Q&A about children's mental health issues with Natasha Devon and Lynn Crilly.

[RachelMumsnet]

To mark Children's Mental Health week, we’re running a Q&A with Natasha Devon an Lynn Crilly, authors of Fundamentals, a new book which offers honest and practical advice to parents and teachers who are struggling to cope with common mental health issues in children, such as body image insecurity, self-harm, eating disorders and anxiety. The book also includes advice on bullying, technology and social media, sexuality and its link to self-esteem and the correct way to communicate about mental health.

Post your questions to Natasha and Lynn before midday on Friday 27 February and we’ll post up their answers on 6th March.

Please note: In certain situations Natasha and Lynn may not be able to give specific advice without actually seeing the person or knowing more about the circumstances. If this is the case they will suggest the best places to go to get more advice or assistance.

About Lynn Crilly and Natasha Devon
Lynn Crilly is a Counsellor, Mother and Author. Through using her unique and very effective form of counselling she has established herself as one of the country’s leading private therapists. She wrote her first book Hope with Eating Disorders in 2012, which was widely praised for its down-to-earth and non-judgmental advice to parents and carers. Lynn is a trustee for the charity ‘Men Get Eating Disorders Too’ ’.

Natasha Devon is a journalist, TV pundit and founder of The Self Esteem Team, who have taught more than 40,000 teenagers in schools, colleges and universities throughout Britain. She works alongside the All Parties Parliamentary Group on Body Image and campaigns for good body image and mental health practice in schools and in the media.
The Self-Esteem Team were given an award at the House of Commons in 2014 in recognition of their services to education. Natasha has been named a Mental Health Association ‘Hero’, one of Ernst & Young’s Top 50 Social Entrepreneurs and Cosmopolitan Magazine’s Ultimate Woman of the Year.

My daughter is 11 years old (nearly 12) and her father and I split up when she was 6. She has always had regular contact with her father every weekend and always had a good relationship.
His partner died last year who my daughter was very close to. Since then he has had several casual relationships (she has never mt any of them). However she read his facebook messages to several women all regarding casual sex. Since reading these she is disgusted with him and wants to see him as little as possible. She said he's not interested in her, just having as many girlfriends as possible and that what he wrote is vile and he has no respect for his deceased girlfriends memory. I couldn't even tell her that she shouldn't have been snooping as he had used her tablet to access facebook and left his account logged on. He also tells her to bring her tablet when she stays with him and she resents this as she feels he is using her.
I have tried talking to him, but he really takes no notice, he has no interest in her life. I invite him to parents evenings, school events etc but he never attends. She now notices this and I can see a real resentment building.
How can I encourage her to have a positive relationship with him, but take her concerns seriously?

My daughter is 7 & a half. We're going through assessments for ASD and are waiting for some support from local services. One of our main issues with her is anxiety & hearing voices who tell her she is no good. A lot of these seem to be triggered from negative self-image & needing things to be perfect. We are walking on egg shells to ensure we don't say anything too negative around her but we need to be normal; a simple comment saying like her shoes smell or she needs a bath could send her into a meltdown of negative thoughts about hating herself! What can we do as a family to help?

The Q&A is now closed. We'll post up Lynn and Natasha's answers next week.

When will the responses be posted, MNHQ?

Hi Selks - we'll chase this up now and see if we can find out what's happening and let you know.

Hi there, we have the answers back from Natasha and Lynne and will post them up now.

Hello All! I’m incredibly honoured and excited to have been asked to contribute to Mumsnet and was anxious to clear up the concerns relating to my ‘credentials’ in the Q & A feed.

My interest in mental health arose after I battled bulimia and depression in my late teens and early twenties (I have now been recovered for eight years). It struck me that, as a ‘straight A’ student, school had somehow left me completely unprepared for the world and it’s challenges, which was where the first spark of the idea for the Self-Esteem Team’s classes came from. I have first-hand experience of a mental health issue, but of course that is not the same as ‘knowing your stuff’. I am acutely aware of the sensitivity of the topic (in fact there is a whole chapter in the book about the mistakes being made in the field of mental health awareness raising) and of the importance of approaching it in the right way.
I do not have any official psychology qualifications (although I have taken courses in NLP) and my experience and expertise has come primarily from working on the ground with teenagers and teachers in more than 200 schools. I work alongside the All Parties Parliamentary Group on Body Image and charities B-eat (eating disorders), Body Gossip (body image) and Young Minds (mental health). My connection with these organisations, along with the database of experts I have built up through writing for a number of national publications, means I am privileged to be kept abreast of the latest research and to be able to check that my classes are in keeping with the current protocol.

I would never presume to diagnose a young person with a mental health issue, or attempt to prescribe medication. Our Self-Esteem Team classes are more generally geared towards every-day techniques for maintaining good mental health, building self-esteem and developing a positive body image. By far the most useful tool in shaping and evolving these classes has been a continued dialogue with thousands of British teenagers, who have very definite ideas about what is currently missing from the PSHE curriculum and the skills they would like to gain to guide them towards a more confident and healthier future. My team have won a government-affiliated body confidence award and our classes have also been recognised by the Mental Health Association.

In order to research Fundamentals, I called upon the expertise of several global experts in the field, including Dr Susie Orbach, Dr David Bainbridge and Dr Jean Kilbourne.

Neither Lynn nor I would ever claim to have ‘all the answers’ but we do feel that we can offer a different perspective which might help to broaden the understanding of parents and teachers and subsequently assist them in combatting common mental health and body image struggles. This was why we wrote Fundamentals and we were delighted when members of the Mumsnet team read it, loved it and invited us to feature on their website as a result. There was no ‘sponsorship’ involved in our relationship with Mumsnet at any stage.

So, now to your questions and comments. Lynn and I have divided them into the ones we felt we were most able to answer:

@WowOoo

The book looks like an interesting read. I'd like to know more about eating disorders in young people and how to encourage my boys to have a healthy relationship with food and their bodies.

I think I need reassurance that I'm doing the right thing for my son. If I suspect something is troubling him and making him anxious, but he won't open up and talk to me or my husband what can we do?

Do we accept that he's OK whilst reassuring him we're here to listen or talk if he wants? Do we try to get him to spend time with an adult friend so he can talk to someone who's not in our family?

Thank you for asking this question – It’s an incredibly important one. In 2015, we are beginning to recognise that eating disorders can affect men, too, but unfortunately most people do not realise that they tend to manifest in a different way. Add to this the fact that diagnostic criteria still used by many GPs are written assuming that the patient is female (‘have they stopped menstruating?’ being a key component in diagnosis of anorexia, for example) and it means that it’s easy for male eating disorders to fly under the radar.

According to B-eat, bulimia is the eating disorder most commonly experienced by men, who make up about 1/3 of diagnosed cases. This statistic only represents those who actually seek help for their condition, however and with so much social stigma still attached to men having eating disorders it’s unlikely to be an accurate reflection of the population as whole.

The challenges of talking to boys about body image/eating etc are almost exactly the opposite of the ones you face with girls. Girls talk about bodies, food and exercise so much they can normalise behaviours and attitudes which are, in reality, really unhealthy. Boys don’t tend to discuss it so much – they might talk about their gym habits in their peer groups, but they don’t admit vulnerability, insecurity, or the real reasons why they are concerned with the issue.

If Dad, or another male role model, is able to, I recommend that they kick start conversations surrounding food, exercise and body image, to let young men know that they aren’t the only male in the world ever to have thought about it (to help reduce stigma). But rather than having a sit down conversation that seems like a huge deal (and therefore might be embarrassing) it’s better to have a ‘drip feed’ approach and just casually make a few comments every week that a) let younger men know it’s okay to open up on topics relating to body image and health and b) lead by example by demonstrating a healthy attitude to food and exercise.

In Fundamentals I talk about the correlation between the lack of male role models in a lot of boys’ lives and this generation’s obsession with the gym. Boys actually crave boundaries and routine and need to be explicitly told what to do, which is why a gym environment often appeals to them. In my experience, male eating disorders are more likely to manifest as an obsession with exercise/being muscular.

In my body image classes for boys, I use a lot of scientific theory –optical illusions and facts about the effects of things like protein shakes on the body, to make the whole thing seem less ‘emotional’ and therefore (in their minds) less ‘girly’. I also encourage them to have a healthy scepticism for capitalism and the way it has commodotized our relationships with our bodies – boys and men hate to feel as though they are being manipulated (which is why evidence shows men are more likely to believe conspiracy theories, for example). I also talk about how the muscles which denote strength are in fact the ones that cannot be seen from the outside (so, for example, male dancers are incredibly strong but often quite slight).

If you are concerned that a young man you know has developed an eating disorder, there’s a fantastic charity called Men Get Eating Disorders Too (www.mgetedstoo.co.uk) which can provide further advice and support and is campaigning for equal priority and support to be given to male patients.

@JaneHersey1953

What Children's Mental Health Week means for many children and young people is meaningless;

Child poverty is the highest ever recorded. Poverty is the major cause of mental illness in people of all ages.

There is currently a 40% increase in youngsters self harming because of poverty since David Cameron came to power. Schools are struggling with this not least because local authority support has been lost.

£50 million + cut from children's mental health services.

Over £2 billion cut from youth services. Youth clubs have been closed.

Welfare cuts mean more children are being taken into care. Children in care are at increased risk of mental illness and self harm. Privatisation looms for many vulnerable children as social service provision will be put out to tender and safeguard checks dropped.

So what does this designated week mean in the light to children being plunged further into poverty and mental illness?

I don’t agree that Children’s Mental Health week is meaningless but you are spot on about social and economic issues having an impact on our mental health. This is something which is so often missing from the conversation and that’s why I devoted a whole chapter of Fundamentals to examining political and socio-economic contributory factors to low self-esteem and poor mental health.

‘The Low Self-Esteem Generation’ was by far the trickiest chapter to write, but along with ‘Sexuality and Self-Esteem’, it’s the one I’m most proud of. In it I look at the way the education system is structured (so children are learning facts not skills), the disenfranchisement most young people feel from the political system, unemployment, the fact that a ‘normal’ job isn’t enough to buy independence any more – All of these things directly impact the way young people feel about themselves and how able they are to deal with life’s challenges.

As a media pundit, it frustrates me that public discussions relating to mental health are so quick to point the finger at what I would call ‘surface considerations’ like celebrity worship culture and social media. These pressures water the soil of poor self-esteem, but the soil itself is made up of far weightier and less easily dismissed factors, which is why doing my job necessitates taking an active interest in politics.

So thank you again for a brilliant and insightful comment!

@Nerf

Once a problem has been identified, how long a wait is benign and when does that tip over into exacerbating the condition?

This is very vague, as it depends who is identifying the problem. If an issue has been brought to your attention from the parents, school, child, take time to collect the facts. Try not to go with your first response, this is an emotional reaction, slow down your thoughts and take time to consider the actions of ‘interfering’ a word that has very negative connotations. If a child is at risk in some way, consider speaking to the family doctor as a starting point. There a safe guarding policy in place which any medical/healthcare professional is duty bound to follow to protect the child, and thus enables the problem to be handled by professional trained to deal with a specific issue.

@Ziglinda

My nephew is 8 and has become very worried about dying. He is constantly asking things like "will I die from touching the TV?" or "will I die because I guessed that something would happen and it did?". His family are very religious so he is also asking me (he doesn't ask his parents who would be deeply disturbed by it) things like "I accidentally said 'God kill me young'. Will I die from that?" It started in early January and I'm at a loss.

This could be the start of your nephew suffering from anxiety. Children experience lots of fears as they mature and dying is a very common one. Try talking to him in a calm manner, instead of reassuring him, stick with the facts, real evidence based proof that he has touched the tv many times and nothing bad has happened to him. Distraction works very well with anxiety, but only if you acknowledge the anxiety first, then move onto a simple distraction activity. Also consider mentioning this to his parents, there may be family tension that he is picking up on, as they need to be encouraged to communicate with their son.

@lozzybeast

My daughter is 11 years old (nearly 12) and her father and I split up when she was 6. She has always had regular contact with her father every weekend and always had a good relationship. His partner died last year who my daughter was very close to. Since then he has had several casual relationships (she has never mt any of them). However she read his facebook messages to several women all regarding casual sex. Since reading these she is disgusted with him and wants to see him as little as possible. She said he's not interested in her, just having as many girlfriends as possible and that what he wrote is vile and he has no respect for his deceased girlfriends memory. I couldn't even tell her that she shouldn't have been snooping as he had used her tablet to access facebook and left his account logged on. He also tells her to bring her tablet when she stays with him and she resents this as she feels he is using her. I have tried talking to him, but he really takes no notice, he has no interest in her life. I invite him to parents evenings, school events etc but he never attends. She now notices this and I can see a real resentment building. How can I encourage her to have a positive relationship with him, but take her concerns seriously?

It is not your responsibility to encourage a positive relationship. Use your energy to strengthen your relationship with her, rather than encourage a relationship with a parent who is not considering his actions on his daughter. It sounds like this little girl has been exposed to loss and grief. Firstly the breakdown of your relationship, the death of his dads ex partner and now the loss of her ‘ideal, father figure on FB. There are stages in the grieving process and she may well be trying to process some of these feelings in the angry stage, be patient with her, encourage her to talk about her feelings and try not to get into conflict with your ex. When the situation has calmed down you may find they find each other.

@helpneeded29

My daughter is 7 & a half. We're going through assessments for ASD and are waiting for some support from local services. One of our main issues with her is anxiety & hearing voices who tell her she is no good. A lot of these seem to be triggered from negative self-image & needing things to be perfect. We are walking on egg shells to ensure we don't say anything too negative around her but we need to be normal; a simple comment saying like her shoes smell or she needs a bath could send her into a meltdown of negative thoughts about hating herself! What can we do as a family to help?

I would suggest that you wait until you have your daughters results as there are so many variables to ASD. I would then expect a care plan and some family therapy sessions to be put in place to support your daughter’s needs. Once you know her diagnosis you can also look for a local support group, as hearing other parents stories and tips are very useful in managing this condition. In the meantime, keep the focus on normal family routines and activities. Pay attention to spending quality time with her, 20 minutes of pure 1-2-1 attention, will help and look for opportunities for you to affirm positive aspects of her personality.

We seem to be missing one more answer from Natasha which we'll post up as soon as we get it. Thanks so much to Natasha and Lynn for joining us for the Q&A and thanks to all those who joined.

We'll certainly look into getting Dr Byron to join us again in the future.