Talking therapy won't solve the mental health crisis

[dreamydell]

There's a mental health cross among children and young people. What's the only solution that's ever suggested? Talking therapy.

This is ridiculously expensive to deliver en masse and there is no evidence that it even works.

Instead of endless calls for more therapy, can we start looking at some real solutions. And don't say banning smartphones/social media. If anyone seriously thought that was the cause of poor mental health then the first line of treatment would be remove a person's phone. This costs nothing so would be a cheap and effective intervention.

Yes agree. The major harms of SM/phones relate to the amount they are used and the activities they displace. I think they would be less inherently harmful if they were only used for half an hour a day or something.

If you're a kid who has a smartphone she uses a little bit every day, but also has friendly, interested parents, enough money in the family, plenty of outdoor play and exercise etc you're probably going to be ok.

Yes, I agree.

I was guilty occasionally of too many trips out and trying to make everything great - but I realised at least by the teen years that some disappointment and failure are essential for kids’ development. If your DC never gets a star at school and the naughty kids do because they behaved well for one afternoon, deal with it yourself as a parent. Say it’s rubbish, but we know you work hard and we’re pleased and that’s enough. There’s no need to go to war with the school. Teaching your DC to take some stuff on the chin is important - while making sure they know you will help if they really do need help eg bullying. No one needs help because they didn’t get a star.

Systemic issues. Parents are overworked and trying to keep a roof over everyone's heads. Financial stress, less work / life balance. The stress will filter down to children,

Family breakdown and the carousel of new partners being brought into the home ( this is a huge issue, leading to potential abuse, kids feeling abandoned, lonely and that no one looking out for them). They may not be able to articulate this whilst in the here and now, and it may manifest in other behaviours.

School has had the joy sucked out of it. They are exam factories. Teachers are overworked and stressed, this filters down.

Social media - you can't act like an idiot / be silly without fear of it being filmed or photographed or you being gossiped about on whatapp / snap chat etc. Fear of public shaming.

Then when they look to the future, what's there for them? Low waged work and being told to be grateful for that. Expensive housing.

Being referred to as snowflakes. So unfair and demeaning.

@ExitViaGiftShop

Being referred to as snowflakes. So unfair and demeaning.

I completely agree about this. Because insulting an entire generation always ended well, didn't it?

See also these endless threads about how "gentle parenting" is the cause of the end of civilization and what they all need is a clip round the ear and a dose of National Service. Its so reductive and stupid.

I think there is an issue with resilience and a tendency to pathologise normal human emotions under the banner of "mental health" which is unhelpful. But it doesn't follow that the solution to this is to go back to trying to recreate a Dickensian approach to raising children.

I'm not sure of OP's point

Do you want to spray them with drugs instead??
What are CAMH supposed to do about the ills of society?

I am a bit sick of things being labelled a 'mental health problem' and pushed off on mental health services. Parenting, education and society more widely need to step up to some of this.

This webinar with J Haidt has just come out - Hugh grant is on it. For all the naysayers re screens and the damage to young people’s MH:

Nope that was my dc and their childhood however all 3 have had struggles with their MH(2 have needed services including hospitalisation). We have been told multiple times we have not caused it and are lovely good parents before we’re accused of being nasty people as per the previous poster. 🙄

Would like to add phones and SM are designed to be addictive, it takes the will power of a giant to resist using them in a unhealthy way which isn’t something teens are renowned for and actually it’s not just your dc’s phones you need to worry about but everybody else’s too. You’re not policing them, stopping your child from being photographed and discussed on them. How long do you keep your child from having a smartphone given all the socialising and educating that is done on them? And how do you train grown teens to not get sucked into overuse given most parents aren’t giving the best role models as per phone usage.

Oh do give over you really don’t know what you’re talking about. Parents do not have the skills or training to treat Anorexia, self harm, severe OCD, suicidal idealisation, CPTSD, clinical depression, chronic anxiety …..and the longer you leave these things untreated properly the worse they get and the more money they cost. Not resourcing CAMHS properly is a false economy.

I work in a team that is part of a national nhs and education England workforce that do just this.

Mental Health Support Teams have been rolled out since 2020 delivering low intensity cbt informed interventions with children and young people. We also deliver whole school approach which aims to educate staff, parents and young people about mental health and wellbeing and how they can cope.

We are an early intervention team that sits at tier 2, camhs is tier 3. The aim is to catch things before they become a more serious mental health need.

There is good evidence this does work, but schools and parents need to be on board and understand the concept of early intervention as we should be working with kids with emerging need. These kids can be hard to identify.

@FurForksSake That's excellent. My only comment is that if should be as much part of learning as maths and english, knowing how you work is a natural part of education, not an intervention.

I have experience of this and think it is a great idea and intervention however in reality the numbers of kids that can be direct targeted are few given the amount of hours allocated to individual schools. Also where is the extra funding to enable schools to fund staff hours to focus on this given how they’re already struggling to cope with SEN workload?

Re emerging need I think masked ND often plays quite a big part to a fair few which gets us back to the need for better ND identification,access to diagnosis and yet more insane wait lists.

I think it also needs to be remembered that CBT isn’t always effective for those with ND which isn’t surprising when you consider how much some ND people struggle to understand, identify and sit with emotions. It would be a worry if it became the only thing on offer.

Parenting is a huge issue

We don't let children take reasonable risks any more so they are terrified of everything and haven't learned that they can cope.

I mused idly to some other parents the other week about allowing my 8 year old to walk along a footpath bordering a green (not a road) between houses to a corner shop a couple of hundred yards away, to spend pocket money on sweets. It's a shop run by locals where he'd be recognised, in broad daylight and we know most of the people in the neighbouring houses. He's good with money.

Friends were horrified. This apparently isn't "safe". We live in a lovely little village.

The older DC here have to get buses a 20 min ride to secondary and a huge proportion are driven because their parents don't think they can cope getting the bus. Those who do get the bus are often driven to the stop and wait in the car with parents until the bus arrives.

When i was that age I wouldn't have been seen dead with my mother & the bus journey with friends would have been the highlight of the day!

Parents do not have the skills or training to treat Anorexia, self harm, severe OCD, suicidal idealisation, CPTSD, clinical depression, chronic anxiety …..

No of course they don't but how people parent is a huge contributing factor to these traits emerging and developing to a point where they impair.

Agreed, schools now have trained senior mental health leads and we work together to imbed mental health into the curriculum.

This week I have reached about 1000 kids through assemblies on mental health. Taught some strategies, discussed the cbt cycle, explained resilience and how to increase this.

Last week I delivered sessions to 200 kids on anxiety and how to reframe and manage it.

Schools are definitely doing more than they were and my son's school (secondary) have wellbeing as a timetabled lesson once a week.

I don't think mental health is much worse now, it's just more talked about.

When I was a teen most girls I knew were either anorexic, bulimic or self harming. Several teens in each year committed suicide at school.

But it was mostly ignored and we were told to get on with it and people rolled their eyes at it being "dramatic teen behaviour".

I think the only difference is that we were more scared of our parents then, so things like school attendance didn't feel like an option. We were just depressed and self harming at school rather than at home.

This has been a problem for a long time and no one really wants to address the real problem which is parents and their parenting. It is also the outer network of teachers and others that are in young people's lives.

More support and education for parents, smaller classroom sizes with genuine, trained pastoral care, a focus on catering to each person's interests and learning style would all go a long way to helping.

That should continue right through higher education as they they enter the working world.

But all of that takes money, effort and everyone being onboard...

I totally disagree and it’s not what we’ve been told. Children have a multitude of contact and experiences with other humans alongside genes and often sometimes ND and other conditions in the mix. These things are not the fault of parents, how are they? Parents don’t generally go round inflicting significant repeated trauma on their children, they don’t steer them into eating disorders or train them into OCD, self harm, suicidal idealisation …

Masked ND is a huge issue, I spend a lot of my time advocating for families, completing referrals and effectively putting together packages of care that are supportive of ND.

I work with parents of primary children and it is common for the parents to have their own mental health needs. The parent work is either for anxiety or behaviour (emotional dysregulation falls under this) and focusses a lot on secure attachment and the importance of the parent being regulated and able to connect.

Social media is an issue for some young people and for some it's their lifeline.

Totally agree, your work sounds amazing and is much needed. ❤️

Thanks that's what I meant

In reply to your later post that parents don't traumatise their children you are just woefully naive. Many of them do. If we could do away with abusive and neglectful parenting we would be able to close half of adolescent psych units.
I'm sure you don't abuse your kids but there is a lot of it about.

As to my knowing nothing you can continue to believe that if you like but I have been an NHS consultant psychiatrist for over 10 years albeit not a CAMH one so I do feel I have some right to comment on this.

It's a surprise to me if I encounter a patient who has not suffered abuse and trauma in childhood or in later abusive relationships and often both.

Latter part of that post to LightPour

Change the curriculum. It’s too hard and boring. Too many kids fail from day one. It’s no coincidence we are 10 years since the Gove curriculum came out. It’s all these kids have ever known.

Of the many parents of children I know suffering including my own - none of has remotely abused nor harmed our children. In all cases the children are from fairly stable and happy homes. It’s as is the child has very little resilience

whereas I grew up myself with parents very unhappily married, feeling frightened by rows and (mild) violence. I am tough and resilient. I was determined my children wouldn’t have to witness what i grew up with, both emotionally and financially. And they haven’t.

i perhaps know ten troubled teen girls like mine and in nearly all cases, the families are relatively well heeled and stable.

When I was a teen most girls I knew were either anorexic, bulimic or self harming. Several teens in each year committed suicide at school.

Balls, when was this? I went to a huge state suburban secondary that I'm still associated with and as far as I'm aware in 50 years of operating they have never had a single pupil commit suicide. There regularly are year groups with no pupils at all with eating disorders or self harm. There always used to be 1-3 girls who got pregnant each year at 16/17 but this is increasingly rare.

Fresh air and exercise. First because it's free.