Young carers: sacrifice and support

While there has been a lot of conversation about the vulnerable over the last two years of the COVID-19 pandemic, and rightly so, there has not much attention given to the people who care for them, particularly the young people who do so. Young carers carry a lot on their shoulders, and this has only been increased with the impact of the pandemic affecting those they love. However, we also need to look out for these young people and give them the support they deserve.

Issues faced by young carers

Young carers are faced with many challenges due to their position and this can depend on the carers, their age, the level of care they give and who they care for. A report on siblings of disabled children from the UK charity Sibs found that the particular young carers they engaged with tended to not get as much attention and support from their parents because of their sibling needing more urgent care. Even something as simple as going out to play centres or restaurants must be adapted to fit the disabled sibling, with the carer sibling rarely getting their own choice.

Young carers have also been found to be at more risk of mental health problems than others, particularly if the person they are caring for is a parent with a mental illness or a history of substance misuse.  A study from Scotland found that young carers, much like adult unpaid carers, were more likely to have physical health issues such as tiredness, backache and bad diets in addition to reporting worry, stress, anxiety, depression and resentment. They were also found to have significantly lower self-esteem and feelings of happiness than non-carers.

Impact of pandemic

The COVID-19 pandemic impacted young carers greatly. Sibs reported that a lot of parents felt their carer children were extremely worried about contracting the virus and giving it to their sibling, or bringing it into the household if their family were shielding or vulnerable. Others also reported their child withdrawing from friends, either because of shielding or simply because they were uncomfortable socialising outside of their household. Sibs also noted cases where siblings would become the object of their disabled sibling’s anger or frustration.

In addition, a lot of activities and support groups normally put into place for these specific carers, in order to give them attention and opportunities to enjoy life outside of their role as a young carer, were cancelled due to COVID-19, and left many young carers at home, where they were often ignored if their sibling or parent needed additional support.

Other young carers have had to take on a range of duties, including shopping for their families or taking care of their home or other siblings. A lot of these young people have had to balance this with continuing their education from home and dealing with having their lives outside of the home cut off due to social distancing and isolation. This is on top of the general struggles of growing up as a child and adolescent. Izzy, a 12-year-old interviewed by a study from the Centre for Research on Children and Families, said she felt her entire life was “being a mini adult, but it’s not a pick and choose the time sort of thing.” 

Support

There have been a range of support services for young carers across the United Kingdom. Young carers groups have been found to be a great resource to help find other young carers and share some of the issues that affect them with people who understand. These groups  are also important as an outlet outside of their role in the family home, providing support  solely for  young carers. Even during the pandemic, some groups were able to schedule calls for young carers which provided them with interaction just for them, and something to look forward to each week at home.

However, many young carers remain “hidden” from services, either out of choice or because they have been ignored. Some simply don’t know about support groups or services, or have been found to not consider themselves ‘carers’. Instead, they  view their lives as “normal” or doing something that’s “expected” of them. Others may be afraid of the stigma their particular situation may bring them, and therefore want to be perceived as the same as their fellow students.

Final thoughts

The pandemic has pushed conversation and debate towards how we care for the most vulnerable in our society, and hopefully will lead to improvements in our attitudes towards care. However, this also has to extend towards unpaid carers, and particularly the young people who often shoulder invisible labour at the expense of their childhood.

Further reading: more from The Knowledge Exchange blog on carers

More than growing pains: young people and mental health

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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Digital Housing Week: How coronavirus is affecting housing

Throughout this week, Inside Housing magazine has been providing a series of webinars offering debate, learning and innovative thinking on how housing providers are responding to present-day challenges and preparing for future demands.

One of the webinars focused on the ways in which Covid-19 has accelerated the move to agile working for housing associations (HAs) and council staff, and how housing providers can tackle the  mental health and wellbeing issues experienced by staff and residents.

Responding to the new normal

Anita Khan, from Settle Housing Association in Hertfordshire explained how her HA responded to lockdown by mobilising its continuity plan. Settle’s first responsibility is to engage with and support its customers, and once the plan was enacted, agile behaviour took root.

Anita described how automated contacts with HA customers enabled it to identify which people were in isolation or shielding. At the same time, methods of enforcement had to change, as the UK government banned evictions. Anita explained that once the HA stopped sending messages warning customers of enforcement of the rules on rent payments, the residents started to engage more positively with it.

Working practices at Settle also changed substantially, with a move away from a face-to-face culture towards remote working. Anita described the process of change HA staff experienced, from relief at not having to make long commutes, followed by fatigue from too many video conferences, and more recently recalibrating to a situation that works.

Agile working in the age of coronavirus

Tony Morrison, an agile working consultant, described the measures taken by Newham Council  to modernise the way the local authority worked. He explained that in 2019, Newham got a new leadership team, and deployed a plan to make the first investment in IT for eight years. The aim was to make sure everyone was mobile by default, and to pivot a local authority with 14.5 million pieces of paper towards a paperless organisation. The plan was already under way when the lockdown was imposed.

Immediately, the council had to adapt to the new situation. Around three thousand members of staff didn’t have effective ways of working from home, and so the council identified who most needed assistance, and delivered laptops and mobile devices to these 500 individuals.

At same time, the council deployed Office 365 and migrated Skype for Business, and enabled staff to communicate with customers using Zoom.

Newham has now rolled out a further 2000 devices to staff, and it’s clear that the lockdown experience has demonstrated the possibilities of remote working.

The council is already looking to the post-pandemic period when it might not require so much expensive office space. Tony explained that now would not be the right time to consider disposal of offices because so many other organisations are in the same position. Instead, Newham is looking at alternative uses for its property estate, including cohabiting with other organisations, pop-up spaces and conversion to affordable housing.

Housing on the frontline of a mental health crisis

There’s now little doubt that the coronavirus pandemic is having a significant effect on mental health. With the loss of lives and livelihoods, and the growing demands for support from already overburdened health services, the fallout from the pandemic is likely to be on an unprecedented scale.

During the Inside Housing webinar, consultant psychiatrist Raj Persaud talked about the unique role housing can play in tackling mental health issues among staff and residents.

He noted that housing staff may be among the first to identify signs of mental illness among residents, because fewer people have been attending GP surgeries during the pandemic.

He suggested that housing staff in this position should raise such issues with community mental health teams. He also highlighted the importance of contacting NHS services by letter. Because letters are legal documents, health professionals are more likely to pay attention to issues raised in this way.

Raj highlighted a key issue housing staff can focus on when dealing with people who have mental health problems:

“Too often, the aim has been to concentrate on the causes of mental illness, but that misses out on the coping skills people have used in the past. The right skills can make a person super resilient, and so it’s always useful to engage in conversation about coping skills people have used for previous life events.”

All of the speakers in the webinar stressed the importance of the human factor in tackling the challenges raised by the coronavirus pandemic. Raj Persaud noted that, in the absence of the water cooler, the pub or the staff room, physical locations have to be recreated virtually. Doing this may feel clunky at first, but even if things don’t feel right, housing staff and others should persist until they find a method that suits them, and enables people to feel they are less isolated.

Final thoughts

One thing is certain: post-Covid will be very different from pre-Covid. But this webinar demonstrated that housing providers are embracing the fluidity of this situation. In an age of thinking differently, those who consider alternative solutions to the problems of the present may be better equipped for the challenges of the future.


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

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

Addressing social mobility through education – is it enough?

The Changing Room Initiative: tackling the stigma of poor mental health in men through sport

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

 

“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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The year that was: looking back on a year of policy and practice on The Knowledge Exchange blog

Before bidding farewell to 2017, there’s just time to reflect on some of the issues we’ve been covering in The Knowledge Exchange blog during the past twelve months. There’s been no shortage of subjects to consider, from health and social care and devolution to  universal credit and town planning.

Missing EU already?
Of course, the major issue dominating policy in the UK this year has been Brexit. In July, we reviewed a new book by Professor Janet Morphet which assessed the UK’s future outside the European Union. While not claiming to have all the answers, the book provides a framework for making sure the right questions are asked during the negotiation period and beyond.

One important consideration concerning Brexit is its potential impact on science, technology and innovation. In August, we noted that, while the UK government has been making efforts to lessen the concerns of researchers, anxieties remain about funding and the status of EU nationals currently working in science and technology roles in the UK.

Home thoughts, from home and abroad
Throughout the year, we’ve been looking at the UK’s chronic housing crisis. In May, we considered the potential for prefabricated housing to address housing shortages, while in August, we looked at the barriers facing older people looking to downsize from larger homes. In October, we reported on the growing interest in co-housing.

The severe shortage of affordable housing has had a significant impact on homelessness, and not only in the UK. In April, we highlighted a report which documented significant rises in the numbers of homeless people across Europe, including a 50% increase in homelessness in France, and a 75% increase in youth homelessness in Copenhagen.

One European country bucking this trend is Finland, and in July our blog looked at the country’s success in reducing long term homelessness and improving prevention services. Although the costs of Finland’s “housing first” approach are considerable, the results suggest that it’s paying off: the first seven years of the policy saw a 35% fall in long term homelessness.

Keeping mental health in mind
A speech by the prime minister on mental health at the start of the year reflected growing concerns about how we deal with mental illness and its impacts. Our first blog post of 2017 looked at efforts to support people experiencing mental health problems at work. As well as highlighting that stress is one of the biggest causes of long-term absence in the workplace, the article provided examples of innovative approaches to mental illness by the construction and social work sectors.

A further post, in August pointed to the importance of joining up housing and mental health services, while in September we explored concerns that mobile phone use may have negative effects on the mental health of young people.

Going digital
Another recurring theme in 2017 was the onward march of digital technologies. In June, we explored the reasons why the London Borough of Croydon was named Digital Council of the Year. New online services have generated very clear benefits: in-person visits to the council have been reduced by 30% each year, reducing staffing costs and increasing customer satisfaction from 57% to 98%.

Also in June, we reported on guidance published by the Royal Town Planning Institute on how planners can create an attractive environment for digital tech firms. Among its recommendations: planners should monitor the local economy to get a sense of what local growth industries are, and local authorities should employ someone to engage with local tech firms to find out how planning could help to better facilitate their growth.

Idox in focus
Last, but not least, we’ve continued to update our readers on new and continuing developments at the Idox Information Service. Our blog has featured articles on the Research Online, Evaluations Online and Ask-a-Researcher services, as well as the Social Policy and Practice database for evidence and research in social care. We were proud once again to sponsor the 2017 RTPI Research Excellence awards, and highlighted the winning entries. And following an office move, in September we explored the fascinating history behind the building where we now do business.

Back to the future
2018 is already shaping up as an important year in policy and practice. One important issue exercising both the public and private sectors is preparing for the General Data Protection Regulation. The Knowledge Exchange blog will be keeping an eye on this and many other issues, and the Idox Information Service, will be on hand to ensure our members are kept informed throughout 2018 and beyond.

Thank you for reading our blog posts in 2017, and we wish all of our readers a very Happy Christmas and a peaceful and prosperous New Year.


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

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

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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Three options DWP should explore in supporting those with poor mental health into work


Traffic cone with the text "works in progress".

By Steven McGinty

Last week, the UK government announced a new pilot scheme to support those with mental illness back into work. While similar to other government initiatives, this scheme has the unique selling point of offering treatment at an earlier stage, alongside employment support.

Like many of the government’s return to work policies, this might prove to be controversial. Many have expressed concerns over a comment from the Department for Work and Pensions (DWP) that suggests that counselling could become mandatory for those claiming benefits.  One of the most notable individuals to question this policy is Tom Pollard, Campaign and Policy Manager at Mind. He suggests that,

“If people are not getting access to the support they need, the government should address levels of funding for mental health services rather than putting even more pressure on those supported by benefits and not currently well enough to work.”

Although this pilot scheme has caused some heated debate, this is just one of the many ideas available to the government. Others include:

Aim High Routeback (Easington Pilot), County Durham

This pilot scheme was launched in 2005, as part of the Northern Way pilots, and was said to take a ‘health-first’ approach. The scheme was based in an NHS Primary Care Trust building, with participants focusing on the practical management of their health conditions, and employment only being discussed once individuals had started to make progress with their health. The project reported an above average return to work rate, in comparison with the other pilots. Interestingly, one of the key findings of the study was that participants were more likely to return to work if they felt like their health was ‘good or improving’.

JOBS II Model

This model was developed in the US and involves the use of peer led groups. The idea is that these groups can be used to support those with mental health problems back into employment, as well as prevent the negative health impacts which can arise from unemployment. The programme works on improving the jobseekers’ ability to search for work, as well as to cope with the setbacks of finding employment. The model has been found to be successful and has recently been recommended by the Department for Work and Pensions.

Mini-ICF-APP

This is a measure for assessing patients that was piloted by a community mental health team in Oxfordshire. The pilot involved asking new patients to fill in a 10 minute survey. This survey allowed medical staff to better assess the support needs of patients, as well as to identify their strengths and weaknesses. The staff were then able to offer more targeted referrals and interventions. For example, the use of cognitive behavioural therapy (CBT) or the tailoring of a patient’s medication. The pilot reported that this approach led to an improvement in outcomes for patients.

This is just a small sample of the research on improving the employment prospects of those with mental illness.

At Idox, our database contains all the research highlighted. We also provide an enquiry service, allowing members to receive the support of information professionals, as well as save time on their research.

Further reading (you may need to be a member to view some of these articles):