Nice consultation on schizophrenia and psychosis
Guest blogger Nushra Mansuri from the British Association of Social Workers urges professionals to respond to the consultation about the current provision of mental health services to children and young people.
The National Institute of Health and Clinical Excellence (Nice) are currently consulting on developing clinical practice guidance on children and young people with psychosis or schizophrenia, for use in the NHS in England, Wales and Northern Ireland. The consultation closes on the 27 September. I think that this is a hugely important consultation for the social work profession to express its views on given that it raises issues about the current provision of services to children and young people experiencing mental health challenges and the future direction of travel. Whilst of course, there has been a lot of progress over the years in terms of multi-disciplinary work in the field of mental health for both adults and children, and hopefully, more of an acceptance of the merits of the ‘social model’ as opposed to the exclusivity of the ‘medical model’, there is still a long, long way to go. Camhs services to children and young people have historically been chronically underfunded and it was disheartening to read a recent article highlighting some of the deficits of the service with regards to children and young people in care. The biggest hole for me in services for children and young people who come into contact with children’s social care, the youth justice system and the UKBA is the lack of therapeutic intervention and support. As far as I am concerned, this should be the common thread that runs through all the services including foster placements, residential establishments, specialist schools and education, secure accommodation including YOIs, STCs as well as Secure Children’s Homes.
There have been a number of very moving programmes on television recently about the experiences of young people in care – one featured Fatima Whitbread and the other featured Ashley Baptiste who had been a contestant on last year’s X Factor. At times, it was painful viewing, listening to the accounts of various young people about their experiences of rejection and how this continues even when placed with carers as their fear is that if they behave negatively they will be asked to leave.
Eileen Munro’s review of child protection services in England is all about the Child’s Journey, and unless we see these issues through the eyes of children and young people we will never understand the pain and trauma that they have encountered and continue to encounter once they enter the care system. All our services need to be underpinned by a child and young person centred approach and this I believe can change attitudes and counter discrimination and prejudice otherwise, we will simply see the reoccurrence of the same outcomes for those with early experiences of trauma in their lives including a greater proportion being diagnosed with serious mental health problems in adulthood. None of what I say of course is rocket science, but it does mean an investment in preventative services which would help to decelerate so many situations reaching crisis point through a lack of crucial and sustained support at an earlier point. Young women subject to sexual exploitation recently hit the headlines and again, those young people who went in front of the cameras talked very poignantly about the need to feel that someone cared about them in residential units. It challenges me to ask the question ‘what should a ‘good’ corporate parent be providing’ and actually I should not be the author of any mission statement but it should be written by children and young people themselves and have the power to hold organisations and professionals to account for their actions or inaction.
Finally, some children and young people of course, will have severe mental health difficulties and this will require more specialist intervention but again, it is important that we work even harder as a society at ‘destigmatising’ issues to do with mental health to help both children and their families not to be overcome by fear and shame. Services need to be responsive, easily accessible to all sections of the community, flexible and free of indecipherable jargon. Whilst resources are in short supply during these times of economic austerity, that does not prevent us from instigating a cultural revolution in attitudes and doing everything we can to ensure that all services to children and young people are benchmarked for their ‘child centredness’ as this can make all the difference to the wellbeing of children and young people. I remember working with a young person who was self-harming and was suicidal. She had been admitted to hospital as a result of an overdose and offered a follow-up appointment with a psychiatrist; unfortunately, the approach that the psychiatrist took was so far from person centred that the young woman simply could not connect with him. Rod Morgan was speaking at a conference I was at recently and bemoaned the fact that we talk about young people being ‘hard to reach’. What I think he meant is that we are often looking at the issues the wrong way round and if anything should be asking why our services are so hard to reach for those children and young people who need them the most?
For more information about the consultation visit the Nice website.
Nushra Mansuri is the professional officer (England) at BASW.