Young people, mental health and cyberbullying

Call out their name. Call it out... you know the reply won't come. Instead your words drop into the void. It happens. And it continues. Too many silences where there should be the cherished sound. Because of the earlier silences, the earlier words disappearing into the vacuum, there is nothing now.

What should be a given still isn't. It's still happening, it continues. People lost. Why? Because confusion still prevails. The world is chaos, especially for kids. Struggling against the pressure of trying to work out who it is they are in this modern environment with all its distractions and online demands. Sexual identity. The glare of the media. Wanting to be wanted. A complete chaos.

But the distance between our desired system and the reality remains; promises made but not kept, labyrinthine routes to the right support, gaps of specialist staff or mental health nurses. All this should not be met with a shrug of the shoulders or an acceptance that this is just the way things are. It matters.

Mental health services are much improved compared to 10, 15 years ago - I've seen that, it's clear. There is a greater diversity in these services - more closely matching the nuances of any mental illness and the attached streamlined care needed - and we know more about each of these illnesses than ever. There is less of a dependency on antidepressants, for example, or less of that reflex action from medics to prescribe them. There is art therapy, cognitive behaviour therapy, a wealth of niche charities. But the whole still isn't joining up, particularly with respect to younger service users.

Referrals from GPs over mental health disorders in young purple are at record levels. One in eight 5-19-year-olds had at least one mental illness in 2017, according to this year's NHS Digital survey (November 2018).

Yet the evidence suggests that illnesses can get worse while children wait for the relevant support - 76% of parents responding to charity Young Minds (August 2018) said this was the reality with their child. According to Health Service Journal, 500 youngsters had to wait a year between the moment of first contact and an appointment with a specialist.

And then there's cyberbullying, a true factor of the present. The NHS Digital survey said one in five children between 11-19 have been cyberbullied in the last year. Additionally, the British Medical Journal found that (all forms of) bullying can have long-team effects on individuals' mental health.

A recent report from Swansea, Birmingham and Oxford universities said that (worldwide) victims of cyberbullying were more than two times more likely to self-harm or take their own lives. But in the NHS study, Anne Longfield, children's commissioner for England, said "only a small fraction of those who need help are getting it". The NHS's own figures say a quarter of 11-16-year-olds with a disorder have self-harmed or attempted suicide.

I'll repeat it, and I write from experience - in the early part of this century, mental health services truly were a mess. The system was a series of circuitous dead ends, through which often the wrong medication was prescribed because it was deemed the simplest - not the most suited - solution. Mental health was way down the national agenda.

I don't recall that period with fondness. And, while there has been progress, these burgeoning 21st-century issues have brought the mind, and evolving impacts on it, into full focus.

Theresa May's recent appointment of a minister for suicide prevention is commendable on one level - anything that raises the profile of mental health and issues around it is obviously needed, but if it merely causes a distraction from results-based action and practical support then it is pointless. It's headline-seeking. There's also a tendency to have sympathy for the more 'trendy' mental illnesses, ignoring things when they get a bit ugly.

Commendable too, the government's plans to boost help in schools through Mental Health Support Teams, but its promises must be met, or broadened, especially now the demands of youngsters are clear. Those existing plans don't even include half of schools by the middle of next decade.

Committing and actually giving money to two key tenets - research and frontline services - must be the priority.

The community can help too. Charities provide fine support for people affected by mental illness, with children's services increasingly prominent. And with the promised £300m funding perhaps not yet in full view, these little bits of help can ease at least some of the pressure on mainstream channels. Mentoring with Young Minds, becoming a befriender with Family Matters (linked to Bullying UK) or joining a Kidscape workshop are just a few examples of potential volunteering.

With those modern pressures above twinned with sadly enduring contributors such as bullying prevalent, a realisation of this support is crucial to ensure that we progress and that, most importantly, mental ill-health is assessed and addressed in patients when they're young and living in a vulnerable world without context.

It could secure their survival.