Welcome to this edition of the featured therapist BlogSpot where Psychodynamic Psychotherapist Andy Lincoln reflects on social change and mental health over a 40 year career in working with young people.
The approach of Mental Awareness Health Week (May 13th to May 19th, 2019) led me to reflect on Society’s increasing concern for the mental health of young people and how we should respond.
According to the Mental Health Foundation, 20% of adolescents may experience a mental health problem in any given year (1), 50% of mental health problems are established by the age of 14 and 75% by the age of 24 (2). Furthermore 10% of children and young people age between 5 and 16 have a clinically diagnosable mental health problem (3), yet 70% of those who experience such problems have not had appropriate interventions at a sufficiently early age (4).
For most of my career before becoming a Counsellor and Psychotherapist, I worked as a Youth and Community Worker in various parts of the country and in a range of contexts, inner city, urban and rural. Over my forty years of working with young people the social background of their lives changed enormously as you may imagine; employment opportunities, racial and gender inequality, gay rights and the enormous social changes that have taken place in family life and education and so on. Indeed, it is quite difficult to remember the world as it was when I set off to Manchester to begin my training in 1973.
I can remember in 1978 being in a meeting with the then County Youth Officer of Bedfordshire when we were discussing how to make youth clubs relevant to young people of the day. There was a small degree of panic in the team as young people’s interests seemed to be getting too sophisticated for the facilities we had to offer. The Chief Officer, a formidable man who had fought in the Spanish civil war against the Fascist forces of General Franco, listened patiently before bringing the debate to a halt by dismissing our worries by saying the basic needs of young people remain the same irrespective of the passing fashions and panics of the age.
He reminded us that the challenges of adolescence are about young people learning independence while still being dependant, that they are searching for their identity and looking to find a place in the world and that this process is exciting but also full of fear and uncertainty for many. Adolescents he pointed out are rebelling against their parents and their childhoods while still needing dialogue with adults they can trust and respect and who trust, understand and respect them. Provide the containment that young people need in their transition to adulthood and they will engage with the Service he told us.
Youth work, with its ethos of young people’s voluntary involvement, was for a long period an invisible service, with no statutory basis in law it had the strength that it could define its work but the weakness of being unrecognised and underfunded.
When it was finally recognised by the Blair government’s social exclusion agenda it seemed that finally recognition was at hand. As in all things however progress is a double-edged sword, with acknowledgement came measurement and with measurement came targets and gradually these began to be the tail that wagged the dog.
Much good work continued to be done but the focus shifted from the emotional needs of young people to measuring their progress and learning outcomes. As I became increasingly disillusioned I began counselling training in my spare time and I recognised the parallels between the ethos of youth work that I had practised and the therapeutic process of non-judgemental acceptance, empathy, being genuine and open and working at the pace of the person one was involved with.
I began to feel that a vital element of support for young people was being lost and as I was based in schools, I could see that teachers had less and less time to informally develop relationships with their students as the pressures on them grew. I had developed a role for myself building relationships in my evening work and in the school day with the more vulnerable students who needed time to be able trust and talk about their many challenges in life, this was invaluable but did not help me meet my targets as these students were reluctant to engage in measurable activities.
I often thought back to that meeting in Bedfordshire and wondered if the real needs of young people were being met by the new curriculum-based service that had evolved. Now I look at what is available to young people I see that spending cuts have all but ended youth services across a vast swathe of the country. I feel the need young people have for contact and dialogue with adults they can trust, respect and who understand them and who can provide safe containment as a first line of defence against the possibility of mental health problems deepening is not being met and as a consequence our young people are being left much more vulnerable.
As the statistics I quoted at the beginning of this piece show mental health issues begin early and appropriate interventions are lacking. Our perspective on the needs of young people needs to be broader and be focused on softer outcomes such as listening, giving time and genuine regard rather than being solely focused on hard outcomes such as achievements and results.
The World Health Organisation’s Comprehensive Mental Health Action Plan 2013-2020 launched in May 2013 (5) recognised the essential role of mental health in achieving health for all people. It is based on a life-course approach, aims to achieve equity through universal health coverage and stresses the importance of prevention. One of the major objectives set out was the provision of comprehensive, integrated mental health and social care services in community-based settings.
More investment in this objective could effectively include better provision for young people such as youth services and in-school support services. This would give access to the emotional support and spaces to talk and be listened to that young people have always needed and that would provide an invaluable first line of defence for young people at risk.
- WHO (2003). Caring for children and adolescents with mental disorders: Setting WHO directions. [online] Geneva: World Health Organization. Available at: http://www.who.int/mental_health/media/en/785.pdf
- Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. (2005). Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62 (6) pp. 593-602. doi:10.1001/archpsyc.62.6.593.
- Green,H., Mcginnity, A., Meltzer, Ford, T., Goodman,R. 2005 Mental Health of Children and Young People in Great Britain: 2004. Office for National Statistics.1.
- Children’s Society (2008) The Good Childhood Inquiry: health research evidence. London: Children’s Society.
- World Health Organisation. 2013 Mental Health Action Plan 2013 – 2020. ISBN 978 92 4 150602https://www.who.int/mental_health/publications/action_plan/en/