The Inbetweeners of Mental Health

The ‘inbetweeners’ of mental health. They’re young people in the transition stage between childhood and adult mental health services. It is the point in which an existing or newly referred patient (over the age of 16 or 18) is transferred to adult services.

The UK’s leading charity in improving young people’s mental health services, YoungMinds, is currently campaigning to improve transition care from child and adolescent mental health services to adult services, preventing young people from getting ‘lost in the system’.

And there are many who are being left in the dark when it comes to receiving the support they need from mental health services.

Did you know that when young people reach the age of 16 or 17, they are no longer eligible for support from CAMHS (Child and Adolescent Mental Health Service)?

But more worrying is that they are often much too young or do not meet the strict criteria to be referred to AMHS (Adult Mental Health Services) as they may be classed as ‘not ill enough’.

So where does that leave the ‘inbetweeners’?

It puts them in a position where, ultimately, they are not able to access any of the services that could help them on their way to recovery. This is a dangerous position to be in for any young person suffering from mental illness.

So why do these issues occur exactly? And what could be done to change them?

First of all, the criteria for support through AMHS is very different to that of CAMHS. AMHS point of entry for treatment is a lot more difficult to meet than CAMHS in regards to the severity of the individual’s mental health. For example, AMHS will often only intervene when a young person has reached a crisis point or are deemed as a danger to themselves or others while those under 16 will often be referred to CAMHS before their illness advances to such stages.

As mentioned in my previous blog, this is where early intervention is key and can not only save a young person’s life but would prevent a young person from having to access more advanced mental health services (such as inpatient facilities) at a later age. If these services and resources are offered to a young person as soon as issues surface, they are able to better equip themselves with the techniques or methods they need to prevent a relapse in their mental health in the future.

This current gap in young people’s mental health care is very worrying and an issue many may not be aware of unless they themselves have tried to gain access. Young people who are no longer able to access CAMHS are waiting long periods of time to reach the correct age for AMSH services, which can’t start until the individual reaches 18.

This huge gap and subsequently, further delays in referral can mean many young people ‘give up’ on transitioning to adult services and therefore never get the treatment they need, having a huge effect on their future mental wellbeing with potentially dangerous consequences. Young people are in essence ’disappearing’ from these services and falling off the radar.

There is also the added funding stress on the NHS, with services in particular areas receiving less funding in mental health services than others, meaning fewer funds for each patient and therefore a lower referral rate. There is a variation from county to county as to what age is classed as eligible for transfer to adult services also. For example, a 16-year-old may transfer to AMHS if they are no longer within full-time education. If they are still in education, they will often not be transferred until they are 18 years of age, showing a contradiction between counties within the NHS.

These young people are being passed from pillar to post. A lack of communication is also present between the two services. Neither CAMHS nor AMHS appears to be making the effort to work in line with each other. This leads to information not being passed between the two mental health services and therefore, many young people will have to undergo another assessment before entering treatment. Understandably, this can also be quite traumatic for a young person.

These services need to provide continuity and routine for already venerable young people.

Between the ages of 16 to 18, young people with mental health are probably at their most venerable. They are often making important decisions about their education. Should they stay for further education or apply for an apprenticeship?

They will often have to make more intense life decisions about relationships and friendships as well.

So why, at their most venerable, are they being turned away from the support they need more than ever?

It’s a frustrating and worrying time for both young people and parents when they are left in this limbo period, often feeling as though their concerns are not being heard or ‘don’t matter’.

The Government invested £54 million in improving young people’s mental health services between 2011 and 2015. Yet young people are still not getting access to the services they need.

Have you or your child experienced the gap in services? How do you think the NHS could improve on this?

Leave me a comment!

Resources: 

http://www.mind.org.uk/information-support/guides-to-support-and-services/children-and-young-people/

http://www.theguardian.com/education/2014/jul/29/chilld-and-adolescent-mental-health-service-failing-children

http://www.time-to-change.org.uk/about-us/what-are-we-doing/children-and-young-people

http://www.youngminds.org.uk/

Georgia 

Mental health and young people: Is there a lack of support?

CentreForum, the independent think-tank, published a report which revealed that nearly a quarter of children and teenagers on average are turned away by mental health services after being referred by their GP’s, teachers, or others.

CentreForum found that this was due to services having ‘high thresholds’ for access to their services, revealed after analysis of the service’s eligibility criteria.

In the report, CentreForum stated that these high thresholds for treatment eligibility prevent one of the most effective forms of mental health treatment for young people- early intervention.

It was also found that young people were waiting for prolonged periods of time to access treatment with the average of the longest waiting times being almost 10 months between the first GP/school referral and the beginning of their treatment. This, along with a lack of funding for mental health services in certain areas of the UK shows a worrying escalation in the support offered to young people suffering from mental illness.

This report has been released in the same week that a UK bereavement charity pushed for a full investigation by the Government into the way deaths of young people in mental health units are recorded. An inquest suggested that nine young people had died within inpatient mental health facilities since 2010.

This only solidifies that there is a considerable lack of support for young people suffering from mental illness.

Early intervention is key.

Depression, anxiety, and other mental illnesses suffered by children and teenagers will often be present at a young age. Certain behavior such as a change in sleeping patterns, irritability, loss of interest in certain activities, and withdrawal from socialisation can often be clear indications of a young person who is carrying the black dog. Some people may question whether this is just the behaviour of a typical teenager. But this behaviour will often extend to prolonged periods of time with little to no change in mood.

This will often affect a young person’s school or college life, resulting in low grades, bad behaviour, or low attendance. These warning signs should be a clear indication that further investigation is needed.

Intervening as soon as a problem is spotted can allow schools to offer the right support and advice for the affected young person as soon as possible. All too often, a young person who has suffered from mental illness will have gone throughout their school life with little to no mental wellbeing support. I know of quite a few young adults who suffer from depression or anxiety and have done from a young age, yet never had anyone listen to their issues or offer support which could have allowed them to receive the treatment they needed much earlier.

Is it a lack of funding? Or a higher demand?

The reality is that figures show funding levels for NHS mental health care in England have dropped by 2 percent in recent years. This lack of funding leads to long waiting lists and less accessibility to the services, which are desperately needed to prevent the potential suicide and self-harm of young people. It also puts a strain on charities that rely solely on donations to provide young people support such as Samaritans and Child Line.

There is also a higher demand for these services due to the rise in mental illness in young people. Statistics by YoungMinds.org.uk show that young people between the ages of 15 to 16 with depression doubled between the 1980s and the 2000s, showing there is a constant increase in the number of young people being diagnosed with mental health issues. This could be due to a lack of knowledge in previous years or maybe just the way our society has changed its views on mental health. Regardless of what has caused this higher demand for services, these resources need to be available to prevent an increase in suicide levels in adulthood as well as self-harm in young people, which is believed to affect 13 percent of children and teenagers between the ages of 11 to 16.

We shouldn’t have to lose a young person due to a lack of support and funding for life-saving services.

If you have been affected by the topics discussed in this post, please contact the following organisations for support:

Mind 

Young Minds 

Parents or teachers in Bedfordshire.

Georgia OX

 

Top 5 Apps for Managing Anxiety

Calm

Free

This mindfulness meditation app is a great introduction for beginners of meditation techniques. It’s a popular app, which allows for guided meditation programs alongside the peaceful background noise of your choosing.

Features include:

A personal profile.

This includes a calendar to track your recent meditation sessions and compare your progression.

Customisable scenes for your background noise.

There are a few that come as default on the app, but you can download more depending on what you find most relaxing. All are free. This is a newer update, which was added so that you can whittle down your favourite scenes, and access them easily from your home page without flicking through a number of scenes before you find the one that works best for you.

Guided Meditation

If you choose to use guided meditation, you can pick a specific program. The default one is called 7 Days of Calm. Using the app for seven consecutive days will allow you to see any changes in your mood and find out if this app works for you.

There are also two default-guided meditations for the app. These are Calm and Body Scan. If you pay for Calm Pro, either monthly or annually, you can access meditation for specific issues or areas of your life you wish to improve. These include problems with sleep, concentration, commuting, and confidence.

Timer

It allows you to have control over how long your meditation sessions last. They can last from 1 minute up to 240 minutes. You also have the option to change the sound that plays when your session has ended (so don’t pick anything that sounds like an alarm bell or it may wake you abruptly!)

Panic Attack Aid (P.A.A)

£2.99

A helpful app for anyone who suffers from Panic Attack Disorder or frequent panic attacks with his or her anxiety. This app features a number of activities to ease symptoms during a panic attack and calm the mind.

These include:

A Breathing Exercise

This uses the movement of a circle to regulate and slow breathing. We often over breath during a panic attack which causes hyperventilation. This exercise allows you to relax your breathing and also gives positive, calming mantras to read and repeat to yourself.

Reassurance

This part of the app includes explanations for symptoms of panic attacks, helping to reassure your racing mind and calm your thoughts. The reassuring explanations are also tailored to your location.

Distraction Exercises

This is my favourite section of the app. This section features exercises and games, which should allow you to focus your mind and therefore, be distracted from your panic attack.

MindShift

Free

This app gives some great insight into anxiety and is laid out like a journal.

This app includes strategies for most anxiety disorders (including Social Anxiety) but would also be helpful for those looking for tools to manage:

  • Test Anxiety (Driving test or exams)
  • Performance Anxiety
  • General Worry and Panic
  • Dealing with Conflict

Its features include:

Anxiety 101

These are clear explanations to why we suffer from anxiety and why it makes us react the way we do (for example, it explains what the ‘fight or flight’ mechanism is as well as where our anxiety comes from)

This feature is helpful for anyone who wants more insight into anxiety and may not have had the chance to do his or her own research yet. It is easily explained and to the point.

Situations

This allows you to address situations you would like help with such as ‘taking charge of panic’.

Check Yourself

It allows you to recognise what issues you may have with your anxiety and how it can affect you.

Thinking Right

It allows you to identify more positive and helpful thoughts, which you can favourite, making them more easily accessible from the main page.

Chill Out Tools which include:

Relaxation Exercises (Calm Breathing and ‘Tense and Release’ for tension caused by Anxiety)

Visualization (Mental Vacation)

Mindfulness strategies (Body Scan and Mindful Breathing)

Active Steps

Gives you strategies you can use in everyday life to overcome your anxiety or panic attacks. These include exposure and coping techniques.

The app also has an inspiration section, which gives you a selection of positive quotes to reflect upon and read when needed.

Anxiety UK

Free

The charity, which helps to support people with Anxiety Disorders, has a very helpful app for those looking for advice from other people diagnosed with anxiety.

It allows you to take a questionnaire to better understand what may be causing your anxiety. I do recommend that people visit their GP before self-diagnosing though to make sure they are not suffering from other medical issues.

You can hear helpful tips from other members of the Anxiety UK community as well as professionals in the mental health sector as well as create your own tips for other users.

This app also includes some links for more information on all anxiety disorders as well as personal experiences from members of the charity.

Pacifica

Free

This app allows you to track your mood as well as your health. This is a helpful way to check how your daily activities may be affecting your mental health such as your diet, water intake, and exercise.

You can also check your progress through a graph to check how your mood changes according to changes in your daily activities and using the app’s features.

Each day you can update the app with your mood. The app will then give you access to a selection of activates which could improve your mood and help you manage your stress or anxiety.

These include:

  • Meditations
  • Relaxation Techniques
  • Daily Challenges (Small, achievable goals for that day)
  • Thoughts Journal
  • Community (discussions by other app users)

*Not SPR

Misconceptions of Anxiety Disorders

Anxiety Anxiety is kind of like that friend who you know has your best interests but is actually REALLY clingy and slightly obsessive

Anxiety is a natural emotional response to anything that our brain deems as being dangerous. Referred to as the ‘fight or flight’ response, it was most useful back in the stone ages to prevent yourself from becoming lunch for a hungry creature double your size.

Hormones, such as adrenaline, would prepare you physically to fight the creature or do a runner! In turn, this would make you feel more alert and ready your muscles for a WWE style smackdown or a Mo Farah run, which would hopefully stop you from becoming a human kebab!

Thankfully, we don’t have to worry as much about creatures trying to feast upon us these days.

But these reactions to potentially dangerous situations are still prevalent and sometimes for good reasons. Without anxiety, we would literally all live our lives like members of the Jack Ass team. As an emotion, it allows us to approach situations with a levelheaded outlook.

‘Hey, Bob, should I dangle my legs off this really tall cliff for the lol’s?’  

‘Hmm, not too sure about that Jim…Sounds dangerous to me’  

‘What’s the worst that could happen?’  

‘Well, you could slip and fall down the cliff to your death Jim’  

‘Yeah, that’s true Bob, better not try that then’

(In this situation, Bob is anxiety)

Anxiety will cause feelings of unease and fearfulness in many life situations from school exams and job interviews to illnesses or breakups. But for many people, these feelings will only be present during a small and reasonable length of time. These are normal emotional reactions that every person will and should feel.

An anxiety disorder refers to an exaggerated and prolonged response that affects an individual’s everyday life. It’s often hard for people to differentiate between suffering from an anxiety disorder or just undergoing a normal anxiety response because anxiety is such a common emotion.

But the two are very different.

There are many misconceptions about anxiety disorders and I’m going to talk about a few of the most common.

Only weak people get anxiety disorders.

You can be the strongest person in the world and still be struck down with an anxiety disorder. In all fairness, it’s usually the strongest and most confident people who suffer from anxiety disorders because they hide their emotions away. It’s a bit like kids films where someone would keep putting stuff under their bed and pretending it wasn’t there until the bed touched the bedroom ceiling.

People who suffer from mental health problems are often ashamed. Society has to lead us to believe we have to put a smile on our faces all the time and pretend to be something we are not. This leads to high levels of stress, which will eventually lead to anxiety disorders.

At this point, people are often left confused. ‘Oh, I never knew so and so was having such a hard time! I thought they were really strong’.

People deal with situations in very different ways. We don’t always know people’s stories or what their lives are truly like. Try not to judge.

Only people with anxiety disorders have panic attacks  

Panic attacks are a common symptom of high anxiety but are not always prominent with anxiety disorders. Specifically, anxiety disorders like Generalised Anxiety Disorder are more commonly diagnosed due to other less obvious symptoms such as insomnia, loss of appetite, and obsessive thoughts.

Panic attacks are a physical reaction to anxiety and regular panic attacks will usually lead to a diagnosis of Panic Disorder (an anxiety disorder which consists of excessive panic attacks). But as stated, they are not always a symptom of an anxiety disorder and a panic attack can happen with or without mental health problems being present (such as the first time someone performs on a stage).

Anxiety Disorders can only be treated with medication

Medication should always be a last resort when it comes to anxiety but you should always decide what works best for you. In the short term, anti-anxiety medication can help you to obtain a better mindset in order to use other techniques.

However, there are lots of alternative techniques that can be used to get on top of an anxiety disorder and medication will often have it’s own side effects which should always be discussed in length with your GP.

Medication free treatments include:

CBT (Cognitive Behavioural Therapy)

Mindfulness Meditation  

Counseling  

Breathing Techniques  

and Hypnosis (and others)

You should always fight anxiety!

Anxiety isn’t something you should fight against, but rather work alongside to control. When you fight anxiety, it often gets worse. Anxiety thinks it’s doing you a favour because, after all, it’s protecting you from ‘harm’. Specific treatments such as exposure therapy will allow you to face your fears a little every day and stay on top of your anxiety disorder.

Anxiety disorders are not easy to deal with. They often make you feel like you’re a prisoner to your own mind but getting the right help and support can allow you to do all the things you love and not feel as though your anxiety disorder defines you. You should never feel alone as 1 in 4 people in the UK will suffer from an anxiety disorder at some stage in their lives.

Keep strong!

Georgia OX

Mind http://www.mind.org.uk

Mood Juice http://www.moodjuice.scot.nhs.uk/anxiety.asp

The Alone Sibling: Dealing with Sibling Loss

1000205_10201530543682559_863423124_nAs a child, I couldn’t have imagined what life as an only child would be like.

A number of my cousins are only children. And although they knew no different, I almost felt sympathy for them. How lonely they must feel? With no one to play with, no one to tell their secrets to or moan about their parents with.

My brother and I were very close as children right through to the teenage years. We were also arch enemies, like most siblings. But through all the beatings and vicious insults, there was always an unbreakable bound and enough love to create world peace 5 times over.

We were best friends, although we wouldn’t have wanted to admit it. There wasn’t much we didn’t speak about. I think my brother was the only person in the world who could make me laugh so much I wet myself (literally). We encouraged each other’s confidence. We bitched about rude people and we would be the first to stick up for one another in a fight (I specifically remember almost reducing a boy to tears when I charged up to him in the school playground after he stole my brothers football).

Yeah, we were pretty much partners in crime.

One of my fondest memories of my brother was him riding down on his bike to my college so that he could walk with me home. (I would often have to bribe him with a Pot Noodle, but still)

The day I found out my brother had gone was single handedly the worst day of my life.

It was like the world had fallen from it’s axis and the ground had crumbled beneath my feet.

It’s strange all the small details that you remember. Like the wheel chair in the family room that specifically read ‘departures lounge’ on the back or the criss crossed button on my cardigan that I repeatedly ran my nail up and down whilst trying not to look at my devastated parents in the corner of the room. And the doctors face when he came into the room with a large group of medical professionals and told us they couldn’t save my brother.

All I can remember after that is falling to the floor as though the ground had dropped, sick to my stomach and crying so uncontrollable I honestly didn’t recognise the noise of my own screams.

All I wanted to do in that moment was go back to being a five year old child. I wanted my parents to sweep me up and tell me it was all OK and just a bad dream like the ones I had when I was younger. I wanted someone to tell me it was all a mistake, that normal, average families didn’t go through this loss. My naivety was so over powering. I felt like the smallest, most vulnerable creature in the world.

The weeks after were just a blur. For any one who has lost a sibling, you’ll know the swarms of people, both old and new who appear at your door step with flowers in hand, cards with well wishes and messages of condolence. And you’ll know that after a week to two after, when those flowers have begun to wilt and the everyday life once again resumes, those visits are far and few between. And suddenly, the daunting realisation that you are now completely alone with your grief hits you like the biggest wave you’ve even faced.

And those waves keep on hitting you, like a Tsunami that ceases to relent.

As a sibling, our grief is often not as noticeable to others. People will continually ask you how your parents are. They don’t mean this in a rude way, as though the are ignorant to the over bearing black cloud of grief that engulfs your head and hangs over you. It’s just they don’t know what else to ask you.

Let’s be honest, sibling grief isn’t widely spoken about. We don’t speak about the effect on an individual, how it changes their life’s for ever. Maybe we are frightened to speak about it. No one wants to image life without their sibling.

But that doesn’t mean our voices shouldn’t be heard.

This is the story of an alone child. How life can change in an instant.

It gets a little easier everyday, but everyday has its challenges.

And the reality of an alone child will always be with you, like a black crow sitting beside you. And occasionally it will consume you, the grief too hard to bear. But you will get through it. Because that’s the only choice us alone siblings have.