16/03/17

Mental health makes a plea for help as cases among young people continue to rise. | BBC News School Report

 

1 in 10 people are left handed.1 in 10 people live on an island. Those are figures that would hardly surprise anyone. But what about 1 in 10 young people aged 5 – 16 suffering from a diagnosable mental health disorder- what’s more, that is around three children in every class.

Mental health among the younger generation is a growing worry and quickly, if not already on its way of becoming a full-fledged crisis. The cause of this is one being put on the soar of selfie culture, as well as cyber bullying’s control in the age of 24/7 technology and of course for teens the common pressures to do well at school and issues in the family home. While it may be important to determine the reason behind this influx, isn’t it time we perhaps stopped not only ignoring the issue but started trying to treat it?

The need for early intervention and having the right support and care on offer, has been more and more heavily emphasized, however it’s something that simply isn’t happening, largely for two reasons. One: there is a lingering stigma, that even in 2017 still exists when it comes to mental health-  nearly three in four young people fear the reactions of friends when they talk about their mental health problems. Two: the help just simply isn’t there. This has then led to a staggering 70% of children and adolescents who experience mental health problems not having appropriate interventions at a sufficiently early age.

Bigger efforts are being made in the hope of changing the way people think and act about mental health. On March 11th Time to Change a movement  funded by the Department of Health, Comic Relief and the Big Lottery Fund, run by charities Mind and Rethink Mental Illness, launched a four year campaign to encourage young people to be more open to the topic of mental health and to be in their mate’s corner, asking them to  “step in” to support their friends, one of many initiatives keen to end once and for all, the taboo image that somehow mental health has acquired compared to that of physical health.

Recently, it was also Eating Disorders Awareness week.  1.6 million people in the UK are affected by an eating disorders, with 14-25 year olds being are most affected by an eating disorders. From 27 February through to 5 March, the campaign run by BEAT focused the week aptly on the importance   of early interventions, stressing how getting people into treatment as quickly as possible and how GPS assisting in this, plays a huge part in bettering the chances of those affected making a full and sustained recovery. As part of this, near the beginning of Eating Disorders Awareness Week on 28 February, the charity even travelled to parliament, talking to MPs, healthcare representatives, mental health advocates and others about ensuring that GPs can give patients the care they need, calling for increased training for the people who will be able to act quickly and at the earliest opportunity.

As the second city, Birmingham seems to be also making attempts to aid this problem, with centers and services that many travel to, across the UK due to their shortage. It is home to the Priory Group which includes the Barberry, offering eating disorders inpatient care. There is also  The Priory Hospital Woodbourne ,an independent hospital, specializing in the management and treatment of a wide range of mental health conditions (Eating disorders, Child and Adolescent Mental Health and a Psychiatric Intensive Care Unit). Perhaps most ground breaking is the Forward Thinking mental health service launched in April last year, that deals with the individual needs of 0-25-year old’s. This marked the first time that services had spanned this age range anywhere in the country, with the intention of ending’ disjointed and fragmented care’, as well as notoriously long waiting lists.

Along with this a new city center drop-in service, called Pause, located at 21 Digbeth (near the Bull Ring), was created as somewhere to drop-in and have a chat with someone about anything worrying them no matter how big or small. However, like most services, there are limitations, there are financial constraints and there are problems that continually emerge, making it that much harder to reach the almost 80,000 children and young people suffering from severe depression, to help the 20% of adolescents  that may experience a mental health problem in any given year and to stop these rising figures.

To investigate further what services are available and how Birmingham may be continuing to try to respond to the needs of young people, a Director in the NHS employed by a local NHS Trust that delivers both Mental and Physical Health Care, who has worked in the NHS for over 30 years, gave their insight into the mental health sector currently operating within the city:

What does your role entail?

This role means I have strategic and operational responsibility and accountability for the delivery of my Group Division. Within this division there are a range of services that deliver both mental and physical health across adults and children. This includes Health Visiting, Allied Health Professionals in children’s services, CAMHS, Learning Disabilities (both In-patients and community), Family Nurse Partnerships and Children’s Assessment Units.

What services are available to young people suffering from a mental health problem and how would you describe these services?

The services to young people are very dependent on how they are commissioned and vary across different Health and Social care economies. With the new transformational funds, CCG (clinical commissioning groups) are shifting their commission services to enable early intervention to occur in a timely manner and focus on prevention before somebody becomes unwell. Schools are also being targeted to support teachers and equip them with skills needed. More so than ever, the digital culture is being explored to provide on-line support, supporting families and carers because it is vital to not just the recognise the child as being important. There has been work done as well to educate GPs who often feel ill equipped and lack confidence in dealing with mental health issues. Currently the service operates in what we call a TIER system but there is a desire to now have a much more integrated approach across the system with Local Authorities, NHS providers and the Voluntary sector all working together. Currently, most areas have a TIER 3 service, some areas have TIER 2 but not all and this provision is inconsistent across the country. TIER 4 is provided by NHS England when in-patient provision is required but there are not enough beds available readily to meet demand. TIER 1 is everybody’s business to provide initial support but GP/Health Visitors etc. need help as this isn’t their core training after all.

The prime minister said mental health had been “dangerously disregarded” as secondary to physical health and changing that would go “right to the heart of our humanity”. From your professional opinion, is this the bitter reality?

There is some truth to the Prime Ministers statement as valuing mental health equally with physical health is vital. The phrase often used now to ensure this is “Parity of Esteem”. What we mean by this is that, mental health must be given equal priority to physical health. This is important for many reasons. Firstly, as many people are starting to realise mental illnesses are very common. What some people may not realise, is that a mental illness is generally more debilitating than most chronic physical conditions. In the bigger picture, these problems also impose a total economic and social cost of over £105bn a year, yet, only a quarter of all those with mental illness such as depression are in treatment. I believe we tend to view physical and mental health treatment in separate silos in health services. However, people with poor physical health are at higher risk of experiencing mental health problems and people with poor mental health are more likely. In my professional opinion, mental health has wrongly been ignored.

Theresa May has also claimed or rather promised that by 2021, no child will be sent away from their local area to receive treatment for mental health issues, do you believe this a promise that can be met?

In terms of lack of care available, there are serious and deeply ingrained problems with the commissioning and provision of Children’s and Adolescent mental health services. This  runs through the whole system from prevention and early intervention through to inpatient services for the most vulnerable young people. There needs to be a focus of investment in CAMHS that should be on early intervention, providing timely support to children and young people before mental health problems become entrenched and increase in severity. Sadly, most areas in the country have suffered insecure or short term funding and I am aware of some young people who have described “battles” to get access to CAMHS. In my opinion the funding is short term, which makes it difficult to attract staff to work in mental health on short term contracts but providers have spent a lot of time negotiating with commissioners to make the funding long term. The issue of access to in-patient units also remains a significant problem as there are insufficient local beds, so children when they need admission often are sent away great distances. Just recently, I had to deal with a young person who needed an in-patient admission and the only bed available was in Surrey.

The government have also announced that there will be trials on strengthening links between schools and NHS specialist staff, including a review of children and adolescent services across the country. Is this a strategy that you believe will have a positive impact?

This will help as CAMHS services receive a lot of referrals from Schools who at times are unfamiliar with mental health issues and how to manage them. There are times when we receive referrals for an issue with a young person’s health which is not a mental health issue but just poor behaviour due to a host of social factors. I think this is a large problem as it runs the risk that some children will be inappropriately labelled with a mental health issue, which we can see carries stigma and prejudices e.g. employment opportunities. That being said, within our local health economy with the new transformational plans, we have used elements of it to employ CAMHS link workers to support schools when they think they have young who may have a mental health problem. The CAMHS link workers will work between the school and the CAMHS service with the aim to provide support and build confidence within schools in terms of educating them what is a mental health issue and what is not and to ensure that young people who are referred into CAMHS are appropriate referrals. Of course, the challenge is there are many schools and to support all schools will require further funding to employ more link workers.

In response to that, it has been announced that every secondary school is to be offered mental health first aid training – which teaches people how to identify symptoms and help people who may be developing a mental health issues. How far do you agree that mental health is more than an NHS-only issue?

It certainly isn’t just the NHS’s problem. The recent new funding in my view is sold by the government as additional investment, however many would say that mental health services have been unfunded and this new funding just addresses the previous existing gap. With rising demand, I think more funding will be required. But it is about more than just funding; it requires the system and all the stakeholders involved with young people with a mental health issue, to work together. This includes Local Authorities, Police, Schools, NHS and the Voluntary sector. Unfortunately, what I often see is young people simply being passed from pillar to post because there is a lack of integration between all these.

To finish, how do you think the current situation of young people’s mental health will fare in say 5 years’ time).

It’s difficult to predict as there are so many things to consider. I think that the government have made a commitment to funding which is a good start. If there is an appetite for organisations to work differently and this is made clear in the NHS Five Year Forward View, then we do have a great opportunity to develop fit for purpose services for young people with mental health problems. But, organisations must be prepared to work very differently and together across the entire system.

To get involved in the campaign support Mental Health Awareness Week (8-14 May 2017) with a them this year of ‘Surviving or Thriving?’.

For more information, advice or support visit the following sites and organistaions:

https://www.mentalhealth.org.uk/campaigns/mental-health-awareness-week

Mental Health Foundation

Together

The Centre for Mental Health

Depression Alliance

British Association for Counselling and Psychotherapy

PANDAS Foundation

Nightline

YoungMinds

Childline

SANE

CAMHS

Forward Thinking

 

Tiah (Year 11)