̽��ֱ�� of Cambridge - Sharon Neufeld

Cuts to mental health services putting young people at risk, say experts

cjb250 — Fri, 15 Sep 2017 12:18:05 +0000

In an article published today in the Journal of Public Mental Health, the team discuss the policy implications of their study published earlier in the year, which found that young people who have contact with mental health services in the community and in clinics are significantly less likely to suffer from clinical depression later in their adolescence than those with equivalent difficulties who do not receive treatment.

Young people’s mental health problems are associated with an increased risk of problems later on in adulthood, including poor mental health, lower income, unemployment, inability to maintain a stable cohabiting relationship, and greater contact with the criminal justice system. However, the team’s previous study suggested that access for adolescents with mental health problems to intervention in schools and clinics reduces mental health problems up to three years later and would therefore yield personal, economic, and societal benefits over an individual’s lifespan.

In the study, Sharon Neufeld and colleagues from the Department of Psychiatry at the ̽��ֱ�� of Cambridge used data obtained between 2005-2010 – prior to funding cuts to Child and Adolescent Mental Health Services in the community and in NHS clinics. Between 2008 and 2013, funding for the services dropped by 5.4 per cent in real terms so that in 2012/2013, only 6 per cent of the NHS’ total mental health budget was spent on these services. ̽��ֱ��knock-on effect of this was that while in 2005/2006, 38% of 14-year olds with a mental disorder had made contact with mental health provision for young people in the past year, in 2014/2015 only 25% of all children and young people with a mental disorder had made such service contact.

One consequence of this has been that the number of young people attending A&E due to a psychiatric condition had doubled by 2014/2015, compared with 2010/2011.

“It’s important to improve young people’s mental health services in schools and strengthen the care pathway to specialist Child and Adolescent Mental Health Services, in order to meet the NHS target of returning contact back up to 35% by 2020/2021,” says Mrs Neufeld.

“We need to acknowledge the mental health suffering in our young people that has only been increasingly apparent in recent years, and resolve to improve young people’s access to effective mental health services.”

She and her colleagues argue that as well as protecting funding for specialist Child and Adolescent Mental Health Services, funding for school-based counselling is also important as their study found that this was the second most used service for young people with a mental health disorder.

“ ̽��ֱ��current government has promised to provide funding for mental health first aid training for teachers in secondary schools, which should enable them to better identify those with mental health issues and connect students to the appropriate support services,” says Professor Peter Jones. “But this is against a backdrop of freezing school budgets, the very budgets that typically fund school-based counselling.

“Funding for school-based counselling must be ring-fenced, whether it be funded through the education sector or NHS, to ensure young people have adequate service access prior to specialist mental health services.”

̽��ֱ��researchers also argue that GPs could use more training in identifying mental disorder. ̽��ֱ��Royal College of General Practitioners reports that nine out of ten people with mental health problems are managed in primary care. However, even in the recent past, most GPs do not include a rotation in mental illness as part of their training. Such gaps in training, say the researchers, mean that GPs correctly identify less than a half (47%) of depression cases.

“This is a huge missed opportunity,” adds Professor Ian Goodyer. “GPs will encounter a large number of individuals with mental disorders, but have insufficient background knowledge to appropriately identify such cases.”

Reference
Sharon AS Neufeld, Peter B Jones and Ian M. Goodyer. Child and adolescent mental health services: longitudinal data sheds light on current policy for psychological interventions in the community. Journal of Public Mental Health; Date; DOI 10.1108/JPMH-03-2017-0013

Funding cuts and austerity measures are damaging young people’s access to mental health services, with potentially long-term consequences for their mental wellbeing, say researchers at the ̽��ֱ�� of Cambridge.

We need to acknowledge the mental health suffering in our young people that has only been increasingly apparent in recent years, and resolve to improve young people’s access to effective mental health services.

Sharon Neufeld

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Teenagers who access mental health services see significant improvements, study shows

cjb250 — Wed, 18 Jan 2017 10:00:46 +0000

̽��ֱ��study, published in Lancet Psychiatry, found that 14-year-old adolescents who had contact with mental health services had a greater decrease in depressive symptoms than those with similar difficulties but without contact. By the age of 17, the odds of reporting clinical depression were more than seven times higher in individuals without contact than in service users who had been similarly depressed at baseline.

Researchers from the Department of Psychiatry recruited 1,238 14-year-old adolescents and their primary caregivers from secondary schools in Cambridgeshire, and followed them up at the age of 17. Their mental state and behaviour was assessed by trained researchers, while the teenagers self-reported their depressive symptoms. Of the participants, 126 (11%) had a current mental illness at start of the study – and only 48 (38%) of these had had contact with mental health services in the year prior to recruitment.

Contact with mental health services appeared to be of such value that after three years the levels of depressive symptoms of service users with a mental disorder were similar to those of 996 unaffected individuals.

“Mental illness can be a terrible burden on individuals, but our study shows clearly that if we intervene at an early stage, we can see potentially dramatic improvements in adolescents’ symptoms of depression and reduce the risk that they go on to develop severe depressive illness,” says Sharon Neufeld, first author of the study and a research associate at in the Department of Psychiatry.

̽��ֱ��Cambridge study is believed to be the first study in adolescents to support the role of contact with mental health services in improving mental health by late adolescence. Previous studies have reported that mental health service use has provided little or no benefit to adolescents, but the researchers argue that this may be because the design of those studies did not consider whether service users had a mental disorder or not. ̽��ֱ��approach taken on this new study enabled it to compare as closely as possible to present study statistically-balanced treated versus untreated individuals with a mental disorder a randomised control trial.

̽��ֱ��researchers say their study highlights the need to improve access to mental health services for children and adolescents. Figures published in 2015 show that NHS spending on children’s mental health services in the UK has fallen by 5.4% in real terms since 2010 to £41 million, despite an increase in demand. This has led to an increase in referrals and waiting times and an increase in severe cases that require longer stays in inpatient facilities.

On 9 January this year, the Prime Minister announced plans to transform the way we deal with mental illness in the UK at every stage of a person’s life – not just in our hospitals, but in our classrooms, at work and in our communities – adding: “This starts with ensuring that children and young people get the help and support they need and deserve – because we know that mental illness too often starts in childhood and that when left untreated, can blight lives, and become entrenched.”

Professor Ian Goodyer, who led the study, has cautiously welcomed the commitment from the Prime Minister and her Government. “ ̽��ֱ��emphasis going forward should be on early detection and intervention to help mentally-ill teens in schools, where there is now an evidence base for psychosocial intervention,” he says. “We need to ensure, however, that there is a clear pathway for training and supervision of school-based psychological workers and strong connections to NHS child and adolescent mental health services for those teens who will need additional help.

“As always, the devil is in the detail. ̽��ֱ��funding of services and how the effectiveness of intervention is monitored will be critical if we are to reduce mental illness risks over the adolescent years. With the right measures and school-based community infrastructure, I believe this can be achieved.”

̽��ֱ��research was funded by Wellcome and the National Institute for Health Research.

Reference
Neufeld, S et al. Reduction in adolescent depression after contact with mental health services: a longitudinal cohort study in the UK. Lancet Psychiatry; 10 Jan 2017; DOI: 10.1016/S2215-0366(17)30002-0

Young people with mental health problems who have contact with mental health services are significantly less likely to suffer from clinical depression later in their adolescence than those with equivalent difficulties who do not receive treatment, according to new research from the ̽��ֱ�� of Cambridge. This comes as Prime Minister Theresa May announced measures to improve mental health support at every stage of a person’s life, with an emphasis on early intervention for children and young people.

If we intervene at an early stage, we can see potentially dramatic improvements in adolescents’ symptoms of depression and reduce the risk that they go on to develop severe depressive illness

Sharon Neufeld

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