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Biological, psychological and social complexities in childhood development
Biological, psychological and social complexities in childhood development

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3.2 Signs and symptoms of mental illness

Adolescents that experience poor mental health may suffer with lack of motivation, low self-confidence and loss of interest which can lead to withdrawing from social support and education. Long term effects of this can be poor education levels, anti-social behaviour and involvement with criminal activity, all of which can have long term impacts on emotional and social outcomes later in life.

Activity 10 Signs and symptoms of mental illness

Timing: Allow 40 minutes

In the Introduction to this course you met Liam. You might remember that he is 16 years old, his parents are separated, he is an only child and he has severe asthma. He recently had a severe asthma attack that required him to stay in hospital for several days and be away from school for two weeks. When he was well enough to return to school, he was extremely anxious and scared that he might catch Covid-19 and not be able to breathe; he became extremely upset. However, in subsequent weeks there were increasing cases of Covid-19 and schools were asked to close to deliver learning remotely.

Examples of newspaper headlines about Covid-19
Figure 4 Covid-19 related headlines

Part A

Imagine you are a healthcare practitioner and have been asked to carry out some physical observations on Liam, who has been having trouble sleeping. He confides in you that he has not been seeing friends as he usually would. He plays on his gaming computer alone in his room for most of his free time (when not being taught remotely by the school) and stays up until the early hours of the morning. His parents and teachers have told him they are disappointed that his grades at school are declining. He does not engage in class and remains quiet unless prompted to speak.

Conduct an internet search for high quality resources (e.g. NICE) on the topic of child and adolescent mental health and read a selection of them. Take some time to think about what could be going on for Liam. Have you been able to spot any signs or symptoms of mental illness? Can you spot any risk factors that might be present, as discussed earlier in this section? What might be the root cause of some of these? Write these down in the following boxes.

Table 3 Considering Liam’s case

Have you spotted any signs or symptoms of mental illness?

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Can you spot any risk factors? 

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What might be the root cause of some of these? 

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Words: 0
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Discussion

You may be thinking that Liam could be showing signs of anxiety or depression.

  • Poor sleep could be affected by his anxiety or poor breathing due to his asthma.
  • Social withdrawal could be due to his anxieties around Covid-19 or feeling disappointed about his declining grades and performance.
  • Poor academic performance could be related to his anxieties around school. When the school moved to remote learning this could have compounded this problem; if he was not engaging in face-to-face lessons then it could be easier for him to disengage from remote lessons.

These can all be signs of poor mental health. Without the right intervention Liam may continue to socially withdraw and under perform in education. You may have noted that Liam could potentially be at risk of bullying or abuse through his online gaming or social media.

It is important to remember that adolescents may find it difficult talking to adults, especially a health professional. It is mentioned that Liam’s parents are separated; there could be more than one risk factor present in Liam’s history or current circumstance that may not be obvious. Liam may find it difficult to verbalise or understand his emotions or feel that people won’t believe, understand or be able to help him. Therefore, it is important to approach Liam in a caring and compassionate way and reassure him that it is safe to discuss anything that may be bothering him. Be mindful not to use technical language beyond the young person’s vocabulary or understanding; it is important to remember the person’s age and developmental stage while conversing with them.

Part B

Take some time to think about how you might respond to Liam’s disclosures. You should also access some resources such as NICE guidelines for depression in children and young people.

Research the process for referral in your practice area/workplace/organisation and find out where your local child and adolescent mental health (CAMHS) team are and what services they offer. There may be a CAMHS team in A&E for urgent cases.

Once you have done this, complete the table below.

Table 4 Responding to Liam’s case
What would I do?
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What services are available?
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What evidence is available to inform my practice?
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Words: 0
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Discussion

It is important that you do not attempt to diagnose a mental health condition or make suggestions to Liam about what may be going on without being trained to do so. But being able to recognise and respond to signs and symptoms of mental illness is a necessary skill in your role.

You may have thought you would speak to a senior colleague or explore Liam’s concerns further. You may have thought about referring him to mental health services in your local area.

You may already be aware of mental health services in your area and the referral pathway/policy, but this activity should have allowed you to explore these further and view them in the context of other evidence such as NICE guidance. The next section will build on some of these themes, exploring social media and a young person’s experience of using mental health services.