New research shows that many teens with mental health problems feel they have no one to turn to. But one group is trying to change that, writes CARL O'BRIEN, Social Affairs Correspondent
KEITH DOHERTY IS listing the names of friends and loved ones he has lost to suicide over the past few years. “There was David, a few months later it was Darragh, and then another David . . .” says Doherty, a softly spoken 19-year-old from Athboy, Co Meath. “In total I lost five people within two years. Depression and suicide was always around. In most cases, I think, they felt they had no one to turn to or that no one would understand their problems.”
Doherty can relate to them. He, too, battled depression and anxiety in his mid-teens, afraid to share his feelings with his parents and unable to discuss them with his circle of friends.
“It was like a box you carry around with you, a box of problems. It kept getting bigger and bigger. You’d talk to your fiends, but they might judge you. You don’t want people looking at you thinking ‘It’s just a matter of time’. And if you tell your parents, you think they’ll have a fit and put you under even more pressure and stress.”
He’d have turned to the mental health services, except they felt remote and adult-oriented. There was also the all-pervading stigma of the psychiatric hospital, the “mad house” on the hill where people went and never came out. Or at least, that how it seemed from the outside.
“On top of that, even if you tried to access services, transport is a big obstacle,” he says. “There’s the cost of going to the GP or specialist, but how can you afford that as a teenager? And then talking to a professional. Sure, a 12- or 15-year-old wouldn’t have a clue how to start talking to someone. You just feel very alone.”
Loneliness. Isolation. Alienation. They are sentiments which course through a report published this week on mental health services for young people. Somewhere To Turn To, Someone To Talk To, published by Headstrong – the national centre for youth mental health – contains some startling results of a survey on how young people are coping with problems and who they are turning to for help.
Overall, it paints a picture of a generation in which significant numbers are reporting high levels of psychological distress, resulting in disturbing behaviour such as eating disorders, self-harm, misuse of drink or drugs and suicide. What’s more worrying is that many feel increasingly isolated and alienated and don’t know where to turn for help.
A total of just 64 per cent say they have an adult available to talk through problems regularly, while only 38 per cent report being able to cope with the problems they face. Almost half report having been bullied at some stage, while one in 10 say they have experienced serious mental health problems, but have not sought professional help.
When stress and anxiety are tracked through the school cycle, it consistently peaks for both girls and boys in third and fifth year, before trailing off.
These figures, set against a backdrop where Ireland has one of the highest youth suicide rates in Europe and where two-income families have less time for children than ever before, make for alarming reading.
Yet Dr Tony Bates, the founder of Headstrong, isn’t pessimistic. While the figures pose challenges for society and the mental health system, he says the path to responding more effectively to the mental health needs of young people lies in listening more to what they need and using existing resources more effectively.
“I don’t think parents are bad, they are doing everything they can. There are more and more books out there now telling them what they should be doing. It’s a wonder they can feel relaxed and be spontaneous at all,” he says. “They often feel feel very blamed and judged if there is a difficulty with their own child. But a young person’s mental health can be influenced by a whole range of issues: school, friends, culture, consumerism, materialism, individualism, society becoming more disconnected . . . The question for me is not how we can save young people from this hardship, but how to equip them to deal with these pressures and empower them.”
ONE OF THE most important findings from the research is that the most resilient young people are those who feel connected to their families and have an adult they feel they can talk to.
“The availability of an adult is crucial, whether that’s a parent, a relation or teacher, Dr Bates says. “We know that the most powerful ingredient of psychological healing is relationships: it ultimately comes down to that. If you don’t have that, nothing else works. If there is a depth of understanding and respect and confidence in a relationship; these things are terribly important for young people.”
He also points out that we shouldn’t be surprised that young people go through stressful or anxious times. Establishing your independence, navigating your way through adulthood and making critical life decisions is no easy feat. Yet this generation faces additional stresses that previous ones haven’t.
“Today’s young people are growing up in a period of rapid change, uncertainty over the future, the absence of a clear set of ideals that transcend material prosperity, and contradictory messages regarding what’s expected of them . . . While this generation seems to have more in terms of education and career opportunities, it’s finding it harder to experience a sense of meaning, belonging and purpose in life.”
For those who falter during their adolescence, life can be especially daunting. Focus-group research shows most young people don’t know where to turn for help and are put off by the many obstacles of adult-oriented mental health services.
On top of that, services tailored specifically to adolescents are non-existent in many parts of the country. Where they do exist, they are typically saddled with long waiting lists. Nationally, more than 3,600 children or adolescents are waiting for psychiatric assessments; of this figure, more than 1,000 are waiting more than a year.
Stephen McFadden (20) from Donegal was diagnosed with depression last year. He is frustrated at the failure of services to respond to the most basic of mental health needs among young people.
“You’re either mentally fine, or mentally ill; we don’t talk about keeping mental health positive,” says McFadden, a student who’s also a youth advocacy worker with Headstrong. “So the perception is that mental health services are all about really crazy people who need to be sectioned. It’s as if it doesn’t respond to normal, everyday problems.”
He also says access to services is incredibly difficult compared to Scotland, where he is attending university.
“In Edinburgh, it’s so easy. You go to a GP and it’s free; here it costs €50 or €60. Young people mightn’t have that kind of money. Young people are also involved in designing services for their age group. You can’t have a group of 50-year-old men who think they know what young people want. Young people over there are at the heart of decision-making. In Ireland, stuff which is supposed to involve young people, like Dáil na nÓg, feels very tokenistic.”
Marie Duffy, a 24-year-old journalist from Donegal, tells a similar story.
“I went through a tough time at school when I was 17. I was put on a waiting list for 18 months and ended up dropping out of school because I couldn’t cope; I needed help right then, but it wasn’t there. It’s no wonder we have a high suicide rate among teens with that kind of response,” says Duffy, who is also a youth advocacy worker with Headstrong.
“When you do get a service, all they want to do is prescribe you medication, whereas you might just want someone to talk to or turn to. There is too much focus on mental illness as opposed to mental wellbeing.”
AND THIS IS where Headstrong’s big idea comes in. It has designed a simple model for young people to access mental health services which, it hopes, could be rolled out across the country. It’s a community model of support for young people that draws together existing services and offers them in a timely, accessible and youth-friendly manner. It also recognises the resilience of young people and their ability to try to deal with the stresses they face in their own lives.
A bricks-and-mortar version of the model has been operating successfully in Galway for the past nine weeks (see panel).
“This isn’t rocket science,” says Dr Bates. “It’s using what we have in a similar way, just making it much more youth-friendly and accompanying a young person right across the system, whether that’s to a GP, a specialist service or to AE.”
Getting existing services onside took several months of gentle coaxing and persuasion, with many fearing that the new model would lead to a sudden avalanche of cases on an already overstretched services. It hasn’t happened, though. Most of the young people it has supported so far have needed simple advice and support; just two young people who came to their attention ended up being admitted into the psychiatric service.
For people such as Keith Doherty, it’s the future for mental health services.
“I got involved in Headstrong when I saw what it was doing. It’s a brilliant idea. It gives young people a voice and means that we’re not ignored. Through the support of some great people, I’ve come a long way,” he says.
“You know, I feel like an eagle these days. When you look around you at all the great things there are and the things you’d have missed if you weren’t here. Young people might need a little help to cope or deal with problems. Everyone out there needs to see that there is light at the end of tunnel – you just might need some help getting there.”