Supporting Children with Mental Health Issues and their Families MARIE HARRINGTON ASWTL CUH

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1 Supporting Children with Mental Health Issues and their Families MARIE HARRINGTON ASWTL CUH

2 The number one health issue for young people is their mental health Mental Health has been defined as a state of well being in which the individual recognises their own abilities and is able to cope with normal stressors in life (WHO,2005). Ireland has a critical lack of knowledge about children s mental health. Our national mental health policy A Vision For Change (2006) is based on data gathered largely outside of Ireland. It acknowledges several areas where an extreme lack of resources exist. My World Survey, National Study of Mental Health in Ireland (2012), captured the views of 14,500 young people aged yrs, 6,085 of which were adolescents. MWS found that over one third interviewed had mild to severe depression or anxiety (Dooley & Fitzgerald, 2015).

3 Looking after your head. Mental Health is all about looking after your head. Life can be tough at times, we all go through ups and downs in our health, relationships, work or school. Good mental health means having the skills and support to deal with these challenges in our lives. Good mental health is a requirement for optimal psychological development, the growth and maintenance of productive social relationships, effective learning, an ability to care for oneself, good physical health and effective economic participation as adults. (Headstrong, 2016)

4 Mental Illness A Mental Health Problem occurs when our thoughts or feelings are troubling us to the extent of affecting our day to day activities or relationships. We may not have a mental health illness but might need help to get through a hard time. A mental health problem that is unresolved may develop into a mental illness. A Mental Illness is a more serious or long lasting problem, which can be diagnosed by a doctor or a mental health professional. It may require medical treatment as well as support. There are many different types, just as there are different forms of physical ill health. (Headstrong, 2016)

5 Types of Mental Health Issues Affecting Children & Adolescents Depression/ Mood Disorder Anxiety (which can be generalised, complex and severe) Attention Deficit Disorder (ADD) and Attention Deficit Disorder with Hyperactivity (ADHD) Significant Emotional and Behavioural issues Post Traumatic Stress Response/ Disorder Complex Behavioural Problems/ Conduct Disorders Complex Bereavement Response Self Harm Psychoses Eating Disorders Obsessive Complex Disorders

6 Why are these issues more prevalent in todays young generation? OVER THE PAST DECADE, THERE HAVE BEEN ENORMOUS AND RAPID CHANGES IN IRELAND S ECONOMY, SOCIO-DEMOGRAPHY, CULTURE, SOCIETY AND VALUE SYSTEMS (WHELAN & LAYTE, 2006). THESE RAPID CHANGES HAVE SIGNIFICANT CONSEQUENCES FOR YOUNG PEOPLE.

7 Changes.. Changes in the economy: Similar to the international economy, Ireland has experienced major economic changes in the last few years and undergone a major reversal in the prosperous economic climate that had prevailed since the mid-1990s Changes in family structure: Significant changes in family structure have taken place since the early 1990s in Ireland. Changes in the meaning of adolescence: A child s journey into adolescence is starting earlier and finishing later than in previous generations. Young people are experiencing at a much younger age many of the personal and social pressures that adolescence brings, and are taking longer to assume the responsibility of adulthood (Arnett, 2004). Social Media: Studies show that social media platforms, such as Facebook, Instagram and Snapchat, can cause anxiety that the young person can feel that everyone is having fun without them. The posts are an idealised version of what's happening. Cyberbullying is enormous for adolescents. Social media can also glamorise drug and alcohol use. (My World Survey, 2012 & Degreed, 2015)

8 How to Support the Child and their Family

9 Connecting through Respecting feelings What I have found to be more effective is to accept what another feels, to acknowledge as fully as possible the extent of their despair and to hear them out. Listening and accepting whatever another is feeling lets them know that their pain has at least been recognised. Good listening makes it safe for someone in distress to come in from the cold. Kindness with respect for another person s reality can restore in them a feeling of being connected. Being present to another who is in a really dark place creates a channel of communication through which pain can gradually be released. And within the safety of being accepted and connected with another, new perspectives on their situation can arise and creative rather than self-destructive solutions to whatever problems beset them can be considered and acted on. (Bates, T. Respecting feelings can make someone feel connected. Irish Examiner, Oct ).

10 Be Respectful Explain clearly who you are and your role. Initial reaction is extremely important. Try not to look shocked or horrified with disclosures. Communicate concern and ask for clarification if you need to but don t take over the conversation. Don t try and give solutions; sometimes it may just be enough to listen to someone and for them to feel heard than it is to present them with a solution to their problems. Make it easier It is easier for a parent or child to talk to someone who presents as being calm and approachable. Ask questions clearly and confidently, as this will reassure the person you are talking to, and may help calm them down if they are upset and emotions are heightened. It s ok to say I don t know ; know your limits and be realistic about what support you can offer. Offer support and regularly follow up to see if they are ok to encourage help seeking behaviour. Use open ended questions eg How have you been? It sounds like your going through a lot at the moment. Show compassion- it takes extreme courage for the child and/ or a parent to tell you how they are feeling

11 The empathic statement: I can see how difficult things have been for you lately It seems that things have been hard for you and that it has been difficult for you to cope You seem to be having a hard time The gentle enquiry: I wonder if you would help me understand how this has been for you? Can you share your concerns with me? Can you tell me about what has been happening? How have things been for you lately? Asking the question: Sometimes when people feel like you do now they can think about hurting/ killing themselves. Have you ever thought like that? Have you ever tried to do anything to yourself that could have harmed you? Are you thinking about harming/ killing yourself now? (Kutcher and Chehil (2007) In Morrissey et al (2008). Psychiatric/Mental Health Nursing: An Irish Perspective)

12 Primary Strategy is Active Listening This intervention strategy relies on a trusting relationship, empathy and listening skills. When we take a non-judgemental supportive role, focusing on the feelings that the child is experiencing, the stress the child feels is often decreased by being listened to and understood. Emphasis is on the child as a worthwhile individual with valid feelings and concerns. It is through the non-judgemental, accepting, uncritical, listening approach that the child receives support in handling difficult feelings without fear of reproach or criticism. Goal is to help children and their parents identify and cope with painful feelings and situations. Instead of responding to the child s words or behaviour, the listening approach responds to the emotions and feelings underlying the behaviour. (RCCP, 2012)

13 What does Active Listening Look Like? Show Respect; Stop what you re doing and give your full attention. Show Interest and that you re trying to understand Body Language, tone of voice and facial expressions can convey a message more strongly than the words we use Listen without interrupting, judging or correcting Keep Calm Try to Understand

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15 Some Common Mistakes Assuming you understand how the child/ young person and their parent feels. Giving advice or rushing in to share your story, or what you heard about someone else. Saying things like cheer up or trying to make them see that the situation could be worse, can belittle what their going through. Remember their emotions are real. Don t tell them they are overreacting or try to make the situation sound better than their perceiving it to be.

16 Normalising & addressing Stigma Mental illness almost always has nothing to do with character, integrity, morality, or any other issue. Most often mental illness has to do with an organ s inability to regulate certain chemicals, neurotransmitters, or hormones (Gronley, 2016). National drive to educate the public about the physiological causes of mental illness. Focus on dispelling the stigma which often causes reluctance in seeking help, and thus issues come to light in the form of a crisis. Treat the same as another patient on the ward. Mental illnesses are just as real and legitimate as pneumonia, diabetes or a broken leg. Showing positive regard, openness and acceptance is essential.

17 Role of Medical Social Work in Supporting Children and their families Role of Medical Social Worker: Explore an individual and family history Identify significant stresses for the individual and family Assess the relationships, supports, resources, strengths and social networks Evaluate past and current strategies being used to resolve the presenting problems Systematic and Client Centred Approach Facilitate emotional support Work in partnership with the MDT Sources of Referrals: Emergency Department Puffin Ward (up to 16 years) Note CAMHS teams have Social Workers as part of their MDT, therefore in the main Medical Social Work do not see these children and their families as a routine, but we are happy to consider such referrals when appropriate.

18 Useful Resources.. Here are some general online support services where you can direct young people or their parents to find information about mental health practitioners, services, and support on issues affecting them. This is not a comprehensive list of services, but is an indication of resources available online. Detailed information on mental health including information on professionals, services, and mental health issues. Information about mental health and the Jigsaw service; an extensive list of links to relevant services that children or parents may need. Information about their work in the community related to the mental health and wellbeing needs of young people aged Information and advice with the goal of promoting the wellbeing of young people between the ages of 16 and Information on issues that can affect children and details of the different ways of contacting the organisation. Provides information about various conditions or treatments focusing on self-help and therapeutic resources.

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