‘Supporting children’s mental health is a collective responsibility’

Laura Morgan, associate director for specialist services and children and young people at Adferiad Recovery, says it has never been more important for mental health services to avoid medicalising life events...

IN recent years there has been welcome progress in promoting the mental health of children and young people in Wales.

The Time to Change anti-stigma campaign, delivered by Adferiad Recovery and Mind Cymru, has led to a positive conversation about mental health. Most recently Time to Change has been working with the ethnic minorities and Youth Support Team Wales to end stigma in black, Asian and minority ethnic communities, training champions to deliver this message across Wales.

There has also been recognition that supporting the emotional wellbeing and mental health of all children is a collective responsibility; increased funding for school counselling services has reinvigorated the pastoral role of education services; and there is a lasting commitment to young people’s mental health in the Wellbeing of Future Generations Act which requires the different departments of government to plan their work with due regard for its effects on people in the future, not least their mental health. providing support for the mental health of children.

Back in 2015, Mark Drakeford, then the Minister of Health and Social Services, was concerned about the pressure on specialist mental health services for children and gave a valuable perspective on how their wellbeing can best be supported: “For many children and young people their emotional needs are better met by talking though issues at the time with their families, school counsellors and youth workers. This is rather than their problems – often related to normal issues about growing up and maturing – being labelled as mental illness with the possible consequenchave faced all the difficulties associated with the Covid-19 pandemic. But Mark Drakeford’s point applies equally here. Many of the difficulties which children have faced during the pandemic are practical ones and, even where there is a mental health component, these problems are not necessarily best addressed by mental health services rather than non-specialists known to the children concerned.

Meanwhile there are disturbing signs in Wales and elsewhere of the inappropriate extension of mental health treatments. Many children are treated with behavioural drugs for problems which may actually arise from challenging family environments or a lack of appropriate educational support. The jump in prescription of anti-depressants for children during the pandemic should also be scrutinised and challenged – are drugs really the right answer to children’s anxieties and fears? These worrying trends are not just a result of mental health specialists failing to define their role more carefully: they also reflect a widespread tendency in society at large to see challenging life events as problems which should be treated medically.

So it has never been more important for mental health services to define their role clearly, refocus their work, and avoid medicalising life events – and that includes the pandemic. The emotional wellbeing and mental health of children and young people largely depends on supportive families, schools and colleges which take their responsibility for pastoral care seriously, and well-supported training and work opportunities.

So what is the role of the specialists? Child and Adolescent Mental Health Services (CAMHS) and other specialist mental health services should be available immediately for young people who have serious mental health challenges. This will only be possible if there is a clear threshold of need for their services: otherwise those who need these services will experience delay, deterioration, and increased risk. Rapid response is essential: working with NHS colleagues Adferiad Recovery’s Early Intervention in Psychosis Services support young people aged 14-25 right at the start of their illness and give them a much better chance of a lasting recovery.

But having a clear threshold for use of mental health services should not mean that any child should fall between different levels of support. Multi-agency assessment of all children in difficulty should always result in a positive referral, whether to school counselling, advice services, primary care, or indeed to specialist mental health services if appropriate.

Adferiad Recovery has published a new guide “Young People and Mental Health” which explores prevention, early intervention, and the role of mental health services