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Young People and Mental Health

The below is a speech I gave about young people and mental health.  It talks a lot about my own history and how I came to be where I am now.

“In May 2009 The Sainsbury Centre for Mental Health published a report called ‘Childhood mental health and life chances in post-war Britain’ using data from tracking three large cohorts of people born in the UK in 1946, 1958 and 1970. What they found, amongst other extremely interesting things, was that the best indicator of future mental health difficulties was mental health difficulty as a young person.  These difficulties influenced life chances by impacting on education, which in turn impacted on employment. The authors of the report remark that a large amount of mental ill health among children and young people goes unrecognised and untreated. They also state that only about a quarter of those with a clinically diagnosable disorder are in touch with specialist mental health services.

Despite being fairly ill when I was at school, I didn’t come into contact with mental health services until I was in my late teens and only then meaningfully when I was in my early twenties and at university.  In many ways, I missed out on the opportunity to have help sooner because I was a young person before a lot of the meaningful and important work had been done to really focus on the wellbeing of young people.

I went to a large comprehensive school in the north of England.  I was fairly unremarkable and bookish.  I wasn’t amazingly happy, but didn’t really fall beyond what might have been considered normal.

When we were fifteen, my best friend tried to kill himself.  We’d been away camping, had a brilliant time being drunk, falling in streams and tripping over guy ropes.  I didn’t hear from him for a few weeks then he phoned me to say that he had tried to kill himself and that he was in a young person’s secure unit.  What he complained about most bitterly was that he had to sit and do group therapy with people he had nothing in common with, taking his medication and doing therapeutic activities.  I took him books and tapes.  He hated having all elements of his behaviour pathologised and laughed at the well meaning questions about why the music he liked was ‘so aggressive’.  He dropped out of school completely.  I found him again on friendsreunited a few years ago and he’s a massively successful computer programmer now, so some things do work out okay.

As The Sainsbury research remarks, and I quote “While associations between early mental health problems and later adverse outcomes are strong, they are by no means pre-determined or inevitable. Many individuals escape from risk and some may even flourish in adulthood.”

When I was in the sixth form, things became a little more problematic for me, and looking back, I suppose I was already experiencing what would much later be diagnosed as Bipolar II disorder.

I’m sure that schools now have a far greater idea of useful approaches to take to their young people experiencing mental health difficulties.  When I was at school, a teacher told me that my head of year was going around asking everyone if I was really unwell or if I was putting it on.  He said he’d told the head that ‘I did listen to a lot of Joy Division!’.

Being bookish and rubbish at football had its advantages I suppose in that it meant I was less likely to get into the kinds of trouble that can have really long term consequences.  I think I knew that education was probably my way out of the life that I didn’t feel suited me.

I’m sure that were I to have been at school now, with the increased awareness of the mental health needs of young people that I would have come into contact with services much earlier.

I did pretty well, considering I really wasn’t quite having the best days of my life.  I came out of it all with three A stars at A level and a place to study English and Philosophy at Glasgow University.

And I didn’t go.  I just didn’t say anything about preparing to go to university and then when the day came just didn’t turn up.  I went on the dole instead.

Eventually I became a volunteer and moved away from Newcastle to, ironically, work with people with mental health difficulties.  I went from there to working with people with visual impairments.  In between, my mother died.  I was 19.

By 20, I was so worn out by working, drinking, finding housing, dealing with the aftermath of my mothers death and a relationship that was rapidly going sour that I thought it might be a good idea to take up the offer of university education, if for nothing else than it would represent some peace and quiet, some secure housing and an opportunity to catch my breath after a fairly disordered few years.

Instead what happened was that I became very ill.  I lost it in fact, managing to be at university for about two months over the space of two years, ending up penniless, in debt, nearly homeless and so ill that I couldn’t do anything.  It was only then that I accepted my GPs attempts to refer me to a Community Health Team and only then that I began the process that would eventually see me as the editor of England’s first aspirational lifestyle magazine for people with mental health difficulties.

University, in common with school, is one of the areas that people focus on most when they think about young people’s mental health needs.  I suppose there are two reasons for this.  The first is that it is easy to ‘see’ when young people become ill at university because they are involved in a fixed programme of work in which they either progress or do not progress.  It’s easy to get your head around ‘not well enough to continue his or her studies’.  In a way it’s like a kind of ever rolling cohort study.  It’s possible to collect data from universities about students with disabilities and therefore measure the level of mental ill health experienced by young people while there.  The second and related reason is that the young people at university tend, on average, to be more able to express themselves and in turn have parents who are better able to express themselves and make a noise on their offspring’s behalf.  We ‘see’ young people with mental health difficulties better when they are involved in an organised framework.

University for most is a kind of halfway house between adulthood and childhood, kind of like adult life with training wheels.  Young people who leave school and go straight into work or unemployment do not have anywhere approaching the level of pastoral care commitment and freedom of choice in access of services.  In many ways, it’s their life chances that I worry about more as very often they can, or have, avoided specialist treatment for their difficulties and may be more likely to be stigmatised because of them.

For me, as for other people with mental health difficulties, university presented some particular difficulties.  I wasn’t aware of myself as a person with a disability, as at that time I didn’t have a strong enough diagnosis and mental health difficulties as disabilities didn’t even cross my mind.  Despite being ill, I felt as if I was failing and felt deeply responsible.

Now of course, looking back, I would have sought the support of a disability officer who would have been able to help me make my case for adaptations.  As it was, I felt as if I was on a stay of execution ready to be edged out.

I wasn’t 18 and didn’t have a parents home to go back to, so my life at university was ‘my life’.  If I had dropped out rather than clinging on, I would have been at the mercy of the benefits system and would have been homeless.  I was lucky that this did not happen.

Short of working on an oil rig or joining the army, the traditional model of university is one of the most immersive experiences available.  You are expected to severe all ties with your previous life and launch yourself into a new town, a new pattern of life and to build a whole new set of friends and colleagues all at the same time.  It is easy to forget just how disruptive this experience is, or how much pressure this can put on the individual.

Despite the fact I was older, I was in the position of trying to build a support network of friends at the same time as my condition was making it increasingly difficult to do so.  To assist this I relied on the traditional tools of booze and other things to make this easier, which in turn worsened my condition.  All of this against a ticking clock of needing to be well enough to do the work that I needed to do to stay at university.  It was like a high stakes game that I sadly lost, collapsing in a complete mess.

In common with most young people, the challenges that I faced were not solely mental.  My condition posed me challenges like money, housing, other health problems.  In short, what I needed was support with all of the difficulties in my life, not just my soon-to-be diagnosed mental one.  Like so many people, I’d ended up in a situation where my mental health difficulties compounded my other difficulties and they in turn made my mental health difficulties more difficult to overcome.

There are three main elements that make for a stable life: a regular income, a safe place to live and a supportive network of people.  By going to university, I removed, by my own hand, all of those three elements and it took me a long time to achieve them again.  That’s the challenge with young people and mental health; to ensure that young people have the opportunity to achieve a level of stability that gives them the chance to overcome their mental health challenges and get where they want to be in life.  That’s the real difference between young people’s needs and other groups:  young people might not have had the chance to get things sorted and stable before their mental health difficulties start to make things more complicated.

It’s like a stool.  Three legs, you’re sitting pretty.  Two legs and you can balance pretty well as long as nothing knocks you off balance.  One leg and you’e pretty much just holding on.  No legs and you’re on your arse and everyone else is looking down at you.

When you don’t have any stable things, then you really can have experiences and make decisions that reverberate right through your time as a young person and potential through the rest of your adult life too.

When I finally received a diagnosis, at the age of 22 there was a brief period of relief followed by a much longer period of shock and existential crisis.  On one hand I was relieved to finally have a name to describe the things that I experience, but on the other hand I was suddenly given the task of trying to work out what someone with that label was meant to do with the rest of their lives.  I didn’t really have any positive images of people with mental health difficulties living productive happy lives to draw on, so I was worried that I would forever spend my days in a kind of grey waiting room, eternally sick and suspended.  in some ways I’m glad that I didn’t have that experience to deal with earlier in life.

I’m not sure that having a diagnosis without a store of positive images of people with mental health difficulties as a teenager wouldn’t have made me stop my life in its tracks even sooner.  When people don’t have good positive information and images to draw on, they build their understandings from what they have to hand, namely popular culture.  I had Ian Curtis and Richey James from the Manic Street Preachers.  I’m sure young people today try to make sense of their own mental health difficulties in similar ways.  I hope now, between us, we can continue the work of showing that mental health difficulties are just a normal part of life and that it’s not just doomed rock stars but mothers, bank managers, nurses, hair dressers, footballers and even magazine editors that have them too.

I think things have begun to change for young people with mental health difficulties.  There is so much more awareness now, admittedly some of it less helpful and well meaning than it could be.  We have to get away from the narratives of tragedy of wasted potential on one hand and containment of problems on the other.  People have mental health difficulties full stop.  What they are is challenges, and they need help to overcome them.  And that’s where we come in.

When I talk to young people, they agree with Kat Cormack, one of Young Minds VIKs that young people aged 16 25 need specific services geared to their needs.

And to that I’d add that one perennial thread that runs through all young people talking about mental health services is that they’d like better information about exactly what they can do if they’re having difficulties and what services such as CAMHS can offer them.

If that information had been around when I was a teenager, it would have been me that took myself to services, because I knew better than most that something wasn’t going as well as it could have been.


Speech given to the Mental Health Today Exhibition seminar ‘Younger people and mental health’ Business Design Centre, London 08 December 2009

Mark Brown is the editor of One in Four magazine.  He’s not feeling that young anymore .