If you missed this BBC documentary, here is the link to catch up with Dr Chris van Tulleken as he investigates whether there are alternative treatments to drugs (in particular Calpol) to treat our children. He focuses on a small group of children who are medicated for Attention Deficit and Hyperactivity Disorder, otherwise known as ADHD. https://www.bbc.co.uk/iplayer/episode/b0b4jjq3/the-doctor-who-gave-up-drugs-series-2-episode-1
Category: Children Therapy
Schools and colleges are to be given the incentive to appoint a designated “senior lead” for developing a ‘whole school approach to mental health. Their role will be co-ordinate support services, provide pastoral care, support school policy and facilitate access to specialist therapies and NHS services for children. According to a green paper which is to be published on Monday, proposals will enable children in England to access mental health in schools and colleges with £300 million in additional funding over the next three years.
Included in the proposal, new mental health support teams are to improve pathways between schools and the NHS to offer specialist support and treatment. Reduction in waiting times for NHS services, mental health awareness training in schools are also planned.
If planned and delivered effectively, the proposal is a step forward. Hopefully sufficient funding will be allocated to provide consistent, on-going high quality specialist mental health support by a skilled designated senior lead. It would be essential to develop clear care pathways enabling children rapid access to specialist mental health services.
Sexting involves sending a sexual text, image (nudes) or video. Once you send out an image though, you can’t control what happens to it. Consequently, sexting can lead you to feelings of exposure, anxiety, embarrassment and guilt. It can also lead to bullying, blackmail and harm. If you’re under age 18, sexting is illegal and it remains illegal even when the person in the image, text or video turns past age 18, if the image was taken when the person was under age 18.
If you are passed on a sexual image or video THINK BEFORE YOU SEND… DON’T SHARE….. DON’T PASS IT ON! Instead think about how the person in the sext might feel if other people saw their image or the video. What could the consequences be for them? For you? Be aware.
If you wish to get an explicit image removed, you can report the image to the hosting site and Net Aware give information about reporting to social media providers. You can also notify CEOP (Child Exploitation and Online Protection) of the incident if the person may be at risk of harm.
Childline and the NSPCC at http://www.nspcc.org.uk offer practical and legal advice about sexting and other issues like bullying, online grooming, sex and how to look after your digital footprint.
Click on this video link to view a video by Childline which offers practical advice about sexting. If you want to learn more about sexting or want to talk to someone about it, you can call Childline free on 0800 1111. You can also download the Zipit app at https://www.childline.org.uk
Art therapy techniques combined with play is effective in children’s counselling.
Art therapy is a form of psychotherapy and it uses art and media as a tool for expression. Its use of visual media makes it successful form of expression and communication with adults and children, especially with people who experience verbal communication difficulties and disabilities. It is also used as a medium with people with neurological problems, mental health, emotional and behavioural issues, neurological conditions and physical illness. It uses creative methods to improve a person’s emotional wellbeing, enhance cognitive abilities, manage stress and promote self-development. Art therapy does not require a client to have any artistic training, rather its techniques rely on the exploration of the properties of a wide variety of materials such as paint, clay, chalks and markers and the use of symbolism and imagery. The image can provide a safe boundary to enable the process of exploration without necessarily involving talking therapies or language, but in so doing can enhance and promote talking.
Art therapists are required to undergo training in psychological theories, clinical practice and human development. The profession has developed from a psychoanalytical and psychodynamic model to embrace cognitive therapies, neuroscience, mindfulness and mentalisation-based techniques. The training is postgraduate and the profession is state regulated by the Health and Care Professions Council (HCPC). Art Therapy is promoted in the UK by the British Association of Art Therapists (BAAT) which provides support, advice and an Art Therapy Practice Research Network for members.
So, teachers in secondary schools are to receive mental health training! £200,000 has been pledged by a Government funded scheme known as Mental Health First Aid and the scheme will also be rolled out into primary schools by 2022. It is fair to say that teachers are on the front line, not just for safeguarding, but additionally for helping to build resilience in children and young people.
Evidence given in a recent report on Social media and children’s mental health by the Education Policy Institute, demonstrates that 37.3% of UK 15 year olds are classed as extreme internet users (6+ hours daily). Evidence of the correlation between extreme internet use and the harmful effects on young people’s well-being makes teachers uniquely well placed to educate about the strong links between periods spent on social media and mental health and well-being problems. Especially to raise their concerns about vulnerable pupils or pupils who are exposed to problems relating to their mental and emotional well-being.
It is also fair to say that the government should ‘get real’ about the mental health problems facing children and young people. Talking therapies are in desperately short supply and underfunded, specialist services, like CAMHS, have long waiting lists. Dumping the problem onto teachers is a pitifully inadequate way to tackle serious mental health issues affecting our young and which require much more specialist input than schools-based first aid. Teachers already have overwhelming workloads and schedules and are driven to attain high targets. Target crunching is not the mind set required to understand and deal with mental health problems. To expect teachers to be able to recognise and cope with mental health issues as well, is not only naïve but it undermines the skill and experience of a properly trained mental health professional. How would a teacher be expected to have the time or skills to successfully deal with a child or young person with a full blown psychosis or offer counselling support to a suicidal teenager?
Funding needs to be pumped into specialist mental health services for children and young people so that trained and skilled mental health professionals can meet the needs of children and young people with emotional and mental health problems. Meanwhile, let the teachers get on with what they are trained to do, and do best, which is to educate.
In a climate of deepening NHS crisis, it is heartening news that the PM is talking about making an investment in mental health services and even addressing the issue of ‘parity’. Whether or not it is a question of ‘hard’ or ‘soft’ parity, one certainty is the fact that there needs to be new Treasury money for these investment plans. Professor Sir Simon Wessely, Regis Professor of Psychiatry at the Royal College Of Psychiatrists states that there is a need for more specialist mental health workers, Child and Adolescent Psychiatrists, nurses etc. “We have a long way to go before mental health services are on an equal footing with those for physical disorders.”
The reality is that almost 250,000 children and young people and children aged 18 and under receive treatment by specialist NHS support services each month and this is probably just the tip of the iceberg. Child and Adolescent Mental Health Services (CAMHS) account for just 0.7% of NHS spending and approximately 6.4% of mental health spending, therefore Clinical Commissioning Groups (CCG’s) will be using some of the 1.4 billion that has been allocated by ministers to improve mental health services for young people. Some mental health charities argue that just how much of this funding actually reaches frontline services is debatable. It is a great pledge, but the capacity for CAMHS to provide support is limited because their services are already overstretched with long waiting lists and high threshold levels for treatment which means that many children are being turned away from services.
Jeremy Hunt, Health Secretary has said that care for children and young people is a “black spot” needing urgent attention as the pressures of social media, cyber bullying and a big increase in self-harming is a “massive worry for parents”. He pledges that he will improve diagnosis and treatment of mental health conditions and put specialists in schools with a proposal that CAMHS and schools work closely together and for more schools to have a CAMHS specialist.
The Mental health charity Sane states that these plans need to “be matched by substantially increased funds to mental health trusts”. Mind said it is “important to see the prime minister talking about mental health” but the difference it made to patients’ day-to-day experiences would be proof.
Teresa May has pledged to help CAMHS by investing £250 million more and by offering mental health first aid training to teachers to recognise symptoms of distress. This puts teachers on the frontline when they already have heavy workloads and are driven by a target led culture that is judged by rigorous observations and inspections. The prospect of Ofsted monitored mental health support provided by schools adds further pressure. An outcome of outstanding, good or requiring improvement is not an appropriate approach to dealing with young people’s mental health issues. The focus needs to be entirely on recognition and sensitive understanding of the needs of the individual child and young person and how they are rapidly going to get the vital support required before self-harm occurs.
Recognition of mental health disorders can require a trained eye and skilled personnel are able to recognise and deal with mental health issues to ensure clear and rapid signposting to the relevant service.
In the UK, approximately 300,000 children and young people are known to experience a form of anxiety. There are notable increases in adolescent self-harm, reported cyberbullying and a significant rise in the number of young women with emotional difficulties. Overall, there has been a marked increase in the severity and complexity young people’s problems while children and adolescent mental health services have experienced a 25% cut in expenditure.
The Anna Freud National Centre For Children and Families (NCCF) have released an informative series of podcasts called “Child in Mind” which is suitable for both parents and professionals alike to listen to and covers problems such as ADHD, anxiety and more issues concerning children and young people.
Raising public awareness of children and young people’s mental wellbeing is critical and equally important is signposting services and where to get help. Contact me if you require help or further information.
To hear the podcasts, visit:- https://soundcloud.com/anna-freud-centre
What is disturbing is that the mental health of children appears to be so depressingly poor and prescribing of anti-depressants to children has significantly increased by GP’s. Research by Dr Ann John at Swansea University shows a 28% increase in prescribing of anti-depressants to children in Wales aged from six to 18, with girls being three times more likely to be prescribed than boys. Furthermore, some of this prescribing is being done beyond the limits of prescribing guidance and using anti-depressant medication that is not suitable for children, due to their toxic side effects. Research would no doubt reveal a similar prescribing pattern in England.
The question is however, whether this prescribing trend reflects an actual decline in children’s mental health with increased incidence of depression, or whether it is due to over-prescribing by GP’s creating medicalisation of normal teenage emotional development. Whatever the cause, training for GP’s and primary care workers is essential because future generations of children are at risk of growing up with a dependency, albeit psychological, on a host of toxic mood lifting drugs.
Counselling support for children and young people can easily prevent the use of potentially harmful drug therapies and normalise emotional turmoil, which is often a natural progression of childhood and teenage development.
Children’s counsellors who are qualified, experienced and trained specifically to counsel children and young people are able to provide specialist support for children in their emotional development. Children’s Counsellors at charities like Place2Be, deliver professional counselling in schools to children from primary age up to 18. They work closely with teachers and other professionals to provide essential support to children and young people. Any concerns about the welfare or mental health of a young person or child may be referred to a GP, who may in turn refer a child or young person to a children’s counsellor.
The use of anti-depressant therapies however, should be administered in the event of counselling therapies being ineffective, and only then with extreme caution and certainly within prescribing guidelines.
The National Institute for Health and Care Excellence (NICE) can issue guidelines about the use of anti-depressant therapies.
The mental health of teenage girls, especially 14 year olds, has worsened according to a Cohort study recently published by The Department of Health. Teenage girls are more likely to suffer from stress and anxiety and over a third of teenage girls reported that they felt distressed, worthless, and unhappy and suffered from poor concentration.
The study reports that young people’s health and wellbeing is now slightly worse than it was in 2005 with girls faring less well than boys and with young people from relatively advantaged backgrounds being slightly more likely to exhibit social distress. Research shows that teenagers need on average, 9.5 hours sleep per night but only get 7.5 hours. Research also suggests that teenagers engaging in social media during the night could be damaging their sleep and increasing their risk of developing anxiety and depression. Girls tend to seek comfort on social media when worried and teens generally feel under pressure to make themselves available 24/7, suffering from anxiety if they do not respond to posts or texts. Girls especially feel more of a desire to be perfect and to avoid a ‘FOMO’ (fear of missing out) Hospital admissions for self-harm in the under 16’s have risen by an astonishing 52% with Head teachers in schools becoming worried.
In comparison with 2005, although girls’ mental health has worsened, teenagers are now more work focused, less likely to drink, smoke cigarettes, or engage in vandalism, graffiti or shoplifting.
Department of Health Longitudinal study of Young People in England. Cohort 2: Health and Wellbeing at Wave 2. Carli Lessof et al.
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