The more observant of you may have noticed that this week (October 10th) it was World Mental Health day. In recognition of this, the round-up this week has a mental health focus. I will be highlighting how this affects people of all ages, the issues raised for the NHS including the mental health of those that work within it, and how we can take simple steps to help ourselves and others.
Global Mental Health Summit. This was attended by 50 countries on World Mental Health day this week. The Prime minister announced the appointment of a minister for Suicide Prevention and pledged extra investment in this area including additional funding for the Samaritans. More details on this in a report from the BBC here. The article highlighted some contact details for mental health charities which I have listed below:
- The Samaritans are open 24 hours a day. Call 116 123 or email email@example.com
- The Campaign Against Living Miserably (CALM) offers support to men. Call 0800 58 58 58 between 17:00 and 00:00 everyday or visit their web chat page here
- Papyrus helps people under 35. Call 0800 068 41 41 – Monday to Friday 10am to 10pm, weekends 2pm to 10pm, bank holidays 2pm to 5pm – or text 07786 209697
- Childline is available for children and young people under 19. Call 0800 1111 – the number will not show up on your bill
- The Silver Line helps older people. Call 0800 4 70 80 90
Young people’s mental health
When talking about suicide, this is inevitably and appropriately an area of concern for us. Social isolation and loneliness shorten our lives, being equated to smoking 10-15 cigarettes a day in terms of the impact on our health. When we think of the lonely groups in society, we often think of the elderly. However, children and young people are the group who report being the most affected by loneliness. Such people might appear to have a wide circle of friends and to be connected by social media but it just demonstrates the truth that you can still feel lonely even if you are not considered alone.
Tracy Crouch is the first minister for loneliness, and gave this interview to the BBC about the need to address this issue. It’s clearly not an easy one. The government may not be able to make friends for us, but we do need action at every level ranging from decisions about how we plan and develop our society and infrastructure, right down to individual day-to-day interactions. When I consult with anyone who is anxious or low in mood, I will always ask about what their connections are with other people and encourage them to seek them out or develop them further. We are ultimately social animals. People do better with real life, face to face interactions when they are struggling.
Living in an affluent commuter town, you might be forgiven for thinking that there’s no big deal when it comes to casual drug use, particularly amongst the middle classes. It tends to get lost in the general debate about legalisation but the reality is that there are serious consequences for mental health, particularly that of young people. This article in the American Journal of Psychiatry highlights the dangers of cannabis use and its impact upon cognitive skills, memory and behaviour. The effects were greater than those of alcohol, and appeared to be longer term. Take home message for me? That we need to be very careful as adults, particularly if we are parents, as to the messages that young people get from us. Adult brains may not in the same vulnerable state as theirs are.
Child and Adolescent Mental Health Services (CAMHS)
As a GP I know many colleagues who work to provide CAMHS in their localities, and do their best in very difficult circumstances with limited budgets and increasing demands. This article reports a 26% rise in referrals into such services nationally. When faced with inadequate resources, services inevitably look at their referral thresholds and it is reported that a similar percentage of referrals are rejected, saying they do not meet the criteria. This could be because of genuinely increasing rates of mental health problems and also a result of increasing awareness of the signs of potential mental health problems due to health campaigns in this area. I don’t have an easy solution for this, but one of the things I recommend is that as parents and professionals we have some knowledge of the options available to us as well as the traditional CAMHS route, which not every young person will need. These might be third sector or voluntary organisations. In my locality we recommend Kooth, which offers many different ways for young people to access support. Suicide awareness and mental health first aid training for young people and adults alike is very important. In St Albans we have the OLLIE foundation which is a charity doing excellent work in this area.
One of the messages on World Mental Health day was “ask twice”. People often say that they are fine when asked the first time. We’ve all done it over our first cup of tea of the day at work. Sometimes it feels as if you are obliged to say that you’re fine, as it might throw a spanner in the works and feel a bit awkward if you tell people how you are really feeling! However, my view on this is that anyone who asks “how are you?” should both expect and be prepared to respond to whatever comes back. If you sense that your friend, family member or colleague may not be feeling fine, ask them again. The point is well made by this short video.
Mental health support for NHS workers
Staying with work, NHS chief Simon Stevens announced recently that there would be an expansion in the mental health service for doctors. It already exists for GP’s and extra funding will be put into making it more widely available. Clearly this is welcome and has been beneficial for the doctors that have used it so far. However, if we are to practice preventative medicine when it comes to NHS workers’ health in the same way that we would like to with our patients, we must consider the underlying reasons why there is an increasing mental health burden. I hope that the secretary of state for health and his colleagues will be considering underlying issues like workforce capacity and conditions as well as proper funding for services. If not, it will simply be a sticking plaster that will fall off sooner or later.
Mediterranean diet…helpful for reducing depression?
It was recently reported that there may be an association between the Mediterranean diet and reduced odds of depression. Now we all know that association is not the same as causation, but I think this is encouraging enough both to look into more deeply in terms of research, and to try for ourselves in the meantime. After all, it isn’t complicated or necessarily expensive to do and has none of the risks associated with taking antidepressants. Here is a simple diagram to remind us of the key components of a mediterranean diet:
That’s it from me this week. The weekly well being round-up will return. Probably next week! Until then, take care of yourself.
Dr Richard Pile