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All in the mind?

14 May 2018

As mental health awareness week gets underway, Danielle Thornton-Lee considers the growing concerns about mental ill health in children and young people. Is it becoming more prevalent, if so what are the causes and how do we know it’s not simply all in the mind? 

The statistics make stark reading: of the 11 million or so children in England, one in 10 has a diagnosable mental health problem.[1]

And of the one in four adults who experience a mental health problem, half of them will have begun experiencing those problems before they were 14 years old, and 75% before they were 18.[2]

While evidence is emerging that mental illness in young people is becoming more common[3], it’s unclear as to why.  Commentary abounds about the more recent impact on young minds of social media, including so-called cyber-bullying. Social media is also surely exacerbating the impact of traditional media (film, magazines, advertising) and celebrity culture which are associated with peer pressures relating to body image and the presentation of one’s young self generally.

Yet is there actually an increased prevalence of mental ill health or is it an increased awareness of its prevalence?  Either way, it’s becoming a growing challenge for the health and care sector with experts recognising that, where possible, early intervention is key to addressing this.

Despite that recognition, more than 70% of children and young people who experience mental health problems do not receive support soon enough[4], and the impact of their experiencing mental ill health is far-reaching. For young people, it means they may struggle to do well at school, integrate socially and adjust to working life.

Young people with behavioural problems may be six times more likely to die before the age of 30.[5]  And mental ill health has wider economic and societal effects, with annual costs to employers of between £33 billion and £42 billion, and £105 billion to the UK as a whole.[6]

From the No Health without Mental Health report in 2011[7], to Future in Mind in 2015[8], the Five Year Forward View for Mental Health [9] in 2016 and the Transforming Children and Young People’s Mental Health Provision green paper[10] currently open for consultation, the response to this rising threat has never been stronger, but could they go even further?

The causes of mental ill health are complex and the health and care system cannot respond alone. Education, employment, family and housing all play an equally important role, with children who grow up in deprivation nearly three-times more likely to develop problems.[11]

Do we need a multifaceted approach that truly puts young people at the centre?

Take for example, the Swedish youth policy bill ‘With a focus on young people – a policy for good living conditions, power and influence’.[12] This bill provides an overall objective for all decision-making agencies that have a responsibility for young people to consider, as one of three objectives, “mental health, where the focus is on promoting the mental health and welfare of young men and women”. So whether it be crime, housing, social care or wider welfare policy, the impact on young people’s mental health is central.

Clearly then, it’s not all in the mind.

Closer to home, what could we do if we truly joined up, not just across health and care, but across society as a whole?

There is already groundbreaking work going on in Leeds and the surrounding areas.

For example, in a first health marketing initiative of its kind, the Leeds MindMate website, set up to support children and young people’s mental wellbeing, features in one of the world’s most popular computer games – Football Manager. Led by NHS Leeds Clinical Commissioning Group, the MindMate Champion programme equips those working in children’s centres and schools with best practice skills to support children and young people’s mental wellbeing.

More young people in Leeds will be able to access specialist care closer to home thanks to a new, purpose-built specialist community child and adolescent mental health (CAMHS) unit to support young people suffering complex mental illness.

A new committee will bring together NHS mental health providers in West Yorkshire to improve mental health services for local communities.

At the Leeds Academic Health Partnership, one of the biggest partnerships of its kind in the UK, we have world-class expertise at our fingertips. Together, we’re exploring innovative ways to enhance and contribute to this work.

As the Swedish approach suggests, perhaps it’s time to take a step back and look at some of the wider socio-economic determinants of health outlined above, which are so intricately interdependent. After all, the evidence clearly demonstrates that mental ill health in children and young people is definitely not just all in the mind.

Danielle Thornton-Lee is Strategic Delivery and Business Manager at Leeds Academic Health Partnership. 













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