Breaking the stigmas of child mental health
Young people are often reluctant to get help with their mental health. Rebecca Moore says more can be done to break down barriers….
Very sadly, I have met many young people who have expressed a reluctance to accept that they are suffering from a mental health problem or unable to get help for fear of being ‘stigmatised’ or ‘labelled.’ This prevents many children and young people from reaching out to support services.
It is generally accepted that if we are physically unwell, a doctor, nurse or pharmacist will treat us, and we trust what they prescribe. When we are mentally well however, there can be a considerable amount of distrust of medical professionals.
We educate young people about their mental health, what it is and what the different conditions are, but not enough is known or understood about how you treat mental illness. This is still a mystery for many adults and children alike.
Detention of children
As well as adults being ‘sectioned’ in hospital under the Mental Health Act 1983, many are unaware that children can also be detained.
If a child or young person is in crisis and the need for support is more urgent, they may be a risk to themselves or others. In these circumstances, it might be appropriate to detain them in hospital to protect them or those around them.
The Mental Health Act has no lower age limit and those responsible for the care and treatment of children should be child specialists, where possible. They should also work with the Child and Adolescent Mental Health Service (CAMHS) if appropriate.
What does it mean to be sectioned as a child or young person?
The hospital ward should be suitable to their age and should have, but not limited to, appropriate physical facilities, a routine for their personal, social, and educational development and access to educational opportunities. As well as the Act, a Code of Practice should be followed which includes:
- The child or young person’s best interests given significant consideration – this is sometimes disputed, as the medical opinion may differ to what the young person feels is best for them.
- Keeping the child or young person fully informed with clear and detailed information about their care, explained in a way they understand.
- Always considering their views, wishes and feelings.
- Any intervention should be the least restrictive option and least likely to stigmatise them.
- Any intervention should be consistent with effective care and treatment.
- Emphasis should be given to not distancing them too much and for too long from family friends and community
- There should be minimal interruption to education, consistent with their wellbeing.
- And the child or young person should have the right to privacy, confidentiality, and their dignity to be respected.
During and after child detention
A child or young person can spend time off the ward, known as s17 leave – this must be agreed by the doctor in charge of care, known as the responsible clinician. Depending on how the patient is improving, this usually builds from escorted leave on hospital grounds to unescorted home leave.
A child or young person can have their section discharged by the responsible clinician if they feel the sectioning criteria is no longer met. Discharge can also be achieved by hospital managers at a Hospital Managers Review, through a Tribunal following an appeal or by the nearest relative who can apply for discharge giving at least 72 hours’ notice to hospital managers. Although this request can be blocked, however, by the responsible clinician on grounds of dangerousness.
Supporting child mental health
GPs can help to offer appropriate medication, advice on sleep, diet and exercise and refer children and young people to other mental health services or providers such as the community mental health team or CAMHS.
Schools also have a role to play in the mental health of children – often they have a dedicated member of staff to offer support and advice to young people and parents and signpost other mental health services.
CAMHS is provided by the NHS to give support to young people with their mental health and wellbeing. It supports young people experiencing low mood or depression, feelings of worry or anxiety, eating disorders, self-harm or suicidal thoughts and feelings after a traumatic event.
NHS Cornwall Partnership can help with child mental health and has a specific service, Mental Health Crisis Cornwall, for those under the age of 19 years old. The Cornwall NHS Foundation Trust also runs Sowenna – a specialist mental health unit providing inpatient treatment for young people aged between 13 and 18.
Our child mental health expertise
Our dedicated team of specialist mental health lawyers provide free advice, support, and representation if a child or young person is detained. We regularly attend Sowenna and other units to provide face-to-face meetings and have a friendly and non-judgemental approach.
Additionally, we can help with advising on after care and care planning if the person is or has been detained under section and assist the nearest relative, as well as providing independent advice to family members
Legal help funding is available which means there could be no cost for our advice or representation – eligibility is assessed at an initial meeting.
For more information, help or advice about child or young person mental health contact Coodes’s specialist Mental Health Team.