Impact News

Responding to Violence, Suicide, Psychosis and Trauma

What’s it like to be a young person with mental health issues?

Three teenagers who have found it hard to forge their sense of identity as young people with mental health issues
guardian.co.uk, Wednesday 15 April 2009 00.05 BST

Rachel Haddon, 21, Preston, Lancashire

Who am I? A 21-year-old female? Student? Mental illness and eating disorder sufferer? Self-harmer? Vegetarian? Or an animal lover? I am all of these things, yet none of these things. I am just me. If diagnoses were put on the end of your surname, like qualifications, I would look rather qualified! But these labels don’t aid and benefit me like qualifications would. It is time professionals stopped treating people as disordered statistics, and instead saw us as people. Ordinary humans, who just happen to have problems. After all, everyone has problems, don’t they? Perhaps our problems just affect us a little more than normal. But what is normal? The only normal I know is the setting on a dishwasher. Over the years I have met many so-called “professionals” – doctors, nurses, social workers and psychiatrists who apparently excel in their field. But most have actually made me feel worse. I don’t doubt that on the majority of occasions their intentions have been good, but instead of helping me, they have just diagnosed, medicated and hospitalised me. Of course, that is often necessary and beneficial, but the most important and helpful “treatment” is to be listened to, and believed. Sadly, many professionals seemingly fail to do this. The attitude of these professionals and the general public is obviously influenced by the media to some extent. It’s not rare to see a headline such as “Prisoner with personality disorder attacks staff”. Is it any wonder that the majority of people think having a personality disorder indicates that you are a dangerous, reckless, violent criminal? Some could argue for freedom of speech, but for those like me who happen to be diagnosed with a personality disorder (regardless of my opinions on the use of this “label”), such statements and in­accurate beliefs only add to our problems. The hope of recovery sometimes seems impossible in a world that functions on stereotypes and stigma.

Saad Butt, 21, London

It has been six years since my father died of a heart attack. Being the eldest, I looked after my mum and my younger brother and sister, as well as myself. I was 15. My GCSEs were a pressurised time and things weren’t easy. I had to grow up fast. My father and I didn’t always have the best of times. Why was it that we were so close and yet so distant? Why is it we wait so long to tell those close to us the way we feel about them? To lose someone close and still live and breathe each day was a big struggle. I had attacks of depression, identity crises and suicidal thoughts. There didn’t seem to be anyone who could help and it didn’t feel like counselling services were available either. But I kept on going, suffering in silence, living in the hope that one day things would be better. Before my dad died, I was involved in my community with the local youth parliament. That kept me going, but when I found a mentor through my community work to talk things through with, things started to change. At 18, I found in him the dad I never had. He became my guardian, had a deep-rooted concern for me, and took an interest in my studies and my extracurricular life. My emotions started to become a positive driver in my life. I love him more than anything in the world. Now I never take anything for granted; I’ve become more focused, more concentrated on what I want in life. My relationship with my mother has become closer. I’m studying for a law degree and I’m still involved with local youth issues – for example, as a member of the British Transport Police youth board. I’m getting married in the summer and looking forward to that and the new life that comes with it. I’ve also learned that it’s important to get help and talk to someone you trust. Above all, have faith, stay positive and cool about life, and go with the flow – it isn’t always as bad as it may look.
Celeste Ingrams, 24, Southampton

The most difficult thing is how people have reacted to my mental health problems. It made me think I was dangerous due to what was going on inside my head. This perception became almost a sense of identity that made me feel secure and reaffirmed my belief that I was “crazy” and uncontrollable. It took me a long time to realise that my “craziness” was my mind coping with the emotions that were reactions to me feeling unsafe and anxious. It is hard to admit vulnerable emotions and this denial came out in my behaviour, which I’m not proud of, but I couldn’t communicate my feelings in any other way. I often kicked against everything, which was self-destructive and led to people being hurt. Although I feel guilty about this, if I’d not gone through this process then I wouldn’t have been able to learn from my mistakes. How I manage is I don’t get too caught up in what’s wrong with me or how others make sense of what I do, but I stay in touch with my emotions. I use coping skills to steady myself, and prevent things getting out of control, often by spending my time expressing myself in more creative ways with art and writing. My experience of living in institutions – NHS or local authority psychiatric units, or residential therapeutic communities – was about feeling controlled and not supported. I think this affected my ability to believe or trust in myself. I try now not to feel caged by stigmas and stereotypes. I know it can be extremely difficult to do this in our society.

• Rachel, Saad and Celeste are all members of mental health charity YoungMinds

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Filed under: Other Mental Health, self-harm, Suicide, , ,

Working to understand men’s mental health

More can be done to help men in this little studied area of wellbeing

Men’s mental health is a particularly salient issue in these troubled times. Worldwide, more than one million people kill themselves each year. In the UK, men are four times more likely than women to kill themselves and there have been over 6,500 male suicides in the past six years.

Incidence data from the last century show suicide rates have peaked during past economic recessions. Gay men are two to three times more likely to have a mental health problem and 4.3 times more likely to attempt suicide than straight men, and have around double the rate of depression and anxiety. 94% of young offenders are male and 80-90% have mental health problems.

Furthermore, while the rate of deliberate self-harm is higher in females (associated with problems in interpersonal relationships), it is four times more likely to lead to suicide in males, and is associated with alcohol, employment, financial and housing difficulties. One question is, will we see an escalation of distress and suicide in males during the current economic downturn?

Men’s mental health is a dramatically understudied and poorly understood area of human wellbeing. Men are half as likely as women to be diagnosed with depression, yet twice as likely to abuse alcohol and drugs.

What’s going on here? One compelling possibility is that what society teaches men about what it means to be a man leads us to express our pain in ways that differ from women. Among the more striking differences is that men are more likely to keep their problems to themselves. We frequently suffer in silence, and sometimes with dire consequences. Our research at Clark University in the US has shown that men who are more likely to value self-reliance and stoicism are more likely to have significant symptoms of depression; they are also more likely to report feeling ashamed of being depressed, and more likely to keep the problem to themselves.

Factors that may lead to mental wellbeing or ill-health are multiple and have complex interrelationships. Comparatively little is understood about how these manifest in men differently to women. There is lack of public knowledge about mental health problems generally. During their lifetime, 25% of the population will experience a mental health difficulty. However, when asked, half of company bosses estimated levels at 0% in their workforce.

Stigma is associated with mental health problems and their perceived effect on employment. In western cultures, boys are taught that it is better to express emotions such as anger than fear or pain and there are cultural sanctions for those who deviate from this. Depression and anxiety may get expressed as anger. Men are socialised to fix problems. As one service user put it “men deal with it – I’m not dealing with it, therefore I’m not a man”. No wonder men may have a tendency to play down their problems, overestimate their ability to deal with them and have a reluctance to seek help. Nor is it surprising that it is commonly hard for those around them to spot the symptoms.

So, what can be done? Men and women need educating in what symptoms to look out for in themselves and others. Signs may include inability to concentrate; being unable to engage with people; a change in appetite; feelings of worthlessness or hopelessness; change in sleeping patterns; and increase in use of alcohol or drugs.

Some men have faulty perceptions about, and place low value on, therapy. As a society, we need to associate help-seeking with strength and courage. Media campaigns in the UK, such as Time to Change, aim to start addressing this. The effects of redundancy on men and women need consideration and employers need educating. At Clark University there are plans to establish the first centre devoted to the study of men’s mental health.

Half of people experiencing depression, after a relatively short course of therapy, go on to make a full and lasting recovery. However, sitting and talking about problems is not what many men are comfortable doing. Therapists need to develop more effective methods of engaging them.

The national strategy, Increasing Access to Psychological Therapies (IAPT), is aimed at identifying and treating anxiety and depression more effectively in the general population. Early statistics show lower take-up of this service among men. While research indicates that higher numbers of women experience mental health difficulties than men, it is unclear whether this is because it is a hidden problem and self-referral to the new IAPT services might help. Linking commissioning of educatio n, social care and health care services may lead to men’s needs being more comprehensively addressed in future.

• Michael Addis is professor of psychology at Clark University, Massachusetts

Filed under: Other Mental Health, self-harm, Suicide

Prison self-harm levels revealed

By Neil Puffett
Children & Young People Now
26 February 2009

The Ministry of Justice (MoJ) has been forced to reveal the true scale of self-harm taking place in young offender institutions (YOIs) following a 14-month investigation by CYP Now. The figures reveal there were a total of 2,040 self-harm incidents last year and 914 assaults on staff.

The MoJ was prompted to release the figures by the Information Commissioner after CYP Now made a series of complaints over attempts to suppress them.

The figures reveal that self-harm incidents have remained at a fairly consistent level over the past three years – 1,835 in 2007 and 2,062 in 2006. However, levels have more than doubled in the past 10 years.

Doubled in a decade

Figures collated in May 2000 for a parliamentary question show there were 879 self-harm incidents in YOIs in 1997/98. Meanwhile, the numbers of young people currently categorised as “self-harmers” stands at 892.

The MoJ admits the figures for 2008 are only provisional and could be even higher as there is a lag in reporting.

The figures, which are not broken down by age, relate to a total of 20 institutions and show variations in how successful each unit has been.

Among the worst performing institutions were Feltham, Glen Parva, Rochester, Stoke Heath and Warren Hill – all of which witnessed increases in self-harm figures of 50 per cent or more since 2006.

Glen Parva has plans to build a further large unit to accommodate 15- to 17-year-olds. But Mike Thomas, chair of the Association of Youth Offending Team Managers, said large institutions will not help the issue.

“It is far better to invest the money in small, more locally based establishments, which are in the best position to work through offending
behaviour,” he said.

The best performing institutions included Castington, Lancaster Farms, Portland and Ashfield. Wendy Sinclair, director of Ashfield, said staff attempt to address the issue of self-harm. “Key to this is a weekly child and adolescent mental health service meeting where specialist psychiatric nurses join forces with co-ordinators across areas such as anti-bullying and
violence reduction,” she said.

The success at Lancaster Farms – which saw five self-harm incidents last year compared with 153 in 2006 – comes despite other problems. In January 2008, rioting inmates caused £222,000 worth of damage, apparently triggered by a 24-hour staff walkout.

Safety concerns

The statistics have prompted concern about the safety of young people in prison and fresh calls for different
approaches to be adopted.

Penelope Gibbs, director of the Prison Reform Trust’s programme to reduce child and youth imprisonment, described the figures as “disturbing and unacceptable”. “These numbers indicate the level of mental health problems is too high,” she added.

Thomasin Pritchard, policy and communications officer at the Howard League for Penal Reform, said a different approach is needed: “Levels of self-harm are a reflection of the fact children are not getting enough support but also that institutes are part of the problem.”

An MoJ spokeswoman said: “Safeguarding remains a priority and the Youth Justice Board is working with cross-government partners and secure estate providers to improve the safeguarding of young people in custody.”

Additional investigation by Tristan Donovan.

Filed under: self-harm, Violence

Suicide & Self-Harm – Individual Places Available on Course in Nottingham

There are still a few places available on the “Razor’s Edge” course in Nottingham. If you are interested, the course is on 23-24th March 2009 and is organised by Nottingham HLG. You can book via the HLG website:

http://www.hlg.org.uk/trainingsubmit.htm

Or contact HLG’s Training Co-ordinator on 0115 956 5313 or email admin@hlg.org.uk

Information about the course can be found at:

http://www.hlg.org.uk/TrngRazEdge.htm

Filed under: Impact Training, self-harm, Suicide, , ,