Supporting Mental Health from Childhood to Adulthood
One in eight 5 to 19 year olds in the UK has experienced at least one mental disorder. However, statistics from Public Health England show that 70% of children and adolescents who experienced mental health problems did not receive appropriate interventions at a sufficiently early age. And this mismatch can have serious implications for later life.
Tamsin Ford CBE, Professor of Child and Adolescent Psychiatry at the University of Exeter Medical School, is at the forefront of helping to transform health services and schools in the UK. Her research focuses on understanding why children have particular difficulties and finding the best way to help them.
“Every contact with a professional represents an opportunity to recognise distress or dysfunction and to intervene to improve a child’s developmental trajectory,”
Tamsin said. “Disruptive behaviour in the classroom may be an indicator of poor mental health and social adjustment, affecting a child’s academic attainment and life chances.”
Since 2010 Tamsin has led a project called STARS, testing the impact of a classroom management programme on children’s mental health, behaviour and academic
performance.
The programme supports teachers to improve behaviour in the classroom through a practical and reflective training course that focuses on the importance of teacher attention, encouragement and praise, motivating children
through incentives and encouraging them to problem solve.
In order to test its effectiveness, the research team have conducted a randomised controlled trial across 80 schools where 50% of participating schools received the training and 50% did not.
Tamsin said: “We saw a small but significant improvement in children’s mental health through the STARS programme and are now running further studies with more than 140 additional schools to see if we get the same results and can gather more detailed evidence of effectiveness.
“There was an amplified effect among children with elevated mental health difficulties, and significant reductions in disruptive behaviour and inattention. Also the teachers who had the training say their relationships with children are better and that they were able to implement the strategies straight away, so it’s been really
encouraging so far.”
Another key development, CATCh-uS, focuses on ADHD
(Attention Deficit Hyperactivity Disorder), a common condition that affects children and adolescents.
Children with ADHD generally have problems paying attention or concentrating, following directions is difficult and they get easily bored or frustrated with tasks. Symptoms of ADHD can interfere with the child’s ability to function at school and at home.
Tamsin said: “ADHD used to be thought of as a condition restricted to childhood, but there is clear evidence that it persists into adulthood for many young people. Two thirds of people continue to have issues into their 20s but there is little or no support for the condition in adulthood. Prisons are full of people with ADHD.”
The project has included a systematic review of non-clinical interventions in schools, a study of young people with ADHD, and a survey of people at different stages of the transition process to adult care.
More than 2,500 young people, parents, health workers and UK commissioners also provided information on services for adults with ADHD in their area, and this information has been used to create a map of available services. This helps identify existing services and gaps in provision for young adults with ADHD.
Anna Price, Associate Research Fellow working on the project, said: “For adolescents who need to transition into adult services, this change comes at a crucial and vulnerable time, when multiple other changes are
happening such as moving on to higher education, starting work or changing home.
“If adult ADHD services are not available, or importantly, if the young person, their parent or carer, or clinician do not know about local adult ADHD services, this individual may slip through the net and stop receiving the support they need. It is therefore imperative we improve awareness of ADHD service provision nationally and this map is a good start.”
Adults with ADHD may have difficulty with time management, organisational skills, goal setting and employment. They may also have problems with relationships, self-esteem and addictions. Medications can help but generally only take the edge off and users can build a tolerance to them that prevents them working in the long term.
“If you’re not functioning well in your teens, you can pay a high developmental price later in life,” said Tamsin, “which is why it’s so important we improve understanding of conditions and also access to services.
“Service provision is patchy across the UK, with areas
including the East of England and South West lagging behind. We have also seen strong links to family background, deprivation and the environment – if you can access green space it generally helps – so there are very
mixed experiences across the country.”
Research has shown a relationship between exclusion from school and individuals’ mental health, so as well as increasing awareness of available services for children and young adults, the team are also working to produce a toolbox for schools with some strategies to help teachers.
In addition, the research is being used to inform future service development and make recommendations for changing NICE (The National Institute for Health and Care Excellence) guidelines. Combined with the STARS training, there is real
potential to improve experiences for young people in the UK and reduce problems that last into adulthood.