One in five children will experience mental health problems at some stage of their childhood.  How and when do parents decide that their son or daughter is not simply going through an awkward stage but may need professional support?

Vivien clearly remembers the day she knew her son Ed needed more help than she was able to provide. ‘It was when Ed slashed his wrists that we realised it was not just a difficult adolescence,’ she says. ‘It was a Sunday, he came to me crying uncontrollably and when I saw what he had done, I just felt so helpless.’  That was five years ago when Ed, the eldest of three boys, was only fourteen.  He is one of a growing number of young people suffering from mental health problems according to a recent report from the Mental Health Foundation which states that about 20% of youngsters will experience a mental health disorder at some time during their childhood.  Ed’s parents, Vivien and Paul, had been aware for several months that Ed was not happy but had put his moodiness down to his age.

‘But when this happened,’ says Vivien.  ‘I immediately phoned the emergency doctor for help only to be told that if his wrists did not need stitching, to wait until the next morning and go to my own surgery.  I couldn’t believe how harsh that Doctor was.’ Vivien’s experience is not unusual according to the Mental Health Foundation. It reports, ‘Our research shows that young people and parents sometimes find the services of specialist child and adolescent mental health services (CAMHS) inaccessible and often find a lack of understanding of their problems.’   Fortunately when Ed saw his own GP, he was immediately prescribed medication and given an urgent referral for psychiatric assessment.  Vivien and Paul soon discovered that mental illness is a long term issue and although Ed’s school was sympathetic, it could only offer limited help.  Ed lost interest in his studies and at 16, desperate for independence, he left school, found a job and moved away. With few qualifications, this is not an easy option for youngsters but he survived.

‘He did manage but my biggest fear at the time was that he would end up sleeping rough,’ says Vivien. ‘We were really pleased that after a while he was able to ask us if he could come back home to live. A year earlier I don’t think he could have done that.’

Ed’s problems have not disappeared although Vivien is not as worried about him as she has been in the past.

‘The doctors helped us through a very difficult patch and there was no pressure put on us or Ed to stop his counselling,’ she says.  ‘In the end, he felt he no longer needed it and was also weaned off the anti-depressants.  He still suffers from depression, but is much better than he was. The sad thing is that at 19, he sees no future happiness in his life.’  The Mental Health Foundation research found that more than one third of children under 16 who suffer from severe mental distress were likely to continue to have problems as adults.

            ‘Child and adolescent mental health services are developing rapidly,’ reports spokesperson Fran Gorman. ‘Yet they cannot meet the huge volume of demand that exists. Recent research has shown an increasing prevalence of mental health problems in children and young people….costs are astronomical when problems are allowed to persist into adulthood.’

Oliver is 7 years old, an only child who has suffered from a conduct disorder rather than an emotional one.  It was after a discussion with his teacher last summer that his mother Jane decided to seek advice. 

‘I am a single parent and work full-time,’ explains Jane. ‘But in the evenings and weekends, I have devoted myself to Oliver.  I don’t have any family living near but it worked out well until he started school.  After about a year though, he became more difficult in lots of ways.  He was aggressive, wouldn’t do what he was told, wouldn’t sit down to eat or simply talk to me nicely.’ 

Oliver’s school recognised Oliver’s behaviour as unacceptable and wrote a letter of referral for Jane. Luckily they did not have to wait too long for an initial assessment with a child psychologist – in some areas children wait up to 6 months for the first appointment.  Play therapy was thought appropriate for Oliver with active involvement from Jane.

 ‘After just a few sessions, he was calmer and he is certainly less selfish at home and getting into less trouble at school,’ says Jane.  ‘Rather than Oliver just getting angry and me getting upset, we seem to talk and cuddle more.’ Through the therapy, Jane has discovered that Oliver’s problems were less to do with changes at school and more to do with his relationship with her.  To date, Oliver’s therapy appears to have been successful and Jane is relieved to have asked for professional support when she did.

For children like Ed and Oliver living in the Bath and Northeast Somerset area, there is a single point of entry (SPE) for children’s health services based at the Bath Royal United Hospital NHS Trust.  ‘In the autumn of 2000 the SPE referral system was established in Bath and North East Somerset,’ explains Neil Simpson, Consultant Paediatrician at Bath. ‘With a child population of approximately 30,000, this was a response to the need to simplify and streamline access to children’s health services, particularly the transition from primary to secondary care.’ Annual referrals  to the Trust’s CAMHS currently run at 500 – 600, usually through a child’s doctor, school or health visitor but a referral can be made directly by parents.   An alternative for older children is ‘Off The Record’, a registered charity with local branches offering counselling and information services for young people aged between 12 – 25. 

At some time or another, most families experience difficulties and these days rarely have the local support of an extended family.  The trauma faced by parents when a child displays serious emotional problems should not be underestimated and it is important for help to be readily available.

‘It has been a life-saver for me,’ Jane says. ‘This time last year I didn’t know how much more I could take.  But now life with Oliver is becoming fun again.’

© Judith Cameron