (@LucSkyz), London rapper but i must say the real stars of the show were the young people.

I attended the event as a member of YoungMinds staff and had my own stall full of information, freebies and sweets (which proved to be very popular!). I spoke to so many young people and told them what we get up to at the nations leading children and young people’s mental health charity and a lot of people expressed an interest in getting involved.

I also got to tell the young people i spoke to about the app i am currently developing with NHS London and there was a lot of interest, young people told me they wouldn’t necessarily know where to go if they needed help or were worried about a friend; something i hear time and time again. It was good to hear that there is a genuine need and want for the app we are working on and i hope that when it is released it helps.

My favourite part of Real Talk was sitting in on the debate “Mad, Bad or Sad” and it was really interesting to hear directly from young people what they think mental health is and how they perceive mental illness and those that suffer from it.

There were some very revealing comments and some great questions; hopefully we busted some stigmas and it was great just to be able to talk openly about mental health with people who might not necessarily think twice about it otherwise.

Overall it was a fantastic event and i am so glad i was able to be a part of it. I’d like to thank the organisers and all the young people that attended.

Mental health, GPs and young people

This morning i called up my doctor’s surgery to get a much needed appointment with a GP. For most this is a task that needs little if any thought. For me however it can be a potential minefield.

What’s more when i called up i was informed that my appointment would be with a new doctor, not one that i had met before or had any experience of. Accepting the appointment, was for me, a pretty big gamble.

I’ll explain. I have had mental health problems to some level or another for most of my life and i have been using mental health services for coming up to nine years now. I have almost endless experience of all sorts of medical professionals from psychiatrists to nurses and everything in between.

Obviously as a UK resident my first port of call when it comes to health (both physical and mental) is my GP. GPs often feel like the gatekeepers to other services and organisations and i have always felt that it is vital to have a good working relationship with them.

However when it comes to mental health nothing is ever so simple. I would like to say that i have had predominantly good experiences but this is not the case.

I think the problem comes, to some extent from a combination of two factors: the fact that this is mental health and that i am a young person. Apparently these two things mean it is often harder for me not only to access the treatment i need but also to have problems recognised at all.

I wish i could say that i was alone in this experience but unfortunately that is far from the truth. I have spoken to countless other service users young and old about their experiences of GPs and they very much mirror my own. I wish i could tell you that young people weren’t told that their conditions were “a phase”/hormones/attention seeking/manipulative. Eating disorders are seen as a fad or a diet gone to far, depression dismissed. And if you were told this after opening up about something deeply personal that you may have not ever shared before, do you think you would go back or try and get a second opinion? I know i would think twice. I know it is a hard fact to stomach that some children and young people suffer from severe mental health problems but we can’t ignore or it deny these people help because it makes us uncomfortable.

All the evidence shows that a huge proportion of adults that have a mental health condition report symptoms starting in adolescence and the power of early intervention, as shown especially in EIiP (Early Intervention in Psychosis) services, cannot be denied.

And yet we still struggle to get our voices heard and to be taken seriously.

GPs need training not only in how to spot the warning signs of mental distress in children and young people but also need to be educated on atypical presentations (we don’t all neatly fit into diagnostic boxes) and a more holistic and open approach to young people.

Luckily today was a positive experience. In spite of all my anxiety in the run up to the appointment i was seen by a doctor that listened to me, took my opinions and preferences into account and made me feel relaxed.
It is just unfortunate that i can’t say that more often.