The mental health epidemic and the ‘deflection effect’

The mental health epidemic and the 'deflection effect'

In recent months a number of major sports stars, Simone Biles, Naomi Osaka and Ben Stokes among them, all very or relatively young, have made their mental struggles public, and while there are undoubted positives to high-profile names highlighting these illnesses, I suggest that perversely a byproduct of these stories - what I call the 'deflection effect' - can mask the growing epidemic, particularly among young people, of mental ill-health in England.

The last few weeks have given us some dismal statistics. An NHS Digital survey revealed that one in six children (under 18) in England has a probable mental disorder in 2021, up from one in nine in 2017. More than half (52.5%) of 17- to 23-year-olds experienced a deterioration in their mental health over the same period, while almost 60% of youngsters in that age group have had problems sleeping this year.

According to the Royal College of Psychiatrists (RCP), more than 190,200 people aged 18 or under were referred to mental health services between April and June this year, a giant 134% increase on the same period in 2020.

And respondents to the Big Ask survey, an initiative from the children's commissioner in England which surveyed half a million children earlier this year, also displayed concerns about their mental health. Girls aged 16 to 17 were the most concerned: 40% of them said there were unhappy with their mental wellbeing.

Why the increases? As ever, it's complex with anything mind related. But NHS Digital cited many contributing factors including social media and 'family functioning'. Covid and its associated lockdowns were there too, but the stats suggest it wasn't the catalyst and instead accelerated pre-existing problems (some 225,000 under-18s were already in contact with mental health services in 2019, the RCP figures show).

And the evidence suggests that services cannot keep pace with the rise in (potential) patients. Back in 2018, I wrote that the Conservatives had pledged to bolster young people's mental health support with £300m, and improve access to services in schools. They also created the role of a minister for suicide prevention. And that's alongside pledges to extend the NHS workforce in the Long Term Plan. Maybe in light of the pandemic those commitments already need to be rethought.

A freedom of information request by the BBC has shown that, between April 2020 and March of this year, 20% of under-18s in mental distress waited more than 12 weeks to be seen by a specialist, while half of under-18s waited more than four weeks. And while they are waiting, it would appear, some are motivated into a trip to A&E. Doctors confirmed that children were being admitted to general hospital wards despite there being no specialist mental health support available there.

(Separate data has revealed that a proportion of adults are being transferred 'out of area' - a development at odds with the government's own pledge. Department of Health and Social Care figures released to Labour MP Jonathan Ashworth recently showed that almost 700 mental health-related patients were sent away from their home area for treatment in April 2021, even though the government promised to end these unsettling placements before that date.)

Through my own experiences this year as a mentor with a mental health charity, I can confirm first-hand this apparent 'tsunami' of affected youngsters. Each week the charity supports hundreds of wonderful young people with various mental issues who are seen by volunteers from a range of backgrounds. Perhaps these members might have tried to access services elsewhere or contact their GP, perhaps not. This particular outlet, with a focus on cognitive behaviour therapy, was started by someone with a passion for mental wellbeing and it's a beacon for others to follow.

But it is clear similar organisations could meet the bulging demand, ideally in a direct relationship with NHS or NHS-backed specialists.

And that needs expertise, ingenuity, and funding.

Dr Elaine Lockhart of the RCP nails it when she says "early intervention is key to recovery. Schools have a critical role to play in this ... without investment, we run the risk of many more [children and young people] needing crisis help". How many diagnoses are missed when patients get fed up waiting?

Without a swift rethink of current measures it looks inevitably as though not enough youngsters will get access to worthwhile services and treatment in as timely a manner as they should. The danger of that trend is the aforementioned missed opportunities to diagnose these people early and in turn the awful prospect of them self-harming or wanting and trying to end their own lives.

And that's why the deflection effect frustrates me, because when many of us see, for instance, Simone Biles in the news after raising their voice, there's a tendency to say 'ah, what a shame' and then forget about it until the next time a celebrity does likewise, and they are met with the same response. Usually some politician will chip in with a soundbite along the lines of 'I sympathise and we are doing all we can in *insert area of concern*'. But all they can would appear to not be enough. The effect acts as a smokescreen to cover failures to deliver real, tangible support. And soon another issue takes precedence.

The presence of mental illness and its effects in the media promotes its severity (and it's probably true that stars speaking out encourage more young people to access help - in turn meaning they all need that help in good time). Big names, especially those with a large online following, should, if they want, always be encouraged to go public and help shed the stigma still blighting mental illness. But alone that presence is not enough.

Investment in enduring ground-level support must be the ultimate goal. That money could fund enhanced support gievn by local councils and schools direct, or be channelled to independent charities and services. Renowned adventurer Bernie Hollywood is planning a solo rowing trip across the Atlantic next year, a phenomenal effort to raise awareness and cash in this area. He's right when he says our young people need hope. But they also need help.