Coming in from the dark
Mental health issues are on the rise throughout the developed world and being young doesn’t make you any less susceptible. Helen Harvey reports.
In a split second, her body would heat up. Her eyesight would start to go, leaving her with tunnel vision. And, if she wasn’t careful, she would start to hyperventilate.
As she sat in the classroom of her Taranaki high school, 17-yearold Nuutea Itchner’s anxiety would render her mute and she would be unable to move. It was very isolating, she says.
Nuutea is one of a growing number of young people in New Zealand who has suffered from some form of mental illness.
Every age group is increasing but the biggest rise since 2008 is in the 12 to 17 age group. The trouble is no one seems to have a definitive answer as to the root cause of the increase and the reasons offered are many and varied.
Social media gets a bad rap, and studies have found a strong correlation between the use of social media and mental health disorders such as depression, anxiety, sleep problems, eating issues, and increased suicide risk, Taranaki DHB Child and Adolescent Psychiatrist Dr Yariv Doron says.
‘‘However, naturally children and adolescents are more vulnerable than adults. As such they will always show more mental health issues when there are challenges within the society that they live in.’’
But while there are various theories and research into the causes there is ‘no bottom line’.
‘‘The Mental Health and Addiction inquiry currently being undertaken by the government will provide further insight and hopefully provide some more answers,’’ he says.
Doron points to a report written last year by Sir Peter Gluckman, who was then Chief Science Advisor to the Prime Minister.
This said the causes for mental illness were ‘‘multifactorial’ and many different parts of a person’s history, experience, cultural background, genetics, and current circumstances could conspire to induce mental illness.
Nuutea’s anxiety hit in Year 11 along with all the pressures that came with NCEA level one. Now in Year 13, she still gets anxious, but has learnt coping mechanisms to help deal with it.
The pressure of assignments and deadlines and the type of structured programme at school stressed her out, she says.
‘‘So my brain goes insane and then shuts off – I procrastinate. Anxiety takes over your brain and so I won’t talk or I won’t move for a while.
‘‘Anxiety would take over...I would need extra time or I would need to do it in a different way than everyone else would, so, like, I would have to take time off school. I would procrastinate quite a lot because of how anxiety would make you put things off.’’
She describes sitting in the classroom when the other students and the teachers were focussing on one thing – the work they are doing – while her brain was thinking about 10 different things at once.
‘‘It over analyses every single thing in the situation. A lot of the time it comes out like it’s trying to protect me, OK don’t do this Nuutea, this will happen, this will go wrong.’’
A couple of times when she had ‘‘weird’’ things going on with her heart she thought she might have to go to the hospital, she says. But she didn’t.
Instead Nuutea saw a natural therapist who helped her get to the source of her anxiety.
‘‘Going to a doctor and getting medication was my family’s last resort, I think. That just covers it up. It’s not getting to the root of the problem, it’s not going back to why you are getting anxiety in the first place.’’
But while Nuutea didn’t get into the mental health system, the number of young people under the age of 15 going to Taranaki emergency departments with mental health issues has doubled in the last five years – from 18 in 2013 to 36 in 2017.
In the 15 to 25 age group presentations increased from 209 to 330 in the same time period. And there was a 154 per cent increase in people from that age group calling the Mental Health Crisis team, now called the Assessment and Brief Care team (ABC), for help – up from
854 in 2013 to 2168 in 2017. In Taranaki the number of people in the 10 to 14 age group being prescribed anti depressants went up from 240 in 2013 to 417 in
2017, and from 1063 to 1944 in the 15 to 19 age group.
Nationally, 10,146 children in the 10 to 14 age group were prescribed antidepressants in 2017 and 56,700 in the older age group. And 1788 children under the age of nine were also prescribed anti depressants.
Taranaki, like other DHBs around the country, has acknowledged recruitment challenges have impacted, in the short term, the waitlist by not having enough clinicians to take new cases.
And there is a gap between the help available at primary care level and the Child and Adolescent Mental Health Services (CAMHS), which is run by the DHB, so many young people are not being given assistance before they get to the stage they need specialist help.
To try and bridge that gap, Taranaki health provider, Tui Ora started its pilot programme Taiohi Ora Youth Wellness Service in January.
The programme is for young people aged between 12 and 18 and in the first six months 145 youngsters came through the door.
That’s quite a high number, Tui Ora Taiohi Ora Youth Wellness team leader Tosca Lammerts van Bueren says. Especially when there is only a small team working on the programme.
‘‘A real need has been identified in the community for a primary mental health service like this. CAMHS is snowed under and we are trying to pick up some of the slack, but it’s a wide scope that we are trying to cover with a very limited capacity.’’
The programme works alongside the pastoral teams in four Taranaki schools.
They are helping young people with mild to moderate mental health issues, such as low mood, anxiousness, anger, relationship difficulties – those who need support with managing emotions and associated behaviours to increase their level of wellbeing and resilience, she says.
‘‘It came about because of wide spread recognition within the whole health sector of the need to support young people before they reached the moderate to severe end. Our service works on mild to moderate and also preventative as much as we can.’’
The idea is to catch the kids before they need to go and see CAMHS, but as it is early days they aren’t able to measure success yet, she says.
The increase in young people suffering from issues like anxiety and depression is not unique to New Zealand – it is similar to what has been seen in other countries.
But New Zealand does have it’s own issues that add to the equation. The impact of the country’s high rates of poverty, domestic violence and bullying, come up again and again as factors making people more susceptible to mental illness.
New Zealand has the secondhighest rate of school bullying out of 51 OECD countries.
Mental Health Foundation chief executive, Shaun Robinson says it is difficult to determine why New Zealand’s rates are so high compared to other countries.
‘‘But there is certainly a correlation between issues that have shaped, and continue to shape TURN TO PAGE 5
‘‘So my brain goes insane and then shuts off – I procrastinate. Anxiety takes over your brain and so I won’t talk or I won’t move for a while.’’ Nuutea Itchner
‘‘People my age are saying, ‘well I want it this way’. In school people are starting to say, ‘I don’t work like that. I work like this,’ there needs to be more of an understanding of the different ways students work.’’ Nuutea Itchner, 17
New Zealand’s culture. Colonisation, violence, sexism and lack of rights for children. A culture of not talking about feelings, racism, homophobia, transphobia – all these elements have a role to play in how our young people behave and what they experience.’’
Many studies show that young people who are bullied are more likely to experience mental health issues, such as depression, anxiety and even suicidal thoughts. This can impact their learning, relationships and their ability to feel good about who they are, leading to ongoing poor mental health and wellbeing, he says.
‘‘Some of the biggest contributors to youth distress are adverse childhood events, including family violence, bullying, poverty, sexual abuse and social exclusion. Early intervention is important.’’
It’s not easy being a young person and the distress isn’t just spontaneously occurring, Robinson says.
‘‘The world in which young people now live is rapidly changing with different stressors, including an ever-changing job market, climate change, the introduction of new technology and more.
These factors can add to the issues that young people have to navigate as they move into adult roles.’’
Nuutea’s view is that her generation is starting to break out of the moulds that say something has to be done in a certain way.
‘‘People my age are saying, ‘well I want it this way’. In school people are starting to say, ‘I don’t work like that. I work like this,’ there needs to be more of an understanding of the different ways students work.’’
While she got support from some teachers, she didn’t get a lot of help from the school, especially from guidance counsellors.
‘‘I think I reached out about 10 times and they never got back to me. I wrote notes, I sent emails and there was no reply. It made me feel a little bit abandoned at school. It was like they didn’t know what to with me.’’
The number of students with anxiety is growing, she says.
‘‘But, I don’t think [the school] knew the extent of what it was like for students.’’
Through her anxiety Nuutea kept up with her school work and is doing well in Year 13.
‘‘I understand my anxiety and how to control it.’’