Vulnerable Youngsters Deserve Better Care

There are promising findings in the new report on young people’s mental health, published today by the Mental Health Foundation. It suggests the voluntary sector is providing the kind of services young people between the ages of 16 and 25 want.

{mosimage}This is welcome news: this group is most at risk of developing long-term severe conditions such as schizophrenia, yet highly likely to encounter problems accessing appropriate statutory treatment when they need it most. The foundation has put one of the government’s favourite mantras – voluntary sector provision of services – to the test and found that, in the case of young people aged 16-25, non-statutory provision for mental health is often the answer.

There are a number of reasons for this, the report concludes, not least of which is the fact that vulnerable young people feel more comfortable about approaching voluntary organisations because they see them as non-judgmental and not intimidating, and feel they have a say in their treatment.

This is important. First – and this is something the report is at pains to get across – if young people avoid approaching statutory services, it doesn’t matter how good provision is, they won’t benefit from it.

Second, the report draws attention to a longstanding complaint from vulnerable young adults and some mental health practitioners: that by structuring statutory mental health provision into either child and adolescent or adult services, it is failing to meet the complex needs of those “in transition” from childhood to adulthood. “For young people with mental health problems, this critical period is also the time when statutory mental health support becomes less clear cut,” it concludes. In fact, the only statutory mental health service required to be available to this group is early intervention in psychosis.

Related to this is the lack of consistency within Camhs (child and adolescent mental health services) provision, with some services having a cut-off age of 16 while for others it can be as high as 19. Today’s report – which is the second part of a two-stage examination of mental health services for young adults – raises a number of issues about the transition from Camhs to adult mental health services. In some instances, it can take up to three years, “meaning that vulnerable young people can disappear entirely from statutory services”.

Then there is the issue of young people being admitted to adult wards. While some do experience good levels of care, the report says that the majority of young people in the Mental Health Foundation’s consultation had negative experiences.

The research, conducted by the Mental Health Foundation, looked at eight voluntary sector projects working with 16- to 25-year-olds. It has attempted to draw lessons from best practice and to document the challenges faced. Its conclusions are blunt.

The government’s push for the voluntary and statutory sector to work together “can potentially be a positive experience”, but for it to work “the basic service model for young people needs fundamental change”.

This is not an argument for voluntary services to take over from statutory provision. Rather, it is a call for more effective delivery of treatment, starting with the understanding that there is not a clear-cut division between childhood and adulthood, that the needs of this “transition” group are varied and complex, and that services should be designed accordingly.

The report includes a list of recommendations on how this could be achieved, including creating a “lead agency” to coordinate commissioning. But however this is done, the critical point is the same as always: if not adequately identified and treated, the mental health problems that take root during late adolescence exact a toll on the individual, on mental health services, and on society further down the line.

Mary O’Hara is a staff writer for Society Guardian