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

 

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