A time bomb waiting to explode

Young people’s mental health services are at crisis point.  GPs are having to cope with the consequences of our failure to focus on prevention, and a lack of access to specialist services.  We may not be able to change the world we have created for our young people, but we need to take action to ensure that help is available when they need it.  GPs are at the forefront of addressing this crisis and they need far more support.

The increase in mental ill health among our young people is exacerbated by our trophy culture. They are under enormous pressure to succeed in every way, not only at school where they are constantly tested and graded, but also by endeavouring to gain social cachet by competing to be ‘followed’ and ‘liked’ on social media. A survey for stem4, the charity which works to prevent mental ill health in teenagers, found that almost four in five (78 per cent) GPs are seeing more young patients with mental health problems than five years ago.   Most (87 per cent) expect pressure on services to increase.

Nearly all (97 per cent) the doctors surveyed had seen a patient aged 11-18 suffering from depression over the past five years.   The same number (97 per cent) said they had seen a patient experiencing self-harm, and six in ten (61 per cent) were seeing more young patients self-harming than five years ago.

However, half (50 per cent) said they had received no specialist training on self-harm and over a third (36 per cent) said they had received training but it was not adequate for them to feel confident supporting young patients.

The survey forms the basis of stem4’s new report ‘A Time Bomb Waiting to Explode’.   302 GPs in England were asked about their patients aged 11-18:

Almost eight in ten (78 per cent) said the number of patients experiencing mental health problems had increased, either somewhat (61 per cent) or greatly (17 per cent), over the past five years

• 63 per cent had seen a young patient with an addiction problem
• 89 per cent had seen patients with eating disorders
• 85 per cent say health and social care services for children are either inadequate (59 per cent) or extremely inadequate (26 per cent )
• 83 per cent say services for young people who self-harm are either inadequate or extremely inadequate

Almost nine in ten (86 per cent) had concerns about patients coming to harm while waiting for treatment. Most (76 per cent) want to see increased funding for mental health, and over half (54 per cent) want more specialist training for GPs on young people’s mental health problems

Dr Faraz Mughal, Royal College of GPs Clinical Fellow for Youth Mental Health, said: “This report provides a worrying insight into the difficulties currently facing young people who need mental health care – and the issues faced by GPs who are trying to care for them.

“GPs are seeing more and more young patients with mental health problems, and they often present in a different way to adults when experiencing mental illness or distress, but services in the community that they could benefit from are underfunded and this invariably puts general practice under pressure and our patients’ safety at risk.

“This report brings home how important it is that family doctors receive appropriate specialist-led training in mental health, that there is more investment in mental health services right across the NHS, and that there is greater integration across health, social care, education and justice services, so that we can deliver the care and support our young patients with mental health problems need and deserve.”

The report paints a picture of patchy and underfunded services hit by shortages of specialists, long waits for treatment, and eligibility criteria so strict that GPs are deterred from making referrals.