Tag Archives: anxiety

More than growing pains: young people and mental health

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woman sleeping on brown armchair

The last few decades have seen increasing rates of mental health disorders among children and young people. But while children and young people’s mental health is currently high on the public agenda, many of these mental health conditions remain unrecognised and untreated.

The NHS conducted a Mental Health Survey for Children and Young People in 2017, interviewing 3,667 children and young people, which was followed up in 2021. The follow-up survey found that 39.2% of 6 to 16 year olds had experienced a decrease in their mental health since 2017, while approximately 52% of 17 to 23 year olds also reported a decrease. Within these last four years, a number of factors appear to have impacted these figures, including the continued rise and prominence of social media platforms, family life, and, of course, the Coronavirus (COVID-19) pandemic.

Impact of the pandemic

The beginning of the pandemic marked the closure of all schools, colleges and universities. Not only were young people faced with the anxiety and stress associated with living through a global pandemic, particularly for those who are immunocompromised or have family members who are, but these closures also cut off access to resources for mental health problems. A survey by YoungMinds in January 2021 found that among over 2000 participants who were under the age of 25 in the UK with a history of mental illness, 75% agreed that they were finding the current lockdown harder to cope with than the previous ones, and 67% believed that the pandemic will have a long-term negative effect on their mental health.

Peer support groups and face to face services such as counselling that could be accessed through school were closed, or made accessible through the internet or over the phone. While this does offer some kind of continued support, it is not a form of support that works for everyone and many young people were left feeling unsupported. The YoungMinds report emphasised that any future provision must recognise the value of face to face interaction alongside virtual and digital forms of support.

Alongside issues with access to support, school closures  also disrupted routines, which for many people of all ages with mental health problems can be particularly important as a coping mechanism. It has been suggested that being unable to attend school or university in person, or part-time jobs, can lead to a relapse in symptoms where young people relied on these routines. Refusing to undertake typical daily activities such as showering, getting out of bed and eating sufficient meals are some of the effects seen amongst these young people – all which can exacerbate feelings of depression or loneliness.

Role of families

Families have been found to play a vital part in helping young people who are suffering from mental health issues. This has only become more apparent with the impact of COVID-19 lockdowns, where young people would most likely be living with their family – whether that be parents, siblings or other relatives or caregivers. Lockdown guidelines that mandated staying at home would leave these young people spending more time with their families, and the closure of other services outwith the home, meant these young people’s households often became their main support system. The NHS follow-up survey found that both family connectedness and family functioning were associated with mental disorder, highlighting the importance of supporting families to enable them to support young people’s mental health.

The Local Government Association has recently published a guide on a “whole household approach” to young people’s mental health, stressing the importance of educating families on how to support their young people. This is highlighted as particularly important when they transition from child services to adult services as many teenagers and young people struggle with the lack of support offered when they are legally considered adults.

Social media

Another big issue affecting young people’s mental health is the use of social media. While there are many reported benefits of social media, particularly in relation to connecting with others, there are also growing concerns about its effects on wellbeing and the pandemic has undoubtedly exacerbated this. The NHS survey found that, in 2021, half (50.7%) of 11-16 year olds agreed that they spent more time on social media than they meant to and 16.7% using social media agreed that the number of likes, comments and shares they received had an impact on their mood. Those with a probable mental disorder were particularly likely to spend more time on social media than they intended, and girls seem to be more affected that boys.

The survey found that 21.1% of girls reported that likes, comments and shares from social media affected their mood, compared to 12.1% of boys. It also found that double the number of girls than boys spent more time on social media than they meant to. Other research has also highlighted the disproportionate impact on young girls. One study found that constant social media use predicted lower wellbeing in girls only and that these mental health harms may be due to a combination of cyberbullying, and a lack of sleep or exercise. This was not found in the teenage boys interviewed.

Solutions

When addressing mental health problems, it is clear that a ‘one size fits all’ approach does not work. As highlighted in the research, mental health problems can present themselves in a range of ways, and depend on a number of variables.  People from different socio-economic and cultural backgrounds, or those with additional needs, often face more stigma and can find it more difficult to express their problems or access the correct support for their specific needs.

There have been suggestions for more targeted support for young people and the issues they may be facing, including more investment in schools and social services. Particularly for adolescents who are transitioning to adulthood, it is important to provide continuous support. As highlighted in the NHS Mental Health Survey, more adolescents and young adults (17 to 23 year olds) mentioned a decrease in their mental health than younger people (6 to 16 year olds). Children and Young People’s Mental Health Services (CYPMHS) notes that the transition from child to adult mental health services tends to begin around three to six months before the individual turns 18, although there can be flexibility.  Perhaps even greater flexibility is required, particularly as we assess the damage left by the pandemic. It is argued that engaging adolescents in the provision of mental health services and a shift towards early intervention and prevention will also be important as we look to build new solutions.

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Museums as facilitators of health and wellbeing in communities

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GNM Hancock, Newcastle

Great North Museum Hanckock, Copyright Rebecca Jackson

It’s estimated that there are over 2500 museums in the UK, ranging from world-famous collections in major cities to small local ones on niche themes. Over 50% of adults have visited a museum or gallery in the last year and there were an estimated 7.5 million visits by children and young people under the age of 18 to the major museums in England.

As well as their educational and leisure value, and their role as drivers of the tourism economy, there is a growing body of research which is considering the wider societal role of museums and in particular, their potential positive impact on health and wellbeing.

Museums and the rise of social prescribing

Within health and social care, we have seen increasing recognition and interest in the role of psycho-social and socio-economic determinants on health and wellbeing. Treatments now often look at the whole person and their lifestyle, not just at the specific medical condition to be treated. This awareness of the impact of lifestyle has led us to view spaces like museums and theatres in a new way and consider how they can be used as a tool to help people to live well.

March 14th was social prescribing day in the UK. And Museums on Prescription is one of a number of culture-led projects which encourage people to use assets in their local communities such as museums, galleries and theatres to help manage conditions linked to depression and social isolation, in combination with traditional clinical medicine.

Arts-for-health settings can have an impact across a number of different areas, including supporting children who have been exposed to trauma and abuse, helping communities integrate and improve social cohesion through the co-production of exhibitions, and helping support people with mental or cognitive illnesses, as well as those who suffer from dementia and Alzheimer’s.

V&A Dundee

V&A Dundee, Copyright Rebecca Jackson

Helping people feel better

As the number of projects increase so does the evidence of positive benefits. There is a growing body of literature highlighting examples of how cultural experiences are supporting both physical and mental health.

A report from Art Fund looking at the calming impact of museums and galleries found that 63% of people surveyed have (at some point) used a visit to a museum or gallery to ‘de-stress’, however, only 6% visit a museum or gallery regularly (at least once a month). Over two thirds of survey respondents (67%) agreed that taking time out for ourselves and choosing to pursue a leisure activity is good for our personal wellbeing and this is where museums and galleries, along with a whole host of other providers like theatres, music venues, public gardens and parks can step in.

Funding is a challenge

A report (2018) from the English Civic Museums Network highlights that services often deemed  “non-essential” (like museums and libraries) actually encourage and foster personal and communal resilience: they stop the crime, the illness, the loneliness from happening in the first place.

However, despite the significant and positive preventative role that participation in cultural activities can play, over the past five years spending on culture in England and Wales has fallen by over 30%, and this has had an impact on museums and the services they can provide.

Natural History Museum, London

Natural History Museum, London, Copyright Rebecca Jackson

Galleries and museums must keep striving to do more

The growing realisation of the potential of museums and galleries to have a positive impact on the health and wellbeing of communities presents a significant opportunity for them to develop programmes and exhibitions which reflect the diversity of experiences within communities and look to develop new ways to engage new audiences. Ensuring that people feel represented and that exhibitions appeal to a broad base of the community is also important in making sure people feel they are able to visit exhibitions and can feel the benefits of doing so.

In their 2015 report, the National Alliance for Museums, Health and Wellbeing, led by UCL, outlined the priorities of the alliance and showcased some examples of the work being done by partner organisations. In February 2019 it was announced that some schools in London are planning to give pupils “theatre vouchers” which entitles them to one free theatre visit per year. Museums themselves are also trying to do more to help engage members of the community and encourage them to engage with new exhibitions.

Are healthy people more culturally active, or does being culturally active make people healthier?

Museums and galleries have the potential to make an enormous contribution to improving people’s lives and enhancing physical health and mental wellbeing. The body of research around the role cultural activities like attending museums can have on health and wellbeing is growing, but there is still scope to do more, and work is ongoing with a number of high profile museums across the UK to promote the link between cultural activities and health and wellbeing.

The question of which comes first – being well initially which allows you be more culturally active, or cultural activities facilitating wellbeing in their own right – will be discussed and disputed by academics and clinicians. But the existing studies highlight the significant positive impact that engaging with museums and exhibitions has had on study participants, particularly those who suffer from mental ill health or degenerative cognitive diseases like dementia.

Museums and galleries, it is clear, have a far greater communal role to play and can evidence their value far beyond being a source of knowledge transfer or a leisure activity. Museum curators and funders need to recognise this as they prepare and plan for exhibitions and outreach projects in the future and clinicians need to be aware of the potential positive impacts for patients when considering care and treatment plans.

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“For many children we are the first point of contact”: supporting children’s mental health in schools

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A 2018 evidence review from Public Health England reported that one in 10 young people have some form of diagnosable mental health condition. This, the report suggests, equates to as many as 850,000 children and young people with a diagnosable mental health disorder in the UK. It also reported that half of all mental health problems emerge before the age of 14, and children with persistent mental health problems face unequal chances in life.

Research has also highlighted the impact of “key factors” like poverty and adverse childhood experiences (ACEs), including emotional trauma, abuse or neglect (which people living in higher areas of deprivation are more likely to experience) on an individual’s chance of developing a mental illness. However, an additional factor often cited in surveys around child mental health and wellbeing is the impact of school, including exam stress, and bullying. Mental ill health has also been found to have an impact on attainment, behaviour and a child’s ability to learn. As a result, teachers are often part of the front line of supporting adults for children who are suffering from mental ill health, with increasing pressure being placed on teachers and schools to identify and signpost children to other services.

Schools, as well as teachers,  are increasingly becoming a focus for the delivery of Child and Adolescent Mental Health Services (CAMHS) in their community. Often schools are at the centre of their local community, so it is logistically convenient to coordinate services there; it can for some be a less intimidating or stigmatising environment than attending a clinic at a GP surgery, for example. School is the primary developmental space that children encounter after their family, and children’s learning and development and their mental health are often interrelated, so it makes sense for teachers to take an interest in terms of attainment and progress in learning. In December 2017, the Department of Health and Department for Education (DfE) published the Green Paper Transforming children and young people’s mental health provision which highlighted the role of schools as key in promoting a positive message about mental health and wellbeing among school age children and young people.

Good work is already being done, but how can we do more?

Research has shown that there is already a lot of good and effective practice being done in schools around children’s mental health. Many schools already work in partnership with local health teams to provide in house CAMHS support in the form of mental health nurses and social workers who are posted on site for children to access. One of the major recommendations in a 2018 Audit Scotland report on child mental health in Scotland was to encourage more of this type of partnership working. The report stressed the importance of joint working between public services if child mental health is to be improved, and where possible to include as wide a spectrum of public services in the delivery of CAMHS support, including criminal justice and housing practitioners, as well as health and social care and education staff.

In some schools senior pupils and designated members of staff are being offered mental health first aid training, and wear lanyards to help students identify them should they ever need to talk to someone. While it is important – particularly for students who participate in mental health first aid programmes – to be made aware of the challenges the role may entail, it can be a rewarding experience for young people to participate in and can also be a vital in-road to support for some students who would otherwise feel uncomfortable talking to a member of staff.

Other programmes like those developed by the Anna Freud National Centre for Children and Families, Centre for Mental Health and the ICE PACK and Kitbag tools (which have been used widely in UK schools) look at resilience building  and promoting coping mechanisms among young people, as well as encouraging the creation of trusting relationships which focus on nurturing and normalising mental illness to encourage children and young people to feel comfortable discussing their feelings and thoughts. These programmes also integrate early intervention and prevention approaches, hoping to identify children and young people who are suffering from mental illness as early as possible and signpost them to appropriate support.

The specific role of teachers

Teachers need to remember that they are not health or social care professionals and that – as much as they would like to completely solve all of the problems of their students – they can only do what they can, and that is enough.

It is also very important for teachers to practise what they preach in as much as teacher self-care is as important as signposting children and young people who are struggling with mental health issues. A 2016 survey by the National Union of Teachers (NUT) found almost half of teachers had sought help from their doctor for stress-related condition. Teacher stress and burnout and those leaving the profession due to conditions like stress do not help to create an environment that is supportive of good mental health in the classroom. Teacher wellbeing is so important and building their own resilience is one way that teachers can start to embed good mental health in their practice. If you are doing it yourself it will be easier to help and show children how to do it if they come to you for advice!

Teachers simply being there and offering a safe space and first point of contact for many children is important. Listening and signposting can be so valuable for those pupils taking the first step and teachers should not be put off by any personal perception of a lack of expertise in mental health – a small amount of knowledge or understanding of what to do next is more than enough. In some respects, teachers should feel almost privileged that a student has chosen to come to them, someone they feel they can trust and talk to.

A poll conducted as part of a webinar held for educational practitioners found that rather than requiring more information about mental illness, what teachers actually wanted was more practical examples of how to apply support in the classroom and how to embed mental health into their teaching and the learning of their students.

A unique opportunity

Schools and teachers are on the front line of public services and have a unique opportunity through regular contact with children to help to build and promote resilience among pupils, and embedding this within the whole school can be an effective way of ensuring pupils feel the benefit without being singled out. Taking nurturing approaches to learning and teaching, and promoting the creation of trusting relationships is key to some of the already effective practice going on in schools. Sharing the learning and best practice that is already happening will be vital to ensuring that support for children suffering from mental ill health improves and adapts to changing needs in the future.

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Writing and recovery: creative writing as a response to mental ill health

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Writing and recovery: creative writing as a response to mental ill health

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“You don’t put yourself into what you write, you find yourself there.”
Alan Bennett

Mental illness, for so long regarded as secondary to physical health, is now being taken more seriously. Media stories about loneliness, anxiety and depression have highlighted increasing concerns about mental ill health, and the issue has also been rising up the political agenda.

In 2017, a survey by the Mental Health Foundation found that only a small minority of people (13%) reported living with high levels of good mental health, and nearly two-thirds of people said that they had experienced a mental health problem.

Prescribed medication is one response to mental health problems, and it’s been reported that the NHS is prescribing record numbers of antidepressants.  But while psychiatric drugs can be of real value to patients, especially those whose condition is very severe, the mental health charity Mind has suggested that alternatives, such as physical exercise, talking therapies and arts therapies, are often more beneficial.

Last month, a conference at the University of Glasgow explored ways in which creative writing is being used to respond to mental ill health, and discussed what makes writing interventions helpful for coping and recovery.

Voices of experience: coping and recovery through writing

“Making and consuming art lifts our spirits and keeps us sane”.
Grayson Perry

Several speakers at the Glasgow conference testified to the effectiveness of writing in dealing with mental ill health and in finding a way to recovery.

In 2012, James Withey experienced a set of circumstances which brought him close to taking his own life. In the darkness of his depression, James felt that he might never recover. But after spending time at Maytree, the UK’s first “sanctuary for the suicidal”, he found that writing about what he was going through offered an antidote to the lies being spun by his depression.

He started a blog, and when he posted a letter to himself, beginning “Dear You.” James found that writing the letter gave him space to express his feelings and to listen to himself.

Before long, readers of James’s blog were responding with their own “Dear You” letters. The word spread that the letters offered a different perspective on recovery, and in some instances, had prevented suicide.

Today, The Recovery Letters project is still going strong, with a website, one published book and another in the pipeline. James is realistic about the project:

“The letters are not a cure for a chronic illness, but they do provide support in helping sufferers of depression accept where they are.”

Policy positions: the view from Wales

“If poetry and the arts do anything, they can fortify your inner life, your inwardness.”
Seamus Heaney

Another speaker at the conference was Frances Williams, a PhD candidate at Manchester Metropolitan University, where she is studying arts and health. In her presentation, Frances explored some of the policy frameworks and public discourse surrounding the field of therapeutic writing in Wales.

She highlighted a recent report, Creative Health, The Arts, Health and Well-being, which  makes a case for the healing power of the arts in many different healthcare and community contexts.  In this report, a creative writing tutor explained some of the ways in which writing can help people experiencing bereavement, including keeping a journal, writing unsent letters, describing personal belongings and resolving unfinished conversations:

“Writing can be a valuable means of self-help, with the page as a listening friend, available any time of the day or night, hearing whatever the writer wants to say. The results of this can be powerful, and include people being able to return to work and adjust more effectively after their loss, acquiring skills for their own self-care which will serve them through the rest of their life.”

Frances also noted that the battle of priorities between impact and value-for-money has driven advocates of arts therapy programmes to defend them in terms of cost effectiveness and social value.

A mapping project by the Arts Council of Wales has taken this to heart, producing in 2018 an audit of the principal arts and health activities currently taking place in Wales.

Writing to the rescue

“By writing, I rescue myself”
William Carlos Williams

The Glasgow University conference underlined the health-giving properties of creative activities and the potential for creative writing to support people suffering with mental ill health. There was no pretence that writing offers a quick-fix solution. As James Withey noted, “…writing is just one element in a toolkit of responses to mental ill health.”

The All-Party Parliamentary Group on Arts, Health and Wellbeing fully supports this concept, and has recommended that policymakers recognise its importance:

“…the arts can make an invaluable contribution to a healthy and health-creating society. They offer a potential resource that should be embraced in health and social care systems which are under great pressure and in need of fresh thinking and cost-effective methods. Policy should work towards creative activity being part of all our lives.”

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Are smartphones damaging young people’s mental health?

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by Stacey Dingwall

Last week saw the launch of Universities UK’s #stepchange campaign – a framework that aims to help universities support the mental wellbeing of their student populations. In their case for action as to why the framework was needed, the organisation noted that recent years have seen an increase in the number of student suicides in the UK and the US, as well as an increase in the number of students reporting mental health issues.

Both countries rank in the top 10 in terms of smartphone users across the world, with close to 70% of each country’s population being smartphone owners. And within that percentage, 18-24 year olds are the highest using age group.

Smartphone dependence and its impact

Earlier this year, the Royal Society for Public Health (RSPH) released a report that looked at the impact that the ubiquity of smartphones is having on young people’s mental health, focusing on their social media activity. Some of the headline figures from the report include the fact that over 90% of the 16-24 age group use the internet for social media, primarily via their phones. It is also noted that the number of people with at least one social media profile increased from 22% to 89% between 2007 and 2016. Also on the increase? The number of people experiencing mental health issues including anxiety and depression.

Can rising anxiety and depression rates really be linked to increased internet and smartphone use? The RSPH report notes that social media use has been linked to both, alongside having a detrimental impact on sleeping patterns, due to the blue light emitted by smartphones. This point came from a study carried out at Harvard, which looked at the impact of artificial lighting on circadian rhythms. While the study focused on the link between exposure to light at night and conditions including diabetes, it also noted an impact on sleep duration and melatonin secretion – both of which are linked to inducing depressive symptoms.

So what’s the answer? Smartphones aren’t going away anytime soon, as seen in the excitement that greets every new edition of the iPhone, a decade on from its launch. With children now being as young as 10 when they receive their first smartphone, parents obviously have a role in moderating use. This inevitably becomes more difficult as children grow up, however, and factors such as peer pressure come into play. And it’s also worth acknowledging that heavy smartphone use isn’t restricted to the younger generation – their parents are just as addicted as they are.

Supporting children and young people

In February Childline released figures which stated that they carried out over 92,000 counselling sessions with children and young people about their mental health and wellbeing in 2015-16 – equivalent to one every 11 minutes. Although technology clearly has its impact – the helpline has also reported a significant increase in the number of sessions it carries out in relation to cyberbullying – the blame can’t be laid completely at its door. Although the world has gone through turbulent times in the past, it’s been well documented recently that today’s young people have it worse than their parents’ generation, particularly in terms of home ownership and job stability. Others have pointed towards a loss of community connections in society, and children spending less time outdoors than previous generations – not only due to devices that keep them indoors but also hypervigilant parents.

In fact, perhaps we hear more about mental health issues experienced by children and young people because smartphones and social media have given them an outlet to express their feelings – something previous generations didn’t have the ability to do. What we should be focusing on is how to respond to these expressions – something we’re still not getting right, despite countless reports and articles making recommendations to governments on how they can do better in this area.

Follow us on Twitter to see what developments in public and social policy are interesting our research team. If you found this article interesting, you may also like to read our other articles on mental health.

Mindfulness in schools: does it work?

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by Stacey Dingwall

Over the last couple of years, the concept of being mindful has almost become a buzzword. However, mindfulness has actually been around since the 16th century, before being developed as a modern day western Buddhist practice from the 1970s.

Transform your life?

On the 17th of March, along with almost 400 other people, I attended the Transform Your Life event at Glasgow’s Trades Hall. The event was organised by the Kadampa Meditation Centre (KMC) in Glasgow, a Buddhist temple which opened in 2013 with the aim of providing a space for people to learn how to meditate and practise Buddhism.

The talk was delivered by Gen Dao, a senior Kadampa teacher who has been ordained for over 20 years, teaching at centres in America and Australia before taking up her current post as principle teacher at KMC Liverpool. Its focus was on equipping attendants with the ability to cope with everyday stresses and anxieties, by applying some simple meditation and mindfulness techniques.

After demonstrating a basic breathing technique, Gen Dao opened her talk by commenting on how prevalent mindfulness has become, noting that it is now used as a management technique and as a means of selling women’s magazines. She spoke about the benefits of using mindfulness not only on a personal level, but also how actively improving your mind can awaken the potential to bring benefit to others. Mindfulness, she explained, was essentially just remembering to breathe, and trying to focus on experiencing only positive states of mind.

The remainder of Gen Dao’s talk concentrated on the importance of mastering the ability to ‘oppose’ negative thoughts, and making the decision to be content and happy, without the intervention of others. Also highlighted was the need to strive for ‘patient acceptance’, or the ability to give up on the feeling that things in your life should be different – instead, we should learn how to view our feelings from a more detached perspective, and not identify with painful feelings, or “bad weather” in the mind.

Speaking to Gen Dao after the talk, I raised the point that, although not a physical pursuit, mindfulness is something that you have to train in, and learning to adapt to a new way of thinking is something that could take some time. Essentially, adopting a mindful outlook could mean changing the habits of a lifetime.

Mindfulness in the classroom

This could explain why some schools are now incorporating mindfulness exercises into classes, in order to prepare young people for the future. Last July, BBC News reported on the first large-scale trial of mindfulness exercises in schools across the UK conducted by the Wellcome Trust, during which researchers will look at whether introducing mindfulness at an early age can help build psychological resilience. The exercises, which will include deep breathing and a practice called ‘thought buses’ in which participants will be taught to see their thoughts as buses that they can either get on or allow to pass by, are designed to show children how to live in the present and eventually, equip them with the ability to solve problems while under stress.

The study will involve around 6,000 children and young people; a considerably larger amount than have taken part in previous evaluations of the impact of mindfulness in schools. While the existing evidence is currently described as limited, these smaller studies have indicated that mindfulness interventions with children and young people do have some success in generating lower stress levels and a greater sense of wellbeing among participants. These findings are important, given that a recent survey of school leaders by the Association of School and College Leaders found that 55% of respondents reported a significant increase in the number of young people in their schools who are dealing with anxiety and stress.

Case study: Mindfulness in Schools Project

The Mindfulness in Schools Project (MiSP) was founded in 2007 by former teachers Richard Burnett and Chris Cullen. Having experienced the benefits of mindfulness themselves, they developed “.B”, a 9-week course that aims to make mindfulness accessible, and fun, for secondary school pupils. The course, which has also been adapted for younger children as Paws B, is now being taught in twelve countries, including the UK. Teachers and pupils who have used the programme report on its ability to restore calm to a class after break, for example, or to calm pupils down at times of particular stress, such as exams or performances. It has also been suggested that the programme can help to improve pupils’ ability to concentrate.

Critics of the impact of mindfulness in the classroom argue that these results cannot be relied on, due to the experiments taking place outside of the boundaries of a randomised controlled trial. They also point to the possibility that participants’ ability to concentrate may only have improved due to their being informed that this is what the exercises are designed to do. Richard Burnett has openly recognised the limits of mindfulness himself, emphasising that it cannot replace the fact that some people require medication and clinical care to deal with their condition, and is more effective in smaller groups supervised by medically trained professionals. Trainers delivering the programme are also open about the fact that mindfulness is not something that will work for every child. What it can do, however, is provide a reminder to breathe when things get too much – something that can surely only be a positive for everyone.

If you enjoyed this post you may be interested in our previous commentary on mental health issues:

Ecotherapy in practice: nature based mental health care

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Ecotherapy, also known as nature-based or green care is an alternative therapy for people suffering from mental health issues. It can be delivered as an individual treatment or in combination with traditional medicinal and talking-based treatments. Charities and research has suggested that it can reduce depression, anger, anxiety and stress as well as improving self-esteem and increasing emotional resilience.

Spessartbach

The mental health charity MIND emphasises the positive health benefits, commenting that ecotherapy:

  • is accessible
  • can take place in both urban and rural settings in parks, gardens, farms and woodlands
  • works through people either working in nature or experiencing nature

It can be structured or more informal, with some areas providing therapist led classes while elements of ecotherapy, such as taking walks or gardening, can also be done without specialist supervision, on your own or with family members and friends.

AAT and AAI (Animal Assisted Interventions and Animal Assisted Therapy)

This form of therapy uses guided contact with animals such as horses or dogs. It is becoming increasingly popular in university settings, with dog cafes or dog rooms during student mental health weeks or during exam times to help alleviate student exam stress. Pet therapy has also been shown to be effective with children and young people who suffer from anxiety or who have experienced trauma, and for elderly people suffering from dementia.

Therapy could be one to one or in a group and could also be delivered to people who are in residential care setting. AAT can also be used to assist mobility and coordination or simply to spend relaxed time with animals where patients can feed or pet them. This interaction can promote bonding between the individual and animal which has been found to reduce stress and anxiety.

Nature Arts and Craft Therapy

Nature based art therapy takes inspiration from nature to create and provide materials to create art work. This type of therapy can also include social and therapeutic horticulture (STH). This can be a particularly effective form of nature based intervention as it can be adapted to suit a wide range of mobility and abilities and could potentially lead to work experience or the sale of goods created, which in itself can build self-confidence and transferable skills.

Adventure Therapy

This therapy focusses on using physical activities to encourage psychological support, It includes activities such as rafting, rock climbing and caving. Often done in a group, this type of therapy aims to build trust and raise confidence. While it can be strenuous, less able individuals can take part in green exercise therapy, which largely includes walks and rambling, or wilderness therapy (which includes physical group and team activities such as making shelters and hiking).

Effectiveness of ecotherapy

In February 2016, Natural England published A review of nature-based interventions for mental health care, which considered the benefits and outcomes of approaches to green care or ecotherapy for mental ill health.

One of the main challenges the report highlights is to increase the availability of green therapies in order to make the practice more normalised within treatment. The authors also speak about the importance of standardising the use of terms such as ‘ecotherapy’, ‘green care’ and ‘nurture based interventions’ to allow people to fully understand what different interventions entail. The report makes nine recommendations, including:

  • expanding the evidence base around green therapy
  • increasing the scale of commissioning of green care initiatives
  • increasing collaboration between the green care sector and health and social care practitioners

Ecotherapy is still not widely accepted as a mainstream approach to mental health treatment. However, it is increasingly being offered as a combination therapy alongside traditional drug-or talking-based interventions. Advocates of ecotherapy hope that this will lead to wider acceptance of the approach and the positive effect it can have on people who suffer from mental ill health.

Advocates emphasise the holistic and person-centred benefits of ecotherapy, which has been shown to improve physical health as well as mental wellbeing. As the video below demonstrates, it increases social skills and in many instances can help people build new or develop existing skills which can help them enter, or re-enter employment. Potentially this may also reduce the burden on care and community mental health services.

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The way forward for mental health services for children and young people

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Black and white photo of young girl.

Image courtesy of Flickr user darcyadelaide using a Creative Commons license

By Steven McGinty

“Not fit for purpose” and “stuck in the dark ages”

These are two of the phrases used by the Care Minister, Norman Lamb, to describe mental health services for children and young people in England. The minister admitted that young people are being let down by the current system and has announced that a new taskforce will look into how the system should be improved.  To coincide with this review, I decided to look at the current situation for children and young people with mental illness, as well as highlight some of the main themes from the latest evidence.

The Office for National Statistics (ONS) reports that one in ten children and young people (aged 5-16) have a clinically diagnosed mental health disorder. This covers a broad range of disorders, including emotional disorders, such as anxiety and depression, as well as less common disorders such as autism spectrum disorders (ASD) and eating disorders. Approximately 2% of these young people will have more than one mental disorder. The most common combinations of disorders are conduct and emotional disorders and conduct and hyperkinetic disorders.

The likelihood of a young person developing a mental disorder is increased depending on a number of individual and family/ social factors. There are a whole range of risk factors, but some of these include:

  • having a parent in prison
  • experiencing abuse or neglect
  • having a parent with a mental health condition
  • having an autistic spectrum disorder (ASD)

It’s important to note that mental illness is complex, and that not everyone in these risk groups will struggle with it. This is particularly true when a young person is in receipt of consistent long-term support from at least one adult.

The impact of mental illness can be particularly difficult for young people. For instance, the National Child and Adolescent Mental Health Service (CAMHS) Support Service reported that young people who suffer from anxiety in childhood are 3.5 times more likely to suffer from depression or anxiety in adulthood. There is also an increased chance of young people coming into contact with the criminal justice system, with Young et al highlighting that 43% of young people in prison have attention deficit hyperactivity disorder (ADHD). The Centre for Mental Health also suggests that young people with mental health problems struggle to achieve academically, as well as in the employment market.

When a government minister condemns his own department, it’s evident that there are severe problems.  However, this does not have to be the case.

Below I’ve outlined some of the key lessons to come from evidence on what makes a good mental health service for children and young people.

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Managing mental ill health in the workplace

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Laptop and coffee mug photoBy Donna Gardiner

As one in six employees will suffer from mental ill health at some point during their working lives, ensuring the wellbeing of employees is increasingly becoming a management priority (EU-OSHA, 2014). Indeed, the financial cost to British business of mental ill health has been estimated at £26 billion per year – which is equivalent to £1035 for every employee.

A public sector problem?

Mental ill health is particularly prevalent among public sector workers. According to the latest Chartered Institute of Personnel and Development (CIPD) absence management report, 60% of public sector organisations reported an increase in mental health conditions such as anxiety and depression among employees over the previous 12 months. This is compared to 38% of private sector organisations and 37% of non-profit organisations. Public sector organisations were also more likely to report that stress-related absence had increased among the workforce as a whole (55% compared to 38% of private organisations and 39% of non-profit organisations).

Considerable organisational change and restructuring was one of the most commonly reported causes of work-related stress, followed by workload. Both of these could be viewed as knock-on effects of budget cuts caused by the economic recession, the current drive towards public sector transformation and the increasing need to ‘do more with less’.

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How should we address loneliness and social isolation among older people?

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For elderly men sitting on a bench

Image courtesy of http://goo.gl/A8ykMA using a Creative Commons licence.

By Steven McGinty

“Loneliness and the feeling of being unwanted, is the most terrible poverty“– Mother Teresa

Yet, for many older people, loneliness and social isolation are the normal state of affairs. A recent study by the Office for National Statistics (ONS) found that 34% of people aged 52 and over felt lonely often or sometimes, with this figure reaching 46% for people aged 80 or over. Rather worryingly, a report by Age UK also suggested that over half of older people consider the television as their main source of company.

In many respects, these figures may not be too surprising, with some arguing that this is simply the by-product of changing societal attitudes. Conversely, it could also be said that these changes are a response to the demands of busy modern life. For example, a report published by the Royal Voluntary Service highlights that, because of uncertainty in the job market, many children have to move away from their parents for work reasons. The impact of this is that many older people are seeing their families less and less, with 48% of parents only seeing their children once every two to six months. Continue reading →