In my lifetime, during which public awareness has dramatically evolved, mental health in Scotland and the UK has never not been ‘in crisis’. Waiting times, despite targets to reduce them, remain lengthy. At no point has it felt like supply of services and psychiatric staffing has been adequate, in the way physical conditions (for the most part, with exceptions) are expected to be seen to in an appropriately timely manner by the NHS. In many ways, the legacy of mental health as an afterthought has yet to be shrugged off: the infrastructure to support it is lacking.Now practitioners are seeing a new surge of mental health concerns, particularly in young people who have struggled with the constraints of the last year. Public Health Scotland published a report on the Impact of Covid-19 on children and young people in Scotland. It’s research indicated that less than half of 11 to 25 year olds felt good about their mental health and wellbeing, with the finding made after pupils returned to school.When combined with the shocking statistic that suicide rates in Scotland are at their highest level in ten years, it’s extremely concerning so many young people are in a precarious place with their mental health. But is it any surprise, when mental health provision continues to lag?
When I first asked for help with chronic depression, back in the 2000s as a young teen, I had to fight to be taken seriously and was fobbed off with vitamins and suggestions of exercise before a trip to A&E put me on a waiting list for a counsellor.
Understanding of mental health has improved, but to someone who feels bad enough to have sought help, waiting for months can be crushing - and dangerous. And yet, we know from the same PHS report that 27% of young people waited longer than 18 weeks to be seen by Child and Adolescent Mental Health Services, a lower rate than the year before, but still far off the target of 90% being seen within 18 weeks.
For mental health emergencies, a rising number of young people are being admitted to Intensive Care, stretching services further.Dr Colin Begg, Consultant in Paediatric Intensive Care Medicine at the Royal Hospital for Children in Glasgow ,told me that he and his colleagues across the UK were seeing “more seriously ill young people after overdoses, self-harm, physical assault, drug and alcohol misuse and other risk-taking behaviours”.
He added: “Our own figures in Glasgow, while still small, are up 4 times on their pre-COVID baseline. All of these are signals of a crisis in mental health. Vulnerable young people have been placed under great pressure by the pandemic, and what we see in PICU (Paediatric Intensive Care Unit) is only the tip of the iceberg.”’Too much mental health funding has attempted to plug holes in the dam, or mop up the spillage. It can’t hold. Until services meet demand, we will continue piling crisis atop crisis, with every generation of young people inheriting the consequences.