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Archive November 2018

A major NHS report has found that one in eight young people in England, aged between five and 19, suffer with a mental health disorder.

The survey, which looked at data from more than 9,000 children living in England and registered with a GP, found an increase in conditions such as anxiety, depression and OCD in children over the past decade.

A worrying one in 18 children aged two to four years now has at least one mental health condition, while 17-19-year-old girls have been identified as a ‘high risk’ group, with one in four suffering with disorder and 46.8% of children in this age category attempting self-harm or suicide.

The emotional wellbeing of children is just as important as their physical health, and while having a conversation with your child about mental issues can be challenging, it can be the important first step in helping them to find the support they need.

Sarah Kendrick, head of service from children’s mental health charity Place2Be, reveals the dos and don’ts for talking to a young people you think may be struggling to cope.

Full story: Independent

Overstretched police forces are having to “pick up the pieces of a broken mental health system” on top of tackling crime, the emergency services watchdog has found.

More than half of all mental health patients who need help in a place of safety are taken there in a police car rather than an ambulance, according to Her Majesty’s Inspectorate of Constabulary, Fire and Rescue Services.

The Metropolitan police (MPS), the UK’s largest force, deals with a mental health call once every four minutes, and sends an officer just to deal with mental health issues once every 12 minutes.

Some health professionals are telling patients in need to call the police in order to beat long NHS waiting lists, the report said.

The watchdog said police were being dragged away from their actual job because officers were making up for gaps left by medical experts as a “national crisis” blights mental health services.

It is the latest report from an official watchdog to criticise the government in robust terms over the effects of austerity on policing, following on from a report from the National Audit Office in September.

Full story: Guardian

90 percent of workers in the U.K. have been affected by mental health challenges. Two-thirds (66 percent) reported having personally experienced mental health challenges and even more — 85 percent — saying someone close to them such as a family member, close friend, or colleague had experienced them, according to results of new research from Accenture. Despite more people speaking out about mental health, UK businesses are falling short and need to do more to support their employees.

“We’re used to hearing that one in four people experience mental health challenges, yet our research shows that the number of people affected is in fact far higher,” said Barbara Harvey, Managing Director at Accenture and mental health lead for the company’s business in the U.K. “It’s clear that mental health is not a minority issue; it touches almost all employees and can affect their ability to perform at work and live life to the fullest.

“It’s time for employers to think differently about how they support their employees’ mental wellbeing. It’s not only about spotting the signs of declining mental health and helping employees seek treatment when needed. Employers need to take a proactive approach by creating an open, supportive work environment that enables all their people to look after their mental health and support their colleagues. The payoff is a healthier, happier organization where people feel energized and inspired to perform at their best.”

The research

The survey of more than 2000 workers revealed that mental health issues are far more prevalent than the one in four figure that is often cited. For three out of four people (76 percent), mental health challenges — either their own or those of others — had affected their ability to enjoy life, with 30 percent reporting they are ‘occasionally, rarely, or never’ able to enjoy and take part fully in everyday life.

The findings come as the taboo that has long surrounded mental health starts to break down, as 82 percent of respondents said they are more willing to speak openly about mental health issues now than they were just a few years ago. 

However, the workplace has failed to keep pace, as only one in four respondents (27 percent) said they had seen any positive change in employees speaking openly about mental health in their organizations. Just one in five reported an improvement in workplace training to help manage their own mental health (20 percent) or to help them support colleagues dealing with mental health challenges (19 percent).

Of those who had faced a mental health challenge, the majority (61 percent) had not spoken to anyone at work about their issue. Half (51 percent) of the survey respondents felt that raising a concern about their mental health might negatively affect their career or prevent them from being promoted, and 53 percent believed that opening up about a mental health challenge at work would be perceived as a sign of weakness.

Yet hiding mental health challenges at work had a negative impact on a majority of those surveyed. More than half (57 percent) reported at least one such impact, including feeling stressed, more alone, lacking confidence, being less productive, or simply ‘feeling worse’.

Full story: Mental Health Today

Children aged 10 and under are among hundreds of young people being given strong antidepressant drugs – in breach of official guidance – that increase the risk of suicide, the Guardian can reveal.

Figures show 597 children and teenagers were given paroxetine and venlafaxine last year. Government guidance cautions against their use due to increased suicidal thoughts and behaviour in younger people, but some experts argue they can be used as a last resort when all other treatments have failed.

Data shows 38 children aged 10 and under were prescribed paroxetine and venlafaxine last year.

According to guidance from the National Institute for Health and Care Excellence (Nice), antidepressants should be a last resort for under-18s, and in those instances only fluoxetine (Prozac) is recommended. Nice says paroxetine and venlafaxine should not be used.

Experts have said the disclosure of their use needs further examination, and expressed concern about the use of medication that may harm developing brains.

“Paroxetine and venlafaxine should not be prescribed as first-line treatment, that is for sure – there is no data to support this and special cautions should be taken as we don’t know the impact of these drugs on the developing brain,” said Andrea Cipriani, a psychiatrist at Oxford University.

“We should not give antidepressants to all kids but only use them if they are clinically appropriate and agreed with the patient first, and even then the best option is fluoxetine.”

Full story: Guardian

A survey conducted by Rethink Mental Key Illness on people’s experiences of care and treatment shows that those severely affected by mental illness are often waiting the longest for treatment and receiving the worst care.

This survey of over 1,600 people shows that the extreme challenges we have experienced as individuals and families are part of a bigger problem. The findings speak for themselves: people are waiting over three months for an assessment alone and over six months for treatment to begin. 

The report found:

  • The average waiting time for an assessment was 14 weeks
  • One in twenty people had waited more than a year
  • One in three people asked for a service that they were told was unavailable
  • Over a quarter of people felt they were referred to a service that was not appropriate to support their mental health
  • Just over half those asked felt they received support for a sufficient and appropriate time
  • Over 20 people had thought about or attempted suicide due to the lack of services

Click here to download a copy of the report.

Sir Stuart Etherington, chief executive of the National Council for Voluntary Organisations, has written to the Prime Minister calling for clarity on the use of so-called “gagging clauses” in government contracts with charities.

The issue has come to the fore again after a story in The Times newspaper (subscription required) this morning said that as many as 40 charities had signed probation service contracts with the Ministry of Justice that said they must not do anything that would adversely affect the reputation of the justice secretary.

The newspaper last month highlighted similar concerns about the use of gagging clauses in contracts with the Department for Work and Pensions, although the Shaw Trust, which was named in the article, said at the time that the contract did not affect its independence as a charity.

Etherington said in a statement today that the issue had rumbled on for some time and he was calling on the government to provide “absolute clarity about whether these clauses, in any way, should prevent charities from speaking out”.

He said: “I have written today to the Prime Minister to ask her to confirm whether these clauses would prevent charities from publicly expressing concern about a particular policy or programme.”

Full story: Third Sector

For the uninitiated, being “sectioned” in England and Wales means being detained in a hospital under the Mental Health Act (MHA). This can happen if someone is experiencing a mental disorder of a “nature and degree” that could jeopardise their health or safety or the safety of others, and they are unwilling or unable to agree to hospital admission.

To put it bluntly, detaining somebody under the MHA is a big deal. Normally you can’t deprive someone of their liberty unless they’ve committed a crime. That isn’t the case, however, if three senior mental health professionals agree that detention is the right course of action. There are checks and balances

I am an NHS consultant liaison psychiatrist, meaning my area of expertise is the interface between physical health and mental health. Often I work in the accident and emergency department, providing the kind of support the chancellor promised to bolster as part of last month’s budget, which contained plans for a much-needed increase in funding for mental health crisis services. Whatever the financial context though, assessing patients for detention under the MHA is always part of my role. It might be a young man with schizophrenia who has been brought to A&E by his desperately worried family as he has become consumed by voices telling him to kill himself; a woman with a depression so severe that she has lost the ability to eat or drink and requires feeding with a tube; or an elderly man originally admitted due to a fracture, but whose recovery has been railroaded by the fact that his dementia has caused him to become incredibly agitated on the ward.

I think of the MHA as a life-saving intervention. Just as an A&E doctor will use a defibrillator to shock a patient’s heart back into life, I will advise detaining a patient under the MHA with the intention of saving life too. Most commonly, the life at risk is the patient’s own. But the MHA asks us to consider the “protection of other people” too, which puts psychiatrists in the difficult position of balancing the needs of the individual patient against the needs of the community. (At this point let me emphasise that people with a serious mental illness are much more likely to be the victim, rather than the perpetrator of a crime, although you would be forgiven for thinking otherwise based on how this issue is portrayed in some media.)

Psychiatrists are sometimes characterised as power-hungry creatures who get their kicks from being able to exert control over others via the MHA. Although it would be wrong to pretend a power differential doesn’t exist, I can wholeheartedly say that if I never had to section a person ever again I’d be thrilled. That’s because this would mean that every patient I saw would be willing and able to receive the necessary care for their mental health problems in a truly collaborative manner – that would be therapeutic gold. Sadly, just as I can’t envisage my A&E colleagues packing away the defibrillator any time soon, I think that the MHA will need to remain a vital tool in helping people with serious mental health problems for the foreseeable future.

Full story: Guardian

New research from Stonewall, Britain’s leading charity for lesbian, gay, bi and trans equality, exposes alarming levels of poor mental health among LGBT people compared to the general population. Stonewall’s study also reveals a shockingly high level of hostility and unfair treatment faced by many LGBT people when accessing healthcare services.

The research, based on YouGov polling of over 5,000 LGBT people, shows more than half of LGBT people (52%) have experienced depression in the last year, and three in five (61%) had anxiety. This compares to one in six adults in England who faced a common mental health problem, such as anxiety and depression, according to Mind.

Experiences of anti-LGBT abuse and discrimination on the street, at home, and at work were also revealed to significantly increase the risk of poor mental health. Two-thirds of LGBT people who’ve been the victim of a hate crime (69%) experienced depression, while three in four (76%) reported having episodes of anxiety.

The situation is particularly concerning for trans people. In the last 12 months alone, more than one in 10 trans people (12%) attempted to take their own life, compared to 2% of LGB people who aren’t trans. Almost half of trans people (46%) have also had thoughts about taking their own life.

Full story: Mental Health Today

One child in every twelve in the UK risks having “behavioural problems from a young age into their teenage years”, putting them at risk of a lifetime of disadvantage and poor health, according to a major new study published today by Centre for Mental Health and University College London Institute of Education.

Children of the Millennium is the report of an analysis of the Millennium Cohort Study, which follows the lives of a large sample of children born in 2000 and 2001, funded by the Economic and Social Research Council.

The report finds that 8 percent of children have severe behavioural problems throughout childhood and early adolescence. The same proportion also have multiple mental health difficulties such as emotional difficulties and hyperactivity which also persist over time. Children with persistent problems are much more likely to have a multitude of risks early in life, including poverty and housing insecurity, parental mental illness and developmental delay. These risks are linked to behavioural problems early in life but are also faced by children with behavioural problems that start later.

Full story: Mental Health Today

Despite the seemingly earlier positive announcement in the Autumn Budget for investment in mental health services, the regulations published on 5 November confirm many people with mental health problems on existing benefits will be forced to make a new claim for Universal Credit. People risk losing their income – and even their homes – in the process of re-applying for financial support they’re already entitled to.

Many people have told us they struggle to read or understand letters from the Department for Work and Pensions (DWP), while others are unable to negotiate the complex, labyrinthine process of applying. People in this situation could face having their existing benefits stopped if they have not claimed Universal Credit in time. 

Vicki Nash, Head of Policy and Campaigns at Mind, said:

“These regulations have confirmed what we have long feared and argued against – that in the move over to Universal Credit (UC) three million people, including hundreds of thousands of people with mental health problems, will be forced to make a new claim. This risks many being left without income and pushed into poverty.

“Overwhelming cross-party concerns about moving people over to Universal Credit (UC) is a testimony to how unfit for purpose the final regulations are. We have repeatedly raised our concerns and are appalled to see them being ignored. The regulations are insignificant in fixing this broken process – as it stands there is still no safety net for people before or during the move to Universal Credit.

“We need a welfare system which works for everyone and allows people to live full and independent lives, not one that leaves people destitute. The Government must do the right thing and withdraw these regulations, before they fall squarely on some of the most vulnerable in society.

“If the regulations are not withdrawn, we are urging them to be voted down.”

Source: National Mind

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