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May 2017

Mental Health Awareness Week (8-14 May) is an opportune time to talk about why good mental health is important in children and young people.

According to the World Health Organisation, mental disorders are the single most common cause of disability in young people and depending on the environment and circumstances, up to
20 per cent of children in the UK may experience a clinically defined mental health problem at some time. Risk factors include difficulties with the enduring emotional bonds that connect one person to another (attachment), adverse childhood experiences, neglect and brain development.

The increased focus on good mental health in children probably stems from an ever increasing understanding that emotional wellbeing in childhood provides the building block for healthy behaviours, good mental health, school readiness and educational achievement – so it is important to get it right.

Most of us agree that childhood should be a time where children are safe from harm and have the opportunity to flourish in a happy and nurturing home environment. Unfortunately in life all families encounter worries and stress at certain times; therefore we need to promote the emotional resilience of children so they can deal with negative experiences, learn from them and develop their strengths. Of course, resilience is not only fostered in the child but in the family and in the wider environment.

We already know that the majority of mental disorders onset earlier in the life cycle, for example studies show around half of people with long term mental health problems experience symptoms by the age of 14 years. Thus the childhood and adolescent stages of development, in particular, represent a crucial window in which good mental health can be promoted, and any mental health problems dealt with.

On our own doorstep, studies show Northern Ireland is differentiated from the rest of the UK by higher levels of deprivation, higher levels of mental health problems in adults and on-going issues with civil conflict stemming from the Troubles. Although our children and young people have grown up in a time of relative peace; the extent and nature of the trans- generational impact of the Troubles isn’t fully understood. It follows that difficulties with mental health in children and young people might be greater here than in other parts of the UK.

In addressing mental health issues it is important to think holistically. For example, many policies on improving mental health outcomes for children and adolescents rightly focus on prevention and early intervention. This includes prioritising maternal mental health and addressing the wider determinants of health outcomes, like poverty, mentioned above.

The Royal College of Psychiatrists advocates ‘parity of esteem between physical and mental health services’ acknowledging that physical and mental health are inextricably linked – for instance that poor mental health is associated with a greater risk of physical health problems and vice versa.

Stigma can come in many forms and can represent a problem in terms of young people talking about their mental health difficulties and accessing help. Many very good anti-stigma campaigns have helped improve our understanding of mental health issues and thus reduce stigma. Most recently Prince Harry’s discussion about his own experience of loss, and the mental health impact of it, has again brought mental health firmly into the public arena. Perhaps contributing to a climate of social change where mental health and physical health issues are viewed with equal significance. Of course we can all do our bit to reduce stigma by challenging harmful language, misconceptions and negative labels, by showing support when people are in difficulty and asking for support when we ourselves are struggling.

Within NI there is much good work in voluntary and statutory sectors providing support, advice, signposting, counselling and other interventions to children and young people presenting with issues in terms of mental health and emotional wellbeing. Some examples of this include the Infant Mental Health Strategy, Family Nurse Partnership, Roots of Empathy, Attachment Based Practice Models, Strengthening Families Programme, Family Support Hubs and so on.

Of course there is more work to be done which includes further research into the causes of mental ill-health in children and young people, dealing with contributory factors like bullying, bereavement or low self-esteem; investigating the best evidenced interventions that help and improving overall coordination between services. All of this will require continued vision, strategy and investment at local and national levels.

Dr Mark Rodgers is an award- winning Consultant Child and Adolescent Psychiatrist. If you have a question for Mark, or a suggestion for a topic which you would like to see covered in this magazine email

The content of Dr Rodgers’ column is for general information only. The information is not for diagnostic purposes and should not be treated as such. You must not rely on the information in this column as an alternative to medical advice from your GP or other professional healthcare provider. You must never disregard medical advice given to you personally or your child, or discontinue medical treatment because of information provided in this column.

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