Mental Illness – The Next Generation

http://www.bbc.co.uk/news/health-29954970

According to the above article 300,000 children and adolescents in the UK are affected by anxiety disorders. We need to be treating them quickly and more importantly, effectively, so that they don’t become adults with mental illness. It is well documented that the quicker a person receives treatment, the more likely they are to recover. They also recover faster and to a better extent than those receiving the same treatment at a later stage in the condition. This means that time is of the essence and we need to shorten waiting times and increase access to age-appropriate services which are currently severely lacking.

The month before I turned 16 I developed depression. I had a lot going on in my life and I was struggling to keep up with it all but had been managing it until the depression hit. It was like I’d forgotten how to cope overnight and everything felt totally overwhelming. I felt sad all the time and cried a lot and had no idea why. My parents weren’t getting on, my Grandad’s Alzheimer’s was deteriorating and I was in my final GCSE year and it was all too much. After 2 months of feeling like this every day I went to my GP and explained the situation. I’d done lots of research and figured out that I almost certainly had depression which I suggested to her. I was practically laughed out of the room and told I had “January Blues” and that “every other teenager in the country is feeling like you are right now”. I told her that this wasn’t true and that I’d never felt like this before and that I needed some help and she simply said that it would wear off and sent me on my way.

Two months later I went back to the same GP because I was feeling much worse. The suicidal thoughts had started and I had begun to self-harm as a means of coping. The GP was the first person I told about any of it. She became very worried and seemed surprised that I was now so ill. She offered to refer me straight to the Children and Adolescent Mental Health Service (CAMHS) at my local hospital so that I could be assessed, and I agreed. I think I waited about a month for that appointment and within 10 minutes of seeing the doctor there I was diagnosed with depression and had a prescription for Prozac in my hand. And so my journey into the Mental Health Service had begun. A side note here – I have had a lot of negative experiences with GP’s who are simply not trained enough to notice, diagnose or even talk properly to patients with mental health problems. They are the first port of call and it is soul-destroying when they tell you to try harder, don’t believe you, or even turn you away from getting the help you’re desperate for. This has got to change and GP’s really need more training in this area!

CAMHS was not a good experience for me, I’ll go more into it at a later date but I wasn’t treated well and was often not believed and patronised by a nurse who was apparently a specialist. I saw a different doctor every time and there was never any talk of therapy, just medication and writing a diary. I was 16 at the time but I was treated like a child and often talked to as if I was stupid and didn’t know my own mind. After a year of this I went to see another GP who wasn’t in the least surprised that CAMHS had succeeded in nothing other than watching me deteriorate and he informed me that he’d been campaigning longer than I’d been alive for them to improve their service. I was lucky enough that at the time my family had private medical insurance and he recommended a psychiatrist at my local Priory hospital. After 3 months of seeing the psychiatrist I’d become so ill that I needed inpatient treatment and in May 2008 I was admitted voluntarily for 9 weeks. Whilst there I was by far the youngest patient at only 17 and everyone else was nearly 10 years older than me and more. Most were the same age as my parents. Being treated like an adult was so much better than being treated like a child, however it was a challenge in the intensive CBT sessions we had because my problems were very different from everyone else’s due to my age.  All credit to the staff there though, they were brilliant at adapting the sessions to me and the patients became like a family (more on this also at a later date).

Circumstances led to my treatment being placed back with the NHS the following year and I was offered group CBT for stress management. Again, I was by far the youngest at 18 years old with the next youngest being in their late 30’s. This caused a huge amount of problems in the session because it wasn’t applicable to my life at all. When we had to come up with a list of stressors I was saying things like college and they were all saying about work. One woman looked directly at me and then offered “children” as a stressor so I looked straight back and said “parents”!  The group wasn’t suitable for me at all and after speaking to the therapist at the end we both agreed that I wouldn’t really get anything out of it and so I left. After that my psychiatrist at the time said that there was very little they could offer me that I hadn’t already tried because I don’t respond to medication and they couldn’t offer appropriate therapy for my age. This, as shown in the article above, is a very common problem. Children aged 8 have very different problems from teenagers, who in turn, have very different problems from working-age adults. We already separate mental healthcare into working-age adults and older adults and I think that there is desperate need to have dedicated adolescent/teenage services. Those who are aged 14-19 should have their own dedicated treatment services because their issues are so different from other age groups in terms of their development and life circumstances. There are so many transitions to go through at this age and older adults who have their own children will simply not have the same problems and therefore there is little to be gained by lumping everyone into one big group session where ultimately everyone feels alienated by a lack of common experience. Group therapy can be great if you get the group dynamic right but placing an 18 year old in with someone in their 50’s just isn’t helpful.

We need to be intervening early with children and adolescents who are showing signs of mental illness so that they can get treatment quickly but it’s essential that they are then given age-appropriate treatment by people who are trained in working with patients of that age group. Without this we’re simply leading the next generation of mentally ill people towards a long journey of poor or even no treatment and increasing the likelihood that they’ll be ill for life.  You may or may not believe that children (and adolescents) are our future but they certainly deserve their own future to be free from mental illness and the first step towards this is creating age-appropriate services dedicated to this!