Abstract
Some ten or fifteen years ago a study of emotional and behavioural problems in young people in Essex was carried out. This revealed that almost half of them had already tried illegal drugs by the age of 16/17. It seems to me unlikely that the percentage numbers have dropped since and (though I have no evidence for this either) likely that by age 18 more than half of young people in that area will have tried taking drugs. Some will have developed a habit. Yet drugs cost money and most of these will not be in paid occupations so how do they pay for them? By getting into trouble very often, stealing or falling into the hands of dealers and groomers and dropping out of school?
What can we do? If an authority figure comes to a “difficult” school to speak to “troubled kids” he/she may make some headway but there will be many who will be closed off to them. An ex-offender may do better and the youngsters themselves may well have interesting ideas and a real understanding of the issues if they can be brought on board to be part of the solution rather than be a part of the problem.
Should we legalise cannabis? Professor David Nutt's talk in which he sets out his passionate arguments in favour of legalisation of drugs will be published in a forthcoming issue. I am not convinced that legalisation will improve the situation and indeed could make it worse.
Many of these issues came up for discussion when I interviewed Emeritus Professor Harry Zeitlin (child mental health) for a quite different publication. He told me that young people who take drugs and cannabis, in particular, are statistically 4 to 5 times more likely to trigger and then suffer from ‘schizophrenic’ symptoms than those who don't take drugs and continuing drug use following diagnosis will exacerbate symptoms and can cause more long lasting psychosis which may not stop when drug taking ceases. Some of these youngsters will go on to develop full blown mental illness after first displaying signs of mental instability and/or disturbed behaviour both before puberty and after puberty. So, are the NHS, primary and secondary schools, universities and social services equipped to notice and treat/deal with these problem youngsters successfully? Are there adequate services in place round the country for mentally troubled younger children and also older children? According to Professor Zeitlin the services are too thin and few and he estimates that NHS child mental health services (provision for under 18's) are funded to less than one tenth of those provided for to adults (also under huge pressure and sometimes referred to as the Cinderella of the NHS). As they are often the first port of call, Zeitlin feels GP's would benefit from greater training and support in this area.
Our overcrowded prisons have a high proportion of people, mainly men, who are functionally illiterate and innumerate and who may also have mental problems and whom in the past would often have been warehoused in county asylums. For example about one quarter of young male prisoners are said to have ADHD. These factors are major contributors to their failure to cope or thrive in society. But how did we get there? How much cheaper and more humane it would be to spend some of the money that it will cost to keep them in prison to keep them out of it and give them help at a much earlier stage?
But where is the long term and over-arching strategy to make this happen?
Though not directly on this point we may soon see a small first step in the right direction, see the report at page 2 of The Times of 8th January 2016. The Times has been running a campaign for greater funding and investment to improve “the alarming state of children's mental health services”) and now Anne Longfield, the children's commissioner has said she will draw up a “lightning” report to urgently attempt to establish how young people are being failed by the system when they need treatment for depression, anxiety, self-harm and if this is contributing to the record number of children with mental health issues presenting at A & E. “A record number of young people are being admitted to hospital for mental health issues. Emergency admissions reached 17,278 in 2014 which is double the number of four years ago” There were 15,668 admissions of young women aged 15–19 for self-harming, burning or cutting compared with 0,255 admissions in 2004 and a 12% jump in one year of the numbers of children with anorexia and other eating disorders being treated on wards.
And this raises another issue: what is it about life in Britain that has become so stressful and leaves so many young people wretched and unable to cope and young women in particular?
Diana Brahams. January 2016