Mental health services need to listen to young people

SpunOut.ie Action Panel member, Owen Brennan recently spoke at the ESCAP mental health conference in Dublin. Owen spoke about the importance of mental health professionals listening to young people and their mental health needs. His speech was part of the presentation by Helen Coughlan called 'The Change Imperative: Why the youth mental health paradigm needs to evolve and why the voices of young people are critical to this evolution.'

Life as a young person is very confronting and hard enough to cope with without carrying the extra burden of mental illness. Our health system needs to take the next step forward in removing the barriers between mental health professionals and young people. It must begin to listen to what young people are saying. In order to establish a youth-friendly service, one must include the voices of young people.

Youth mental health services must understand that they need the participation of young people in order to provide better outcomes with young people. Just as psychiatrists and psychologists are the experts on mental health, young people are the experts on young people. We know our needs best and the current youth mental health paradigm must evolve to meet these needs.

One issue with our current youth mental health model is that it does not behold youth participation on any level. Young people have no say in a service that exists for us. We have no input into service design or service delivery or into the interior design of the spaces where these services are located which prevents a youth-friendly atmosphere from being developed. I firmly believe that young people are best positioned to judge what is youth-friendly and what is not. It is no secret that many of the current youth mental health services are not youth-friendly. This is echoed by the experiences and opinions of young people who have accessed these services.

This is no surprise, how can we possibly expect these services to be youth-friendly when those making decisions fail to include the voices of young people. It is easy to see that the traditional model of our mental health services are not suitable for young people, however with the inclusion of young people we can vastly improve the typical experience of a young person who engages with our youth mental health services.

To establish youth participation in our mental health services the authorities must give us one simple thing; the opportunity. Give us the opportunity to become included and to have our voices act as a catalyst for the evolution of our youth mental health paradigm, allowing it to become a model with more benefit for young people. When the authorities and experts within these services begin to actively listen to what young people have to say then these services can begin to help young people a lot more.

Those within our mental health services must involve the voices of young people in order to help feel safe and comfortable when accessing professional help. We must change the style of our mental health services. In all aspects a partnership must be established between young people and mental health professionals. Young people can provide critical consultation on how services can be moulded to better suit young people which will break down barriers between young people and mental health services.

One such barrier is the attitudes and perceptions of both young people and mental health professionals. There is a stigma among young people when it comes to our mental health services largely because of the medicalisation of our problems. The eagerness of a psychiatrist to prescribe pills to a young person going through a tough time is not the help we seek. A young person does not feel like they are being taken seriously, when they sit down with a mental health professional they are often lectured on why a prescription is the solution to their problem.

This attitude of some mental health professionals makes us feel belittled and this is the opinion of young people who have engaged with these services. I urge you, as those with the responsibility of delivering front-line mental health services to young people, forget the option of prescribing pills to us in the first instance and instead work on building resilience of young people.

The culture in youth mental health services must change from one that is heavily medicalised to one that is youth focused and based on therapeutic intervention. Young people must stop being treated as a diagnosis but instead as what each one of us is; an individual.

Young people do not want to access a service with an intimidating or judgemental atmosphere or one which promotes the products of pharmaceutical companies, but we will not hesitate to access a service which listens to us and takes us seriously. The establishment of youth participation will over time persuade mental health professionals to adapt a more youth-focused approach when working with a young person. Influential youth involvement in our mental health model won’t happen over-night, but you, as the mental health professionals, can better help a young person the next time you sit down with us by establishing a meeting of two experts. 

You are the expert on mental health, but you are not the expert on any individual young person you meet, that young person is. Refrain from writing a prescription. Instead hear the young person out. Listen to them talk about themselves and their problem with genuine care. Talk with them not to them. Do not give them an answer with a diagnosis from the latest edition of DSM; instead give them a solution with an understanding.

Value the involvement of a young person in a session and you will achieve better results with that young person. All we want as young people going through a tough time is to be respected, taken seriously and most of all actively listened to. I know that with greater youth participation in youth mental health services, more mental health professionals will recognise this.

There is one model for youth mental health services here in Ireland which I believe should be replicated by all our services working with young people. This model and service is called Jigsaw. Jigsaw is a model which is shaped in all aspects by consultations with young people. It is a model which I believe works best with young people. I believe this because Jigsaw acknowledges the needs of young people.

Those behind this innovative model understand that youth mental health needs to focus on the development of strengths and resilience of young people rather than focusing on us young people as a problem that needs to be fixed. Jigsaw also holds a core value of having young people actively engaged in the design, implementation and review of services to ensure they are accessible and non-stigmatising for young people. Jigsaw is a model of youth mental health service that our statutory youth mental health services should strive to resemble for the benefit of all young people.

In order for the essential evolution of our youth mental health paradigm, it is critical to include the voices of young people. We bring with us our expertise as what it is to be a young person in this that and age.  We can provide a new youth angle which can be embedded into all aspects of our services to ensure that best practice is followed and the best possible outcomes are achieved by and for any young person who accesses a youth mental health support service.

We must combine our expertise as professionals and young people, we must lose the prescription culture and stigma towards our services, we must build resilience in young people and work together to tackle mental ill-health among young people and provide the best youth mental health services possible.