Mental health and children, young people & families

By guest author Lucy Taylor

Hello, my name is Lucy Taylor and I am the Children, Young People and Families Officer for Powys Association of Voluntary Organisations (PAVO). 

My role is to support the organisations across Powys that work with children, young people and their families. This involves acting as a conduit between the organisations, for example Action for Children which works with families, and the statutory partners, for example Powys County Council which, in some cases, commissions part of their work. I use a blog, Facebook and network meetings to keep the sector up to date and informed. 

Another part of my work is to support the Play Networks and to raise the awareness of play. We ask: are there enough opportunities, time and space for our children to play in Powys? It was working with organisations looking at what services are available, and what support is needed for children and young people, that the gap or thinning of services that support them when they are having low level mental health worries was noted, hence this blog post.

Listening to young people speaking at the Mental Health Today conference in Cardiff in May this year I was struck by their common sense approach to some of their issues. They knew that life was not always going to be plain sailing - that events or relationships could knock them back. They wanted to be self-reliant, not turn to medical interventions or for the medical community to medicalise their problems. They recognised that in helping and supporting friends through their low patch in life, they may put their own mental wellbeing and stability at risk. Their request – “A toolkit for life, not a bucket of sand to hide from it.”

Mental Health Today conference presentation

This is the issue and where some gaps in support appear. Everyone can experience a wobble in their wellbeing. But, with a few self-help tools, some supportive friends and community, the knowledge of where to go for help early on, we may all take a role in our and our community’s wellbeing, leaving the expertise of medical interventions to those whose condition requires it.

The Young Adult Peer Support Project (YAPS) which was run by Ponthafren Association as part of the One Powys Connecting Voices lottery-funded programme was really excellent. When it wound down recently as the funding came to an end none of the young people (age 16 – 25) involved with the project was happy to see it go. Peer support projects like these are extremely valuable, as the first port of call for a young person struggling with their emotional wellbeing is friends and family.

The Making Sense Report was produced in January 2016 as a response to the Together for Children and Young People programme. It had emerged that referrals to Children & Adolescent Mental Health Services across Wales had increased by over 100% between 2010 – 2014, and four organisations – Hafal, Mental Health Foundation, Bipolar UK and Diverse Cymru – joined together to find out why and consider what could be done to address the situation. Young people themselves, who had been in contact with CAMHS teams in Wales, reported on their health and wellbeing and called for “non-mental health professionals such as education staff, counselling services and youth groups to share responsibility for the emotional needs and development of young people”.

For children, young people and their families to have access to informal and non-medical support, we – the families and communities – need to be able to recognise when we, and our neighbours, need a bit of help. It is also crucial that we know how to source help in our particular locality. Information and connectivity is the key. The PAVO Community Connectors help people in Powys (aged 50+) and their families or carers, to access community-level services and activities, (tel: 01597 828 649) – and Powys People Direct “one number for children, adults and families for information and support services” (tel: 01597 827 666) can also help.

The third sector as a whole plays a huge role in providing services and opportunities for children and families in Powys. From the playgroups and play networks, guides, cadets and St John groups to sports clubs and arts organisations. Then there are the agencies offering more targeted support or drop ins. Think of Action for Children, Mid Powys and Brecon Mind or Ponthafren Association.

Powys Youth Service supports young people around their emotional wellbeing in youth clubs or at school. The service has recently noticed that where it used to work with pupils around exam stress, now stress is more general and anxiety about life and the future prevalent. Online counselling and advice is available via an organisation called Kooth (Xenzone) .

But what of families, education and skilling our young people for life? If “it takes a village to raise a child”, what part do we all play in ensuring the wellbeing of all the children? Can Google or YouTube really teach you everything? The ability to budget, know about nutrition, healthy eating and exercise, or how to cook from scratch? These are the life skills the young people want, alongside how to protect their mental wellbeing, perhaps using such techniques as yoga, meditation or mindfulness.

Would it surprise you to know that a walk in the park or taking time to walk and be around trees can also help? The Japanese call it “Tree Bathing” and have invested in public awareness of the benefits of being outdoors. 

PAVO staff are working with organisations from the mental health and children’s arenas, alongside green or outdoor providers, to look at how best we can work together and bolster our communities and families by making the most of the green resource we have on our doorstep. We will be meeting in the coming months to discuss the support we can all offer. For more information call 01597 822191 and speak to Lucy Taylor or Jane Cooke.

Why not take five minutes out from your busy day to walk in the fresh air, appreciate the sights and sounds of nature? Perhaps grab some friends and all walk together. Take the children to the park or share a picnic with other friends and families. It may not solve any problems but it can help soothe your mind and give you a place to start. Like eating elephants you can take life one bite at a time.

There is currently a Welsh Government consultation on: The Emotional and Mental Health of Children and Young People. If you, or someone you care for, has been in contact with Child and Adolescent Mental Health Services, then you can give feedback up until 29 September 2017.

The Children, Young People and Education Committee’s Inquiry will consider whether the ‘Together for Children and Young People Programme’ is on track to deliver the ‘step-change’ in CAMHS services that is needed. It will also consider how effective the programme has been in promoting the resilience of children and young people, including a focus on the role of education in preventing mental health problems. The Together for Children and Young People (T4CYP) programme is a multi-agency service improvement programme that is aiming to reshape, remodel and refocus the emotional and mental health services provided for children and young people in Wales.

Unconventional Wisdom? Time To Challenge – Tackling Stigma

As the manager of a mental health voluntary service in Powys that provides a mental health information service, I am asked, in the conditions of our funding contracts, to “tackle mental health stigma”.  The dictionary defines stigma as a mark of disgrace. Goffmen defines stigma as an "attribute that is deeply discrediting".  

The Time To Change Campaign has been running across England since 2008.  It has been responsible for much activity from staff and volunteers across the country, all hoping that their efforts, attempting to tackle stigma, are having a positive impact.  You can look at evaluation reports from their work here.   It was no surprise to me when the Time To Change Campaign moved over the border, to Wales, last year.  The Welsh campaign is led by Mind Cymru, Hafal and Gofal.  

For many in Wales, this hailed a truly positive step forward, Comic Relief, Welsh Government and The National Lottery were willing to invest in mental health and stigma.  We were given a national focus for tackling stigma and surely all of those trying to tackle mental health stigma would get behind this campaign, work and stand together.  The campaigners hope that by tackling this stigma we will ensure that more people will come forward to ask for help.  In our mainstream services that often means getting the “right” diagnosis and then the “right” help based on this.

The easier path for me to take, as a manager of a service tasked to tackle stigma, would be to get in line to champion the campaign across Powys, join forces with others and together surely our efforts would have a positive impact.  However, I can not act in this way, because I do not believe that the main idea that underpins this campaign, and others like it (e.g. Saneline’s Black Dog campaign), is sound. 

So what is the bad idea that I think needs to be challenged?  Simply this, the mainstream idea that mental illness diagnoses are valid.  These campaigns use the terms “mental illness” as if diagnosis is the truth for understanding our behaviours, misbehaviours and distress.  The campaigns aim to see “mental illness” normalised and seen in the same way as physical illness.  This very statement implicitly indicates that the same evidence underpins a mental illness diagnosis as, say, a cancer diagnosis. 

My challenge to the idea of "mental illness" as a valid diagnosis comes in the form of the ideas of Thomas Szasz and his articulation of them.  In my opinion his arguments are based on logic and reason and I can never hope to articulate his ideas better than he.  You can access lots of videos of Thomas Szasz via the Internet, but here are two to get you started, should you be interested. 4 minute video highlighting a series of statements that summarise his position here and secondly a 5 minute video where he shares his opinions of diagnosing children with “mental illness” here.

 
As well as underpinning it's campaign with the idea of "mental illness", Time To Change uses the approach of statistics that tell us things like - 1 in 4 of us are effected by mental health problems.  In Powys, last month, this approach was challenged at an event, as one that in fact increases stigma, by reinforcing otherness.  Melanie Santorini from the Campaign led a discussion in response to this challenge and there seems to have been some agreement there that perhaps a message of “it's not 1 in 4 it's everyone!" would be more useful.  

Whilst I agree that yes potentially “all of us” could find ourselves experiencing mental distress and exhibiting behaviours that could be perceived as symptoms of “mental illness”, I do not think that all of us, or any of us for that matter, could have a "mental illness". 

All of us are living.  All of us will face things in our lives that are challenging to us (e.g. bereavement, sexual abuse, divorce, redundancy, becoming a victim of crime, illness).  Depending on our life experiences to that point, we will respond in different ways to the challenges that we face, and indeed in different ways depending on the timing of these challenges.  For some that response may be hearing voices, for some it is extreme and debilitating sadness, for some it may be behaviours that challenge our place in “normal society”. So I too would challenge the bold “1 in 4” type statements that many of this type of anti-stigma campaign use because I think these statistics are misleading.  They do not challenge us to understand that any of us, at any point in our lives, could find ourselves struggling to cope and that in response to this we may find that our emotions and actions fall outside of our current society’s understanding of normal behaviour.

And of course society's and individuals' understanding of normal behaviour changes all the time.  For example, I wonder whether I would have accepted a diagnosis of “Female Hysteria” as an illness if I had lived 100 years ago and how I would have responded myself to a women exhibiting “symptoms” like "sexual desire" and "a tendency to cause trouble".  Would I too have seen these behaviours as unacceptable, as symptoms of mental illness?  Would I have wanted “to help” this woman behave normally?  Or would I have asked myself whether her response was perfectly valid given her experience and given the constraints within which she had to live? 

Anyway back to tackling stimga.  The option that I perceive to be the easier one and the one that looks to most people, it seems, like the right thing to do (i.e. act in the name of these campaigns), I am afraid is not one I can take.  I have tried here to explain why.  I think that action, effort and good intentions based on underpinning ideas that are wrong, will produce unforeseen bad consequences. Eleanor Longden clearly articulates the consequences she had to face when her experiences where seen through a “mental illness” lens in this 15 minute video.  

So even though this is not the easiest path for me to follow, I can not support this campaign directly.  A close friend of mine often uses the following quote – I hope he is right...

“The truth will set you free, but first it will make you miserable.”  James A. Garfield

So how do you think we should be using our funding to tackle stigma?  What do you think about these campaigns? What do you think we could do to tackle stigma i.e. the disgrace, the badge of shame that we attribute to our mental distress?

There are many people out there, across Powys and indeed across the world,  challenging the medicalisation of distress and the conventional wisdom surrounding mental health, in our society and within our mental health services.  I would love to hear your thoughts and ideas.  You can comment on this blog, follow me on twitter @powysmh, get in touch with me here or keep up-to-date with events we are running on our website.  Why not join us at our free conference on Sept 19th.  Jacqui Dillon is to be our main speaker to help us continue with this debate.  I hope to hear what you think ...