Young people’s mental health forces its way onto the political agenda
Times launches a campaign
To some, teenage mental healthcare is one of the most neglected corners of the health service despite evidence of what a Times Leader recently referred to as ‘a mental illness epidemic among young people.’
Official data shows that a record number of youngsters are being admitted to hospital for self-harm, eating disorders, depression and other psychological disorders. Emergency admissions for psychiatric conditions soared to 17,278 last year, double the number four years ago. There were 15,668 admissions of young women aged 15 to 19 for cutting, burning or harming themselves, compared with 9,255 admissions in 2004.
However, the last full study of the state of teenage mental health was published in 2004.
The Times, which has launched a campaign calling for action, believes that part of the increase in self-harm is’ a result of better reporting as the stigma attached to mental illness slowly fades. Yet much of it must be attributed to the fast-changing culture in which teenagers grow up, vulnerable to cyberbullying and living in the distorting mirror of social media.
In response to the crisis, The Times on 12 March launched a manifesto written by Tanya Byron, the leading clinical psychologist and government adviser, and three other experts in the specialty, representing the Royal College of Psychiatrists, Great Ormond Street Hospital and the Young Minds charity.
It called for:
- A “state-of-the-nation” study to be carried out immediately to update statistics that professionals have to use, which are now 11 years old.
- An urgent revival of early intervention services in schools and communities to prevent children from being forced to wait until their conditions are life-threatening before getting help.
- Investment in emergency beds to end the scandal of children being held in police cells, on adult psychiatric wards or being sent across the country in the midst of a crisis.
- The 18-week waiting time for non-urgent physical health treatment to be extended to cover non-urgent children’s mental health.
Professor Byron called the manifesto “a blueprint for urgent change”.
A big challenge is that there is not a joined up approach to the issue of young people’s mental health . A silo mentality has existed which sees the issue straddling several government departments and agencies – Health (Social Services) Justice and Education. GPs, Health visitors, Sure Start Children’s Centres, schools,-school health services including school nurses, colleges, primary care and youth centres, and the Secure Estate(Youth Justice) all have a part to play in not only identifying problems and providing support, but in helping to address the stigma attached to mental health and the discrimination and prejudice encountered by those with mental health issues.
A report, out last month, from the Children and Young People’s Mental Health Taskforce -Future in mind – promoting, protecting and improving our children and young people’s mental health and wellbeing’ recommends a complete overhaul of mental health services and makes a number of proposals the government wishes to see by 2020. These include:
A comprehensive set of waiting-time targets for services
The launch of a hard-hitting anti-stigma campaign
One-stop shop services in the community to direct young people to places that can help
Continued support throughout teenage years and into the early 20s to avoid the “cliff-edge of lost support” at 18
Greater use of online tools and apps to encourage self-help
Improved care as close to home as possible for children and young people in crisis
Extra training for GPs and other who work with children, such as staff in schools
The report sets out how much of this can be achieved through better working between the NHS, local authorities, voluntary and community services, schools and other local services. It also makes it clear that many of these changes can be achieved by working differently, rather than needing significant investment.
Rewinding a bit-to January 2015 – a survey of headteachers, the first of its kind, found significant gaps in the “critical” treatment of their pupils’ mental health needs.
The survey, conducted by the liberal Centre Forum think tank’s mental health commission, found that head teachers at more than half of schools in England believe the referral system for sending their pupils to child and adolescent mental health services (Camhs) is not working. Experts say it is vital to identify pupils who need support with mental health issues early on.
“The results of this survey suggest schools and young people are often let down and left to fend for themselves,” said Paul Burstow MP, chair of the commission, who warned that, on average, about three children in every classroom would experience mental health problems. “With a price tag of up to £60,000 per child per year, the life-long impact of mental illness on young people and their families is something we can’t afford to ignore.”
Demand for mental health services among the young is increasing. Economic pressures, parental separation and the impact of social media are all cited by headteachers as factors behind the rise in behavioural and emotional problems among pupils.
But when schools in England do refer pupils to mental health services because their needs are considered too complex to be managed “inhouse”, more than half, 54%, report that the referral system is ineffective.
The findings confirm concerns raised in the commission’s final report, published earlier this year, which concluded: “Schools cannot be expected to do it all, yet many head teachers are feeling unsupported by Camhs. It appears the relationship betweeen schools and Camhs is flawed in some areas or the country in terms of access, communication and follow up.”
The Commission’s final report titled ‘The pursuit of happiness‘ calls on policymakers to:
- Establish the mental wellbeing of the nation or the “pursuit of happiness” as a clear and measurable goal of government.
- Roll out a National Wellbeing Programme to promote mutual support, self-care and recovery, and reduce the crippling stigma that too often goes hand in hand with mental ill health.
- Prioritise investment in the mental health of children and young people right from conception.
- Make places of work mental health friendly with government leading the way as an employer.
- Better equip primary care to identify and treat mental health problems, closing the treatment gap that leaves one in four of the adult population needlessly suffering from depression and anxiety and 1-2% experiencing a severe mental illness such as schizophrenia.
It is hard not to conclude that desperately vulnerable teenagers are falling through the gaps of a system ill-equipped to offer treatment that could prepare them for a full and healthy life. There is also a big challenge across the board in altering people’s perceptions about mental health, and education and information will play an important role in addressing this challenge.
Interestingly, at the end of last year I was asked by a client to predict what might be of shared concern to politicians post May. In short what were the priority consensus issues .Mental Health was not on the agenda, or at least not high on the agenda. It is now. It is being given added momentum by the Times campaign. Nick Cleggs most recent speech makes very specific mention not only of concern but a firm pledge on resourcing (the Lib Dems to their credit have taken this issue on board in much the same way they did-the Pupil Premium)
“I have announced that we will be putting an extra one and a quarter billion pounds over the next five years into mental health services for children and young people…”said Clegg
It is also important also to note that character education is on the agenda which embraces the idea of promoting resilience in children, pushing positive thinking(the happiness agenda) the use of meditation and reflection, while promoting well-being, all of which are thought to impact on children’s mental health and the alleviation of stress . The work of Professor Richard Layard and that of Professor James Arthur of the Jubilee Centre, is instructive in this respect. Sir Anthony Seldon has done more than any other Head to focus policy makers on these issues, and back in September 2006, launched a course in happiness and well-being for Wellington Colleges’ 4th and 5th Forms .
The Department for Education is now leading work to help schools ensure more pupils develop the character traits, attributes and behaviours, which, alongside academic achievement, underpin future success.
Ironically, of course, much pressure on children is thought to come from exams and, testing and the requirements of the accountability framework. A new education movement-Slow Education- has recently been spawned ,which sees the pace of everyday life and endless target’s and the test driven , ‘factory schools’ system as not conducive to good education and learning, and seeks to reduce pressure on children to allow them more time to understand what they are being tested on. It aims to establish a culture of deeper learning, so not just frenetic knowledge driven learning ,that tests short term memory, rather than real in-depth understanding.
Some experts say that exam stress, social media, bullying and the pressure to look slim and attractive are combining to make children’s lives unmanageable.
So that is the nature of the problem. Addressing it strategically, in a joined up way, though, is a huge challenge. Any issue that straddles government departments and agencies and requires a multi-disciplinary approach have big barriers to overcome and need clever management . And it is as much an issue of leadership and capacity as it is of resources. Schools, of course, already have much on their plates, so giving them even more to cope with has its own challenges, at a time when there are moves to reduce teachers workload.(and their stress)
But at least politicians have the issue on their agenda now, which is likely to continue well into the next Parliament.
Report of the work of the Children and Young People’s Mental Health Taskforce.
Future in mind Promoting, protecting and improving our children and young people’s mental health and wellbeing-March 2015
In addition, International Studies suggest that our children, in terms of happiness and well- being ,are not doing as well as they might be in comparative terms. A UNICEF report of 2014 on Well Being places the UK 16th out of 29 countries. A Children Society 2012 survey found that while most children are happy with their lives as a whole, around one in 11 (9%) are not. This amounts to half a million children in the UK aged eight to 15 who have low well-being at any given time.
The government is also committing £14 million over two years to invest in an Advanced Wellbeing Research Centre (AWRC) in Sheffield, which will be a world-leading research centre to design, develop and implement physical activity interventions and productsto improve wellbeing. The AWRC will form part of Sheffield’s Olympic Legacy Park and is due to open in 2016.(Budget Announcement 2015)