YMCA response to the Children, Young People and Education Committee inquiry into emotional and mental health of children and young people in Wales
YMCA is committed to creating healthy, sustainable communities in which young people can fulfil their aspirations. We are the largest voluntary sector provider of activities and services that promote health and wellbeing in England and Wales.
Supporting young people through mental health difficulties is at the foundation of the work that YMCA undertakes, as we seek to develop them in body, mind and spirit.
YMCA Cymru’s 2016 Manifesto We Believe uncovered an urgent need to address the mental health difficulties being faced by young people.
To help encourage young people to speak out about their mental health difficulties, YMCA, in partnership with the NHS, launched research and a nationwide campaign in October 2016. #IAMWHOLE aimed to tackle the stigma associated with mental health difficulties and encourage young people to seek help.
1. Introduction
1.1 Growing up can be a positive time for many. However, there are thousands of young people across Wales for whom the experience is very different. Mental health difficulties among children and young people are common, and can be both persistent and damaging.
1.2 However, the challenges young people face are not limited to their mental health difficulties as many also take on the day-to-day stigma that too often accompanies them.
1.3 Indeed, our I AM WHOLE[1] research revealed that more than a quarter of young people (26%) with mental difficulties had felt the negative impact of stigma. Of those who had experienced this stigma, more than two in five young people (43%) did so at least once a week.
1.4 The research uncovered the overwhelmingly negative impact this is having on many aspects of young people’s lives. Critically, 71% of young people who experienced stigma as a result of their mental health difficulties said that it negatively impacted their willingness to share their mental health difficulties and 71% said it negatively impacted on their willingness to access professional support for their mental health difficulties.
1.5 Keeping mental health difficulties hidden can further add to feelings of isolation and loneliness experienced by a young person, leading to a vicious circle of suffering and solitude. This is critical given that young people often see speaking out as one of the first steps towards seeking help and recovery.
1.6 While it is important that effective support services are available for young people experiencing mental health difficulties, the stigma surrounding them must also be tackled so that young people feel able to access these services without fear of negative repercussions.
2. Promoting emotional wellbeing, building resilience, and establishing and protecting good mental health
2.1 More than a third of young people (38%) with mental health difficulties first experienced symptoms before becoming a teenager, and 14% first experienced symptoms before the age of 10.
2.2 Given the early onset of symptoms and the prevalence of stigma received at young ages, it is clear that interventions must start young and begin in the places young people most often frequent, namely schools and colleges.
2.3 Despite this, schools were named as the main arena in which young people experience this stigma, with 57% of young people who experienced stigma as a result of their mental health reporting to have experienced it here.
2.4 This is linked to the fact that friends (43%), and teachers and lecturers (32%) were named as two of the most common groups perpetrating stigma by those who had experienced it as a result of their mental health difficulties.
2.5 For interventions to be effective at this level, schools must first become environments in which young people feel able to speak openly about their experiences of mental health and seek the support they need, when they need it.
2.6 Given that ignorance was named as a common cause of the perpetration of stigma, education provides a logical starting point by which to tackle it. Indeed, four fifths (80%) of young people who believed that people are stigmatised as a result of their mental health difficulties thought that education could stop the stigma.
2.7 Educating people about mental health, and mental health difficulties more specifically has a two-fold effect. Firstly, it would help prevent some of the unintentional stigma that so many young people experience by tackling the ignorance that often causes it.
2.8 Secondly, educating individuals about mental health helps to make them aware of their own experiences and potential difficulties, which, in turn, helps to improve support-seeking behaviour.
2.9 Many young people reported feeling guilt and shame when discovering their mental health difficulties. Such feelings can perpetuate symptoms and cause the young person to become trapped in a vicious circle of shame, isolation, and self-stigma, which then prevents them from seeking help.
2.10 This self-stigma, therefore, provides an inherent barrier to establishing and protecting good mental health among young people. It is critical that mental health difficulties are normalised in order to break down this barrier and ensure that measures to improve the resilience of young people are as effective as possible.
2.11 Normalising mental health difficulties and tackling stigma requires people to be open about mental health and their difficulties in order to combat the myths and stereotypes that so often dominate the dialogue around them.
2.12 Indeed, 66% of young people who believed that individuals with mental health difficulties receive stigma as a result said that talking about mental health is key to tackling it.
2.13 Similarly, almost half of those young people (48%) who believe that people are stigmatised as a result of their mental health difficulties said that people sharing their difficulties would help to combat the stigma.
2.14 To help aid conversations around mental health difficulties, YMCA produced #IAMWHOLE: Stories[2], a collection of accounts from young people about their experiences of mental health difficulties in their own words.
2.15 In the words of Connie, 22, in the Forward to the piece “Once the conversations begin, you promote understanding for others and break down misconceptions people hold, and others illuminate your own understanding… A normalisation occurs, and that’s a very powerful thing because it allows people to access the help and treatment they really need.”
3. Support for young people with mental health problems
3.1 All professionals working with, or frequently interacting with, young people should be provided with mental health training. This is not only so they can impart their knowledge on young people, but also to prevent them from being the unintentional perpetrators of stigma.
3.2 Indeed, speaking to young people as part of the #IAMWHOLE research revealed countless tails of young people participating in lessons in school, which they felt were stigmatising and exacerbating of their mental health difficulties. While much of this was unintentional, the negative impact on the individuals was no less.
3.3 As a minimum, therefore, it is important that a whole-school approach is taken towards supporting young people with mental health difficulties so that interventions extend beyond the PSHE environment.
3.4 While it is important to educate teachers and professionals working with young people about mental health, it is equally important to recognise that they are often not best placed to support young people experiencing mental health difficulties.
3.5 Pressures to achieve challenging academic results mean that teachers are often already pushed to their limits with little time to address mental health difficulties. This is coupled with the fact that teachers are not experts in mental health and often feel ill-equipped to address mental health difficulties in their students.
3.6 Instead, the role of teachers should be to recognise symptoms and sign-post young people to the appropriate services, whether that is in school or outside of it.
3.7 While important, lessons on mental health and a focus on resilience and prevention must not be seen as a substitute for more specialised and long term support for young people in need, which includes one-to-one and face-to-face support.
3.8 Recognising the range of services that are needed to effectively support young people with mental health difficulties, we have developed YMCA Mental Health Champions; a comprehensive programme that aims to improve the mental health of young people aged 11 to 21.
3.9 The project involved young people from the outset to help design materials and messages to make sure that it connects with the people it is aimed at. It also recruits and supports young people to be able to deliver the programme, resulting in a youth focused service that supports young people to help themselves.
3.10 By using three interconnected strands, the project aims to help raise awareness and destigmatise mental health issues, offers a fully quality assured counselling service and improves the knowledge and support that key adults, including teachers and parents, can offer the young people they work with.
3.11 Recognising the importance of peer-to-peer support, the programme recruits, supports and trains young volunteers to become mental health champions. These champions have access to six developed workshops, each focusing on different areas of mental health, increasing awareness, removing stigma and advising on easy-to-use coping strategies.
3.12 The programme has also developed four workshops to help key adults support the young people they come in to contact with. The workshops deal with topics such as anger, anxiety, depression and self-harm, offering practical advice on how they can begin the conversation with young people and also how their actions can help have a positive impact.
3.13 However, recognising that peer-support programmes are not a substitute for professional services and the difficulties that can arise when trying to access publically funded counselling services, Mental Health Champions offers a counselling service to those young people who need additional help but do not meet the referral criteria for Child and Adolescent Mental Health Services (CAMHS).
3.14 While the school is the natural environment to start tackling mental health difficulties given the prominence it plays in the lives of young people, YMCA also recognises that for some it may not be suitable. This is particularly important in cases where schools provide the source of a young person’s problems, including exam stress, bullying and social anxiety.
3.15 For this reason it is important that a suite of support options are available for young people, which accommodate for differing levels of need, differing styles of support and differing locations, depending on the preferences of a young person.
3.16 While there are a number of effective services already available, including those provided by the voluntary and community sector, they can be difficult to navigate for a young person seeking help or a parent or carer looking to support their young person.
3.17 Recognising this, YMCA’s Right Here project working in partnership with Brighton and Hove CCG, created Find Get Give, an online directory of mental health support services that work with 13 to 25 year olds. One of the website’s unique selling points is that young people can give feedback on the services they have received, enabling their peers to read how young people rate a service that they may be thinking of approaching for help.
3.18 The website also contains a help and advice section which provides immediate support for young people in need, as well as help and advice for parents and carers worried about young people.
4. Building skills for professionals
4.1 As already noted, while interventions must train those working with, or frequently interacting with, young people about mental health, teachers are not best placed to address the mental health difficulties of young people.
4.2 Given the number of high-quality voluntary and community sector organisations specialising in assisting young people with mental health difficulties, an emphasis instead should be put on creating partnerships between the two, creating comprehensive packages of services both in and out of school to best meet the needs of young people.
4.3 Critically, all applicable services should be specifically designed to meet the specific needs of young people, which often differ from those in the older age groups who have mental health difficulties.
4.4 Efforts should look at how all professionals can be better equipped to support young people with mental health difficulties, including healthcare professionals.
4.5 This point is particularly pertinent given that of those young people who had experienced stigma as a result of their mental health difficulties, 43% said it came from GPs or health professionals. Naturally, given their professions this is likely to have occurred in those vital instances where young people are seeking support.
4.6 Young people reported mixed experiences of this support-seeking process. While numerous young people reported the ease of the process and how helpful their GPs and health professionals were, others reported being met by people who they felt did not understand their difficulties, did little to support them, or lacked the necessary resources to help them.
4.7 Speaking out and seeking help can be difficult for young people, and it is important that when they do, they are met with friendly and supportive services which effectively meet their needs. Training professions in the specific needs of young people will go some way towards achieving this.
4.8 In addition, the pivotal role of the family cannot be forgotten. Research for the #IAMWHOLE campaign revealed that of those who had been stigmatised as a result of their mental health difficulties, 86% said it came from their parents or guardians.
4.9 Again, while much of the stigma originating from the group can be unintentional, the negative impact that it can have on an individual with mental health difficulties is no less.
4.10 Accordingly, it is important that parents and guardians are provided with support and information so they feel better equipped to support a young person experiencing mental health difficulties.
5. Social media and the internet
5.1 Young people with mental health difficulties report mixed experiences of social media and the internet.
5.2 While many young people interviewed as part of our #IAMWHOLE research identified social media as having a negative impact on their health and wellbeing – stating that it often exacerbated feelings of isolation and loneliness – experience of stigma via these means was relatively low.
5.3 This is likely linked to the fact that experiences of cyber bullying were comparatively low (14%) compared to other manifestations of stigma (71% of young people who had experienced stigma as a result of their mental health difficulties said that they had been subject to negative attitudes).
5.4 While incidences of explicit cyber bullying are relatively low compared to face-to-face abuse, often much of the content on social media and on the internet more generally succeeds in fuelling the negative perceptions that so often dominate conversations about mental health.
5.5 Therefore, while education and early-interventions are critical to effectively tackle stigma and support young people, it is important to also address the wider public conversations about mental health and the negative messages that too often dominate the media and undermine more positive interventions.
5.6 In order to achieve this, action must be taken to combat the irresponsible reporting of mental health difficulties in the media, which have seemingly become part of everyday life.
5.7 The onset and expansion of social media has provided the ability to reach millions of people with relative ease. In order to tackle stigma, this must be used to counter the negative dialogue and normalise mental health difficulties in the eyes of the public.
5.8 The #IAMWHOLE campaign is an example of a positive use of social media to counter the negative dialogue around mental health.
5.9 A partnership between YMCA and NHS, born at YMCA’s Right Here project in Brighton, the campaign aims to tackle stigma and encourage people to talk about mental health. Launched on 10 October 2016 (World Mental Health day), the campaign saw people across the world posting supportive selfies on social media to help spread awareness.
5.10 Campaigns like #IAMWHOLE show the positive uses of social media and the internet. While they are not a substitute for direct interventions in schools, they are an effective addition to raise awareness, change the dialogue and tackle stigma.
6 Conclusion
6.1 While mental health difficulties themselves are inevitable in some cases, young people are currently being failed by a system that does not provide adequate support and in some cases even perpetuate the stigma and suffering that so many experience.
6.2 While education and schools provides a critical starting point to support young people, it is necessary to realise the interventions in school will only go so far in tackling the problem.
6.3 Listening to the voices of young people in #IAMWHOLE: Stories revels that no two experiences are alike and therefore no one-size-fits-all approach is likely to be effective.
6.4 Therefore, supporting young people with mental health difficulties requires a multifaceted approach. In order for this to be effective it is important that mental health difficulties are understood in the context of those young people who experience them and interventions are formulated around their specific needs.
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