Do Young Adults Suffering from Mental Health Problems Receive the Care /Support They Need?

Abstract

The bond between funding in mental health and quality of care is not an unassuming one. Conflicting to common belief, the majority of mental health services providers and private trusts have not run out of money. However, declines in funding for minor mental health services and a right lack of confidence in future funding have activated mental health trusts into transforming their organisations, staff, services and care, in order to remain providing limited mental health services. Transformation platforms have delivered financial firmness in the short term but it has unsuccessfully failed to address on-going questions with capacity and this has resulted in reduced access to quality care and service provision for young adults with mental health issues.

A final vital factor is that mental health service providers have few opportunities to increase income or protect against increased financial pressures.

Table of Contents

Click to expand Table of Contents

Chapter 1 Introduction

Chapter 2 Literature review

2.1 Greater partnership working between mental health and care workers social 

2.2 Person centred mental health service

2.3 Building therapeutic relationships

Chapter 3

3.1 Aims

3.2 Objectives

3.3 Research Methodology

3.4 Understanding the Research Process

3.5 Data Collection

3.6 Primary Research

3.7 Ethical considerations

Chapter 4 Findings

4.1 Waiting Period for effective treatment

4.2 Suicide cases

4.2 Life expectancy

4.3 Feeling of isolation

4.4 Embarrassment from being mentally ill

Chapter 5 Analysis and Discussion

5.1 Information and statistics

5.2 Mental health issues and causes

5.3 Anxiety disorders

5.4 Schizophrenia disorders

5.5 Early signs

5.6 Government‘s position and funding

5.7 Demand for mental health services for patients

Chapter 6 Conclusion/recommendations for further study

6.1 Primary and Secondary Research

6.2 Differences between primary and secondary research

6.3 Causes of mental health problems

6.4 Consequences of poor mental health in young people

6.5 Risk and protective factors

6.7 Why the mental health of young people matters

6.8 Existing Services

6.9 Adequacy of the mental health services

6.10 Recommendations for future research

6.11 Improving age-appropriate care for young adults.

6.12 CAMHS

References

Chapter 1: Introduction

As a support worker supporting young adults (18-24 year old) suffering from mental health problems, the author believes that young adults should get the best support and their needs should be catered for in a way that focuses on their wellbeing. Mental health is defined as a state of well-being in which every individual realises his or her own potential, abilities and having the capability to cope with normal life (NHS Choice, 2016).

Mental health sufferers should not be stereotyped but should get the best support in order for them to contribute to the community and also have a life that does not have discriminating connotations.  On the other hand being healthy is defined as a “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”(WHO, 2014). Furthermore  mental health can be defined as  “Emotional, behavioural, and social maturity or normality; the absence of a mental or behavioural disorder; a state of psychological well-being in which one has achieved a satisfactory integration of one’s instinctual drives acceptable to both oneself and one’s social milieu; an appropriate balance of love, work, and leisure pursuits.”(Nordqvist, 2017).

The current situation is that the responsibility of care of young adults suffering from mental health problems has changed. Instead of relying solely on hospitals, families and the community now play a major role in supporting young adults to recover or live with their condition and the best support being expected from mental health professionals. The support should be provided in a person centred way and their independence should also be promoted.

Most young adults after being discharged from hospital or mental health institutions live with their families. Families that live individuals with mental health problems play a vital role in giving information that is relevant to provide the best care and treatment. Mental health professionals have a duty to support families that live with young adults with mental health issues (WHO, 2014).

Young adults suffering from mental health problems often experience problems such as being outcast by their social circles and their confidence tends to deteriorate leading to less activity. Getting employment and fulfilling their personal needs are some of the problems that young adults suffering from mental health issues face. Family members often bare the difficulties in supporting individuals with mental issues and the question is that, do they get enough support from mental health professionals and what can be done to improve the level of support they deserve?

Family members caring for young adults with mental problems use different strategies to cope. Some families cope by accepting the situation, researching about the illness or not accepting the existence of the illness.

This research is to find out if young individuals with mental health issues get the best support that they need and importantly whether families who care for these individuals get professional advice and support.

Family members faced with difficulties often suggest that they need for more information about the causes of mental health illnesses so that they can participate and play a role in the treatment of their ill relative. Information required by families who care for young adults with mental health problems varies but in most cases there are questions about the effectiveness of medical treatment and side effects of drugs used to cure the illness.

This research will also involve finding out the causes of mental health problems in young adults and also find out if there are any preventive measures that can be taken to avoid the mental health illnesses affecting young adults. Not with-standing the fact that there are people born with the condition, issues relating to drug and alcohol abuse shall be investigated.

It is a fact that the mental health sector is operating on limited resources. However understanding the effect of financial support versus the impact of the illness to family members and the community is an issue that needs to be addressed. In England and Wales caring for young adults with mental health issues involves inter agency co-operation. The systems put in place are designed to support young people with mental health issues; but how adequate are they?

Chapter 2: Literature review

In carrying out the research the author used the secondary research method. This involves analysis, interpretation and summarisation of data obtained from primary research methods. In this type of research, the researcher uses information gathered by government agencies, associations, labour unions and media sources. The data assembled is primarily published in newsletters, magazines, pamphlets, newspapers, journals, reports and encyclopaedias.  In order to address the research question the author had to choose relevant statistical data.

Between 2015 and 2016 statistics show that only a small percentage of young adults aged 18-19 were in contact with mental health services about 5%, and only 3.8% adults aged between 20 and 29 years were in contact with mental health services (CQC,2017). It is a concern that such a small percentage of people is seeking help from the required mental health services. Primary researchers have come up with statistics that infer that there is a considerable number of young adults out there who are not receiving enough support to cope with their mental health issues. Unless these young adults get professional help their mental health will continue to decline. And also, when it comes to young adults, they are less likely to accept the fact that they have a mental health problem mainly due to stereotyping they may receive from their family and friends. To get help as a mental health patient one has to accept it and come to terms with the illness (CQC, 2017).

Data from the OECD (Organisation for Economic Co-operation and Development) showed that, from 2002 -2012 in England, over 3/4 of mental patients who died from suicide had not been in any form of contact with a psychiatrist, GP and any other health care professional a year preceding the year of their passing. There is a strong belief that if they had been in contact with someone professional their chances of survival could have been greatly increased and they could have learnt how to manage their symptoms and side effects of their mental illness promptly (BMA, 2017).

In addition, it is said that there is a shortage of mental health nurses, as from January 2010 – Jan 2017 the number of mental health nurses decreased by over 10% from around 41,000 to 36,000. This could also be a factor that is causing young adults not to receive the care they need. If the number of nurses keeps on decreasing that means that a lot of services will not be able to attend to as many patients. Those who need intensive care are the ones who are most likely to be admitted to a mental health award in hospitals, of which this could also be a concern because most mental health patients are admitted for a long time in hospitals (CQC, 2O17). Mental health therapists often have a long waiting time for their patients, which also bring into question their adequacy in providing their expertise to a larger populace. In 2013 statistics show that out of 1600, over half the number of patients had to wait over three months and over 10% had to wait over a year just to get an appointment. If the care that young adults receive is inadequate, this may lead to overreliance on antidepressants. Relying too much on using antidepressants may cause severe side effects and adverse health outcomes such as overdosing which can be fatal.

Due to the lack of adequate mental health services a significant number of mental health patients across England and Wales had to travel from their closest local mental health service to somewhere else in order to access acute care. In 2014 the average distance travelled by patients was as far as 80 miles and in 2012/13 about 5% of emergency mental health care services within the UK were not in the area that they were required. This makes it much more difficult for mental health patients to receive care they require because a considerable number may not be in a position to travel long distances because of financial issues. Without receiving the required form of care, mental health patients are more likely to deteriorate further or take their own lives depending on the type of mental illness they may suffer from. In the worst possible scenario some may become suicidal as they may get to a point where the stage of the illness becomes unbearable to live with (BMA, 2017)

In 2015 the government adopted a ‘No Health without Mental Health’ policy which emphasises parity between mental and physical health. The policy also states that care should be personalised to reflect people’s personal needs, people who use service should be well informed and also have ways of getting information when they need to choose the provider and treatment that is suitable for them.  The policy is meant to focus outcomes that can be quantified and also empower local authorities and mental health practitioners to have the freedom to bring up innovative strategies that will lead to  improvements in services that deliver support to individuals with mental health problems (DoH, 2015).

2.1 Greater partnership working between mental care workers and social networks

Partnership working in health and social care involves bringing together different organisations involved in the treatment or caring for individuals with mental health issues so that they can all benefit from the combined expertise and resources. The target in having a partnership is to optimise the efficiency and improve the quality of services provided.

A network of family and friends within the community was seen as key in providing a safe framework for the discussion of problems and could play a valuable role in accessing mental health services, particularly in crisis.

However, social networks could also be perceived as a barrier either through their absence, or by providing an alternative to professional services (Bridge Partner Network,2017).

2.2 Person centred mental health service

Bhui and Sashidharan 2003 states that ‘a true user-oriented service, the benchmark of future mental health services, offers choice and a mixed economy of care suited to the needs of the individual and flexible enough to accommodate difference’ (pp11).

The first step to ‘personalisation’ is the provision of tailored information for people to be involved in issues pertaining to their health, care needs and support. Information is tailored, conveyed and analysed primarily by communication between the staff and the service user. Personalisation also gives the service user a platform to give their own knowledge and also express their own feelings and preferences. It is important that communication should be bi-lateral and equal. The participation in decision making should be enabling and empowering for the service users. This enables service users’ own values and preferences to be heard. Service users’ participation in decision making especially in care or support planning ensures that they determine the future course of their care, treatment and support. Personalised care and support planning can enable people to identify their goals and develop a sense of control. Social worker can ensure that care and support are built around the individual and their carer(s), with services working together for the outcomes important to the service user.

2.3 Building therapeutic relationships

The importance of the therapeutic relationship between the practitioners and service users is also highlighted. The therapeutic relationships must not focus on people’s diseases but rather in relationships that people have. By focussing on strengths, the practitioner moves away from the tendency to blame the service user, but towards discovering how people have strived despite adverse circumstances. Thus, the focus is upon the person’s strengths, desires, interests, aspirations, abilities, knowledge, and not on their weaknesses, problems or needs as seen by others (Saleebey 2002).

In such therapeutic relationships, practitioners and mental health patients are equal, and they work in partnership in addressing the patient’s mental health problems. The mental health patient’s individuality is taken into consideration. In this model, mental health patients are the ones possessing the strengths and that strength is the one that aids them for their their recovery. Mental health patients play a part and their preferences are incorporated into the therapeutic relationships. In therapeutic relationships mental health professionals save as team workers who have the professional and technical knowledge to help the mental health patient identify and put their strengths into use for their recovery. As in all cases where individuals have to work as a team, every player has to make an effort to help the team succeed. Young people with mental health problems rely on professionals for technical advice while the opinions of the patients help practitioners to understand them better.

Chapter 3

3.1 Aims

This research aims to collect information on mental health illnesses, and to understand the level of awareness of mental health problems. It is also proposed to investigate the care and support services provided for young adults.

3.2 Objectives

• The  research will look at different causes of mental health problems
• Find out about the services that already exist and if the services provided are beneficial and have impact on individuals.
• Investigate the current and previous legislation on how effective to protect mental health patients.

3.3 Research Methodology

The research onion was developed by Saunders et al. (2007). It shows the stages that must be covered when developing a research strategy. When viewed from the outside, each layer of the onion describes a more detailed stage of the research process (Saunders et al., 2007). The research onion provides an effective progression through which a research methodology can be designed. Its usefulness lies in its adaptability for almost any type of research methodology and can be used in a variety of contexts (Bryman, 2012).

3.4 Understanding the Research Process

The research onion was developed by Saunders et al. (2007) in order to describe the stages through which the researcher must pass when formulating an effective methodology. First, the research philosophy requires definition. This creates the starting point for the appropriate research approach, which is adopted in the second step. In the third step, the research strategy is adopted, and the fourth layer identifies the time horizon. The fifth step represents the stage at which the data collection methodology is identified. The benefits of the research onion are thus that it creates a series of stages under which the different methods of data collection can be understood, and illustrates the steps by which a methodological study can be described.

The author utilised the mono method of gathering information. The mono-method involves using one research approach for the study. In this research an archival research strategy was used. An archival research strategy is one where the research is conducted from existing materials (Flick, 2011). The research involved a systematic literature review, where patterns of existing research are examined and summed up in order to establish the sum of knowledge on the adequacy of the system in place to deal with mental health issues affecting young adults. Archival research may also refer to historical research, where a body of source material is mined in order to establish results.

The Qualitative Research Consultant Association, 2017 defines qualitative research as “a research designed to reveal a target audience’s range of behaviour and the awareness that drive it with reference to specific topics or issues”

The research approach used was interpretivism. In this approach the researcher will used constructivism. Funderstanding, 2011 defines constructivism as “a philosophy of learning founded on the premise that, by reflecting on our experiences, we construct our own understanding of the world we live in”. Interprevitism is an approach that highlights the expressive of human nature in social and cultural life.

The researcher will gather data through a secondary research. The researcher will use archival research to broaden the primary research which is already known and search for evidence from original archival records. It will be a challenge to recognise, find and interpret relevant documents and also this is time consuming.

Therefore reliability and illustration of data is destabilised to a certain level as well. The researcher will use a method of reasoning as the inductive approach. Trochim, 2006 defines inductive as “reasoning works other way, moving from specific observations to broader simplifications and theories”. Moreover, Trochim, 2006 illustrate that this method is occasionally called “bottom up”, using accomplices. This way of reasoning will help the researcher to discover the project and as a final point end up emerging some overall conclusion. Therefore on the other hand inductive intellectual cannot promise its conclusions.

3.5 Data Collection

In carrying out the research the author sourced secondary data. Secondary data is information that is derived from the work or opinions of other researchers (Newman, 1998). For example, the conclusions of a research article can constitute secondary data because it is information that has already been processed by another. Similarly, analysis conducted on statistical surveys can constitute secondary data (Kothari, 2004). However, there is an extent to which the data is defined by its use, rather than its inherent nature (Flick, 2011). Newspapers may prove both a primary and secondary source for data, depending on whether the reporter was actually present.

Researcher will collect data by using the qualitative research which can be defined as a study which is directed in natural setting. On the other hand the researcher, in result will become the instrument for data collection. Creswell, 2014, p.4 defines “qualitative research is an approach for exploring and understanding the meaning individuals or groups attribute to social or human problem.

3.6 Primary Research

“Primary research is defined as factual, first-hand accounts of the study written by a person who was part of the study” (Study.com, 2003- 2016). “Primary research is more costly and time consuming but it will give better results than secondary data” (Grattan and Jones, 2010)

3.7 Ethical considerations

As a social work student, the author had to comply with the university’s code of conduct when carrying out the research. The author conducted a secondary research in which there was no direct or indirect contact with participants. Nonetheless, the well-being of the author during the research process is important.

There are times when researchers researching on sensitive issues experience trauma. It is a good idea for the researcher to be comfortable with their area of research, if not then professional help should be sort. This could be in the form of counselling services.

Chapter 4: Findings

In carrying out this research the author utilised various sources of information so as to try and reveal the true status of the mental health services in the United Kingdom. The results of the research are presented in a descriptive form.

From data sourced from NHS Digital the following statistics were revealed. NHS Digital is the national information and technology partner of the health and care system.  Their team of information analysis, technology and project management experts create, deliver and manage the important digital systems, services, products and standards upon which professionals who work in the health and care organisations depend.

From statistics obtained from NHS Digital on young people who have at some time been in contact with mental health services in England, in 2016 to 2017 females aged 16 to 17 were most likely to have had an open referral with mental health and learning disabilities services, according to figures released in the Mental Health Bulletin(2016-17).

Between 2016 and 2017 statistics show that over 10 per cent of 16-17-year-old females in England are known to have had an open referral with  mental health institutions run by the National Health Service. This figure includes young adults with learning difficulties or autism.  About two per cent of those referred to mental health hospitals were admitted in hospital as part of their treatment or recovery process.

During the same time frame eight percent of males aged between the ages of 16 and 17 are known to have had an open referral with the mental health services in England. The eight percent represents a figure of around 50 000.

Of the total number of people known to have had an open referral with mental health institutions which stands at over two-and-half million over half a million were below the age of 18 years.

Considering the whole population in England statistics show that five percent of the population is known to have had contact with secondary mental health institutions during the period between 2016 and 2017. This figure also includes those who have had an open referral with learning disabilities and autism services. It is estimated that a quarter of adults in England will experience mental health issues each year. The list of mental health conditions is not exhaustible but may range from anxiety and depression to alcohol dependence, drug misuse and psychosis.

Three quarters of mental health disorders begin at an early age, that is , below the age of 18 and fifty percent of mental health issues in adults start before the age of 15. This excludes those suffering from dementia.

Research has shown that in an average group of 30 young persons, 3 are likely to experience mental health problems. Figures published by the department of health reveal that a tenth of children between the ages of 5 and 16 have been found to have a mental health problem.

Of concern there has not been an improvement in waiting times. There’s been a rise in the time that children have to wait to receive treatment for complex mental health conditions.  Children with depression and anxiety are often not being identified meaning that they do not get early help which leads to more complex health issues later in life..

4.1 Waiting Period for effective treatment

The time that one has to wait to receive help after being diagnosed with a mental health illness can be as long as ten years. When young people who need help with mental health therapy are not treated early the condition may reach a breaking point causing young people to harm themselves, have suicidal tendencies, become violent and aggressive. If the issues are not addressed early children will eventually drop out of school making normal life harder in years to come.

4.2 Suicide cases

Most young people between the ages of 20 and 34 in the UK die from suicide.  The Office of National Statistics has revealed that the number of young adults who commit suicide has been rising over the past 10 years. Each year the number of suicide cases is greater than that of the previous year. Published statistics show that in 2015 1,660 young adults under the age 35 years committed suicide. This figure shows a 103 increase as compared to the 2014 suicide figures.

4.2 Life expectancy

According to a research carried out by Oxford university psychiatrists it was found that individuals with mental health issues die earlier than people with no mental health illness. The average figure by which life expectancy is reduced is 15 years. Mental health suffers’ life expectancy is reduced more than that of heavy smokers. Life expectancy of heavy smokers is estimated to be reduced by eight years.

4.3 Feeling of isolation

A considerable number of young people, about 50 per cent, believe that anyone who is as old as them will face isolation and discrimination if they were to be diagnosed with a mental health illness. The same numbers of young people also believe that friends will withdraw their friendship if an individual was diagnosed as having a mental illness.

4.4 Embarrassment from being mentally ill

About 50% of young people have a belief that being diagnosed as having a mental health issue is embarrassing and can make individuals lose their self-esteem. The findings from a survey carried by YouGov/MQ indicate that there is a high level of mental health issues in the student population. The survey found out that more than 25% of students have mental health issues. From the survey it was also found that female students are more likely to be open with their mental condition as compared to male students.

Chapter 5: Analysis and Discussion

In an effort to find out whether mental health issues affecting young adults in the UK are given enough attention and resources, the researcher has utilised statistical data from various sources. Statistical information which was found relevant in shading light on the adequacy of the mental health system was sourced from government’s data agencies, journals reports and newspapers.

In order to get an accurate picture of the vulnerable group under investigation it may be of importance to define the term ‘mental health illnesses’ in a context that aims to help rather than condemn those suffering from the condition.

Mental health of an individual is defined as a state of well-being in which an individual realises his or her own potential, having the capability of coping with normal stresses of life, being able to work efficiently and as having a capability of making a contribution in one’s community. United Nations’ organ, Wealth Heath Organisation (WHO) has put an emphasis on this definition by defining health, as contained in their constitution as “is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” (WHO, 2014)

5.1 Information and statistics

As outlined in the aims and objectives of the research, the researcher has a view that it is essential that causes of mental health illnesses are discussed in-line with the services that are in place and meant to cater for young people experiencing problems associated with mental health.

Data obtained from NHS England shows that;

• Young people when they enter adulthood tend to be more susceptible to mental health illnesses.  Three quarters of mental health problems that are never cured for the entire life of an individual are diagnosed at the age of 25.
• Young adults with mental health issues normally do not get help early due to various reasons. They may be reluctant to seek treatment or they be in an area where mental health clinics cannot cope with the number of patients. Lack of early treatment often leads to mental health problems for the rest of an individual’s life.
• A significant number of young adults find statutory services that they are entitled to either inaccessible or incapable of meeting  their individual needs.

According to a house of commons’ document a majority of adult mental health problems begin in childhood, with half of adult mental health problems starting before the age of 15, and 3/4 starting before the age of 18. During the period between 2015 and 2016 the British government committed to improving mental health care for young adults, as part of their commitment to treating mental health issues with seriousness as it is done with physical health in an effort to improve lives of young people.

5.2 Mental health issues and causes

According to the Department of Mental Health, England report, the period of transition from childhood to adulthood is a critical time in some young adults’ lives. Apart from physical changes on their bodies as part of growing up there are emotional challenges as young people move from adolescence to adulthood. There are also social challenges that accompany independence and having control of themselves. Some young people endure a challenging transition from childhood to adult life and dealing with social challenges can require some greater degree of resilience and adequate support.

This process, which frequently endures right up to the age of 25 and beyond, leaves young adults at particular risk of experiencing mental health problems. The economic uncertainty facing the current generation of young adults, characterised by insecure income, employment and housing, may further impact on levels of wellbeing.

Information from primary researches has also shed light on the notion that there are strong links between physical health and mental health problems. It has also been established that about a third of people with a long-term physical health problem also have a mental health problem. Almost half  of people with a mental health issues have previously battled with a long-term physical health problem.

5.3 Disorders caused by anxiety

Mental health problems that young people are normally faced with include not only of the following as the list is endless.

Examples of disorders caused by anxiety

• Panic disorder – the person experiences sudden paralysing terror or a sense of imminent danger which triggers a panic.
• Some people have a fear of objects or situations. When this fear is reaches a threshold that is extreme it can be a sign of a phobia. There are many types of phobias and  these may include simple phobias such as a disproportionate fear of objects, such as fear of snakes. There are social phobias, an example being the fear of how other people judge you.  Phobias often impact negatively in an individual’s mental health.
• Obsessive-compulsive disorder (OCD) – An individual suffering from obsessive- compulsive disorder has obsessions and compulsions. They may experience mood swings and start having thoughts that that keep them stressed or keep on doing repetitive tasks for longer than normal.
• Post-traumatic stress disorder (PTSD) – this can occurs when an individual has experienced horrific situations in life or has been through a traumatic event. It is common amongst ex-service individuals who have been through traumatic situations during the war. Individuals with post-traumatic stress disorder feel their life or other people’s lives are in danger. They may feel scared or have a feeling that they are not in control of their lives of what is happening around them.
• Mood disorders

Individuals with mood disorders experience considerable changes in mood. The individual can change from being happy to sadness or depression. When the depression becomes major the individual becomes less interested in activities that they previously enjoyed. Individuals with mood swings experience periods of sadness that often longer than normal.

• Bipolar disorder – Individuals with bipolar disorder change from episodes of euphoria to a feeling of depression.
• Seasonal Affective Disorder) – SAD is a type of depression that is caused by lack of enough daylight. It is most experienced by individuals who live in countries that are farther away  from the equator. In these countries nights are longer than days during different seasons.

5.4 Schizophrenia disorders

It is yet to be determined whether schizophrenia is a group of related illnesses or a single disorder. It is a complex condition which normally emanates at a young age. Individuals with the condition have thoughts that are not coherant and have difficulties in processing information.

5.5 Early signs

It is impossible to precisely tell whether someone is developing a mental health problem, however, if signs show in a short space of time, they may  offer clues about an individual’s mental health condition.

5.6 Government’s position and funding

A report by Mental Health Foundation, 2015 has found out that;

• Mental health issues contribute more as the main cause of the burden of disease worldwide. In the UK, mental health problems are responsible for the largest burdenof disease, nearly 30% of the burden, compared to heart diseases and many forms of cancer which contribute just over 15% each.
• Mental health services in the UK do not have enough resources to cater for all young people with mental health issues adequately. Lack of resources leads to long waiting times for individuals to get specialist help. The funds poured by the government are mostly channelled towards coping with the mental health of individuals who are already ill rather than investing in prevention.

In the UK, the cost of addressing mental health problems is estimated to be around £ 80 billion pounds per annum and this is about 5% of the country’s Gross Domestic Product.

The report clearly depicts a picture of mental health services struggling to cope with an ever increasing number of individuals who need mental health care. This scenario is cultivated by many factors including cuts in government spending. Benefit cuts have led to more children and young adults becoming distressed and even contemplating to commit suicide, and older people being affected by dementia.

“The impact of rapidly rising demand, workforce shortages and the failure of funding to get through to the frontline means core mental health services are being overwhelmed,” the report added. About 66% of respondents, who also included 115 chairs and chief executives of acute hospital trusts, acknowledge there has been a rise in the number of patients seeking mental health treatment , including those who turn up at A&E. 70% of the health professionals who attended the meeting foresee an increase in the demand of people requiring mental health support and treatment.

5.7 Demand for mental health services

When a question was posed to the mental health professionals as to why the demand was rising, one correspondent replied by saying “More people of all ages are becoming ill as a result of the pressures of modern life.”  The problem of financial cuts has rendered community-based mental health support to offer limited services forcing more people with mental health issues to seek help from A&E units.

Mental health organisations found raised concerns at NHS Providers’ findings that large number of individuals with mental illnesses are not getting the help they need. In the survey carried out by the Mental Health Foundation, about 60% of NHS trust bosses admitted that they were unable to fulfil the demand for mental health support from troubled children and young adults, raising concerns  that  children’s mental conditions will deteriorate during the waiting time which can be more than a year before they can receive therapy or care.

Government ministers and NHS trust leaders have set out guidelines to make mental health care accessible to everyone. Not surprisingly a small number of NHS bosses, about a tenth, told NHS Providers that they feel they are on top of the situation in managing the current demand for specialist services and are working hard on meeting the care needs for those who are still in need of mental health care.

Severe staff shortages are a blow in the trusts’ endeavour to improve services. NHS bosses have expressed that they have problems in recruiting and retaining enough mental health nurses and psychiatrists.

Chapter 6: Conclusion/recommendations for further study

The research showed that there is a lot of improvement required in mental health services in the UK. The level of support that young adults suffering from mental health problems receive from mental health services falls below expectations according to statics published by primary researchers.

The author preferred to find an answer to the research question by using data already collected and analysed by primary researchers. Secondary research was found appropriate for the research question.

6.1 Primary and Secondary Research

• Primary research is one that involves the gathering of fresh data, i.e. when data about a particular subject is collected for the first time, then the research is known as primary research.
• Secondary research is a research method which involves the use of data, already collected through primary research. The main difference between primary and secondary research lies in the fact that whether the research has been conducted previously or not.

6.2 Differences between primary and secondary research

• Primary Research is the gathering of first-hand data relevant to the research question Secondary Research uses data obtained from primary researchers.
• Primary Research collects raw data, whereas secondary research relies on analysed and interpreted information.
• In primary research, the data is collected by the researcher or hired person whereas in secondary research the data collection is performed by primary researchers, the secondary researcher collects relevant statistical data to answer the research question.
• The primary research process is involving and it deeply explores the research topic by collecting first-hand information. On the other hand secondary research process is fast and easy and it aims at gaining broad understanding about the subject.
• In primary research, the researcher collects data and the data is always specific to the requirements of the researcher. As opposed to secondary research, where the data lacks particularity. The researcher needs to select data that is relevant to the research subject. It is possible that it may or may not be as per the requirements of the researcher. The data could be outdated or not appropriate for the research question.
• Primary research could or normally comes with expenses emanating from the exploration of data and facts from various sources. Unlike Secondary research, which is an economical process where the low cost is involved in acquiring important information because the data is already collected and analysed.
• Primary research consumes a lot of time as the research is done from the starting point, that is, the researcher needs to collect data himself or herself. However, in the case of secondary research, the collection of data is already done, the research takes comparatively less time.

After comparing the two methods of research the author found the secondary research method suitable for the research question under investigation.

The secondary research was chosen by the author because of its simplicity and less time consumption. Required statistics for the research was sourced from newspapers and reports on mental health issues in England and Wales. The secondary research method has its disadvantages. Data sourced can be outdated thereby leading the researcher to false conclusions. When carrying out the researcher has to source information from reliable sources.

The author found this research successful as all objectives of the research were met.

6.3 Causes of mental health problems

Mental health problems reported among children and young people have continued increasing over the past fifty years (Mental Health Foundation, 2015). Cases of anxiety and depression amongst young adults and teenagers have increased by over two thirds in the past quarter of a century.

Cases of individuals with a tendency of harming themselves have risen at an alarming rate. One out of 15 young people are thought to be vulnerable to self-harm. Good mental health is the base of young adults’ emotional and mental growth. Good mental health helps in the development of confidence, independence and a sense of self- worth. It is a fact that young people who are mentally healthy will have the ability to:

• Develop psychologically, emotionally, creatively, intellectually and spiritually.
• Initiate, develop and sustain mutually satisfying personal relationships
• Become aware of others and empathise with them
• Play and learn
• Face problems and setbacks and learn from them
• Enjoy and protect their physical health
• Make a successful transition to adulthood.

6.4 Consequences of poor mental health in young people

There is growing evidence that some types of mental health problems can be an indicator of unwanted outcomes that an individual may face later in life. For example, there is a strong, unfavourable relationship between childhood behavioural problems and facing exclusion socially later in life. Behavioural problems in childhood can also lead to offending behaviour and failure to keep a job.

There is also a strong relationship between childhood and adolescent mental health issues and mental health problems in adulthood. Previous studies have shown that 50% of young adults with a mental health problem had been first been diagnosed in childhood.

The economic and social cost of failing to address the emotional problems faced by children and young people is high. It is estimated that the costs endured by public services used from childhood through to adulthood by individuals with mental health issues as children are 10 fold higher than those for individuals with no significant health problems.

6.5 Risks and protective factors

Social background plays a part on whether an individual is vulnerable to experiencing mental health problems later in life. Children living in fragmented families are more likely to suffer from mental health problems. The educational status of parents can be a factor as well as the socio-economic status of the parents in determining the quality of life that children live. Those with low socio-economic status, are less likely to provide for their children adequately.

6.7 Why the mental health of young people matters

A Mental Health Foundation, 2015 project identified four categories of young people as being particularly vulnerable to mental health problems. These categories are children with emotional and behavioural issues, young people with nowhere to live, children who are under social services’ watch and young criminal offenders. These groups are also less likely to have their problems diagnosed or to receive professional help to deal with them. Other groups recognised as vulnerable to mental health issues include young carers, refugees and asylum seekers and young people with learning disabilities.

It is apparent that parenting style has a strong influence on children’s emotional development. Key protective factors include children feeling that they are loved, trusted and understood, having interest in life, optimism, autonomy, self-acceptance, and resilience. Furthermore, the school environment has been found to play an important role in the prevention and management of mental health problems in children and young adults.

6.8 Existing Services

Recent Government policy, spearheaded by Every Child Matters, has placed increased focus on children’s wellbeing and promoting mental health, with early intervention and prompt identification of mental health issues in young adults. Local Children and Young People’s Plans have been introduced to provide support for more integrated and effective services. Strengthening health promotion in local communities and targeting resources to the neediest communities have been highlighted as priorities. Youth Matters, the Governments’ strategy for youth published in March 2006 intends to build on this by empowering young people to have a say in the moulding of services they need. The strategy aims to encourage young people to get involved in the decision making that affects them.

To integrate services for children, Children’s Trusts have been developed in all local authorities. The process of combining support and services is to be supported by a common assessment framework, information sharing amongst health professionals.

A substantial policy review of children and young people, published by HM Treasury and the Department for Education and Skills in 2006, aimed at analysing the factors that contribute positively towards good mental health with the intention of feeding into the following Comprehensive Spending Review. Building resilience is an important theme and there is recognition of the importance of good social and emotional skills in helping to protect children and families from poor backgrounds later in life. The review also set out a variety of measures and additional investment to improve support for parents and for families trapped in a cycle of low achievement.

6.9 Adequacy of the mental health services

For services which seek to provide support and care for children and young people who need to use mental health services, either at a universal or specialist level, it was clear that policy levers needed to be set in place to drive development. To address this, the National Service Framework (NSF) for Children, Young People and Maternity services15 was published in 2004, describing the support which children and young people should expect to be able to receive. Standard 9 of the NSF addressed the mental health and psychological wellbeing of children and young people. It stated that by 2014: “All children and young people from birth to their eighteenth birthday, who have mental health problems and disorder have timely access to timely, integrated, high quality, multi-disciplinary mental health services to ensure effective assessment, treatment and support for them and their families.”

Research has shown that only 25 per cent of children with diagnosed psychiatric disorders were accessing mental health services. Although not all young people wish to access specialist services and often find support elsewhere, there is a question of whether this is even offered as an option for many young adults experiencing mental health problems.

Despite the reports of significant progress, there is a question as to whether the reality of services on the ground matches up to the high aspirations of the NSF. Ways need to be found to ensure these aspirations can be met, with special consideration being given to what young people say they want, what is known to work, and their needs.

6.10 Recommendations for future research

Further investment is needed in research to determine which interventions are most effective in cutting down risk factors and reinforcing protective factors, and this research should underpin policy.

Developing a research and development strategy coupled with knowledge management must be part of the agenda too, as should workforce development. And, critically, more needs to be done to protect the mental wellbeing of all children and young people by educating them and those who look after them about the factors that help and hinder mental health.

Greater and more targeted investment will be needed to ensure that the gains made in the past are not compromised.

Furthermore, little information is available about service outcomes. CORC, which is part of the Evidence Based

Practice Unit at University College London, is researching in this field. This area of work needs to be supported to improve understanding of the impact of CAMHS, so that services can be shaped according to best practice.

However, even with sustained investment, CAMHS services cannot be expected to bear responsibility for ensuring that all young people who need some form of support receive it. Most CAMHS services are highly specialised and essentially low volume, and historically often did not deal with issues relating to behaviour problems, which are now part of their caseload.

Future development needs to push forward the intentions within Every Child Matters and local Children and Young People Plans to place increased focus on prevention coupled with improved primary mental health care for all children and young people. This needs to be provided through universal services and located in the settings young people will access, with funding for this and any specialist advisory support from CAMHS effectively planned for and resourced.

6.11 Improving age-appropriate care for young adults

Adult Mental Health Services issued a statement that age appropriate care for young adults falls below expectations. They acknowledged that they offer mental health services to teenagers who are currently in full-time education.

6.12 CAMHS

The period of transition into adulthood is a critical time in a young person’s life. It is crucial to work towards breaking the cycle of mental ill health at an early stage to avoid problems getting to a critical point as children progress to adulthood. Specialist care, engineered to address the needs of young people in these years, can be of great importance. In addition to treatment and care which addresses the mental health problem, young adults and children need to be supported as they progress towards leaving mental health care, and support in building up skills and self -esteem to take with them as they grow into adulthood.

This issue has been backed by the British Government. In 2005, the Social Exclusion Unit stated that “… the ways in which young people become adults has become more complicated and diverse but policies have generally failed to keep up with such changes. The age structuring on which many policies are based is often complex, inconsistent and working against the principle of resources following need.”

Despite this, man-made barriers remain and young people often find themselves not elligible for children’s services, or being excluded from these on the basis of their age because they have grown up living with their mental health issue.

The provision of age-appropriate services for young adults between the ages of 16-25 is urgently needed. There should be universal agreement as to the age range that defines young adults, as of current are many discrepancies as there is considerable degree of inconsistency.

A person-centred approach in providing mental health services for young people between the ages of 16-25 is needed to take into account changing care and support needs of young people as they move into adulthood.

To establish what is needed locally, services should be supported in carrying out a thorough needs assessment of the population covering geographic, demographic and workforce issues, prevalence and type of problem and the identification of gaps in service provision. Young people and families should be central to any assessment process.

References

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