2 Professional approaches

There can be a surprising range of professions and practitioners involved in helping young people with mental health problems. The next activity will get you thinking about what you already know.

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Listen to this interview of a parent talking about their child’s mental health and the different professionals that can provide a supporting role.

Download this audio clip.Audio player: Audio 2: Providing a supportive role.

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Transcript: Audio 2: Providing a supportive role.

SPEAKER 1

Our daughter went off to university. And that’s where it absolutely came to a head and her whole world unraveled. She would frequently ring in the middle of the night, so we’d get phone calls 2:00 and 3:00 in the morning. She would ring at any time in the day, panic stricken, couldn’t cope.

We would go up. We went quite frequently. And she didn’t look well. She was almost hiding in her student room unless she had to come out for a particular reason.

And I think, when I look back on it, what breaks my heart is she tried so hard. She really tried hard to make it work. But at that point, the illness had taken over.

We contacted the Hall of Residence of the college that she was in. And they arranged for her to see the university counsellors. And the university counsellor encouraged her to see the university GP. And she got an appointment with the university GP who, it’s going to make me feel quite emotional, who to this day, I think, saved her life because she diagnosed that she was suffering from anxiety and depression.

She put her on medication. I think she realised at that time she could not continue to study at University. She needed to come home. We brought her home and started the very long and painful progress of her getting better.

I think the GP enabled her to understand she was just suffering from poor mental health with a diagnosis of depression. Not feeling unhappy and depressed, actually depression. And that went together with anxiety.

It was the work that happened between the clinical psychologist and our daughter that started to build the blocks and she started to get her life back on track. And we will be indebted to this clinical psychologist forever, as I’m sure our daughter is too. I will freely admit, I would come home on occasion and wonder what I would find, particularly when I came home on one evening, and we’re talking now over the winter period so it was dark outside, no lights on in the house. I can remember I didn’t even put the car away. I just jumped out of the car and ran in. And she’d just been unable to get out of bed all day.

And it didn’t happen overnight. She saw the clinical psychologist, in the initial stages twice a week. And then it tailed off eventually to once a week. But it took three months for progress to be made.

And I can remember spending the whole weekend in tears thinking, would she ever get better? And the following weekend, she turned me, to the blue, and said, “I feel different.” And I said, “What do you mean?” She said, “I feel different. I don’t feel like I’ve been feeling for the past two or three years.”

And that was the corner that was turned. But it doesn’t happen overnight. You want it to happen quickly. These things cannot happen quickly. It’s slow.

It’s still, I would argue, it might even still be a work in progress. But suddenly, that corner was turned. And I think as a family, we knew that we weren’t there, but we were back on a straight road.

End transcript: Audio 2: Providing a supportive role.

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Audio 2: Providing a supportive role.

Have a look at Figure 5 below for a summary of the professions and teams that can be involved.

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Figure 5: A treatment hierarchy of professions and services.

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A diagram of three rows:

Primary care: General Practitioner, Practice Nurse, Community Psychiatric Nurse, School Nurse, Counsellor.

Secondary care: Psychiatrist, Clinical or Educational Psychologist, Psychotherapist, Occupational, Art, Music, Drama, Speech and language, Education Therapists, Support, Time and Recovery Worker.

Tertiary care: Specialist eating disorders team, Forensic mental health team, including Youth Offending Worker.

Figure 5: A treatment hierarchy of professions and services.

Primary care is usually the first point of contact for people when they become unwell, for instance, when they experience symptoms that are of concern to themselves or others. Primary care is also usually the ‘gateway’ to receiving more specialised care.

Secondary care is for someone who has received primary care and is referred to the next level of care. These services are usually consultant-led (with a psychiatrist as the clinical lead) and include mainstream out-patient services like Child and Adolescent Mental Health Services (CAMHS), as well as in-patient psychiatric units.

Tertiary care is for someone who requires a highly specialised team of professionals. This may involve someone being treated by an eating disorders team (e.g. in an in-patient unit for people with severe eating disorders) or in a forensic mental health facility (i.e. in a facility treating offenders who have severe and enduring mental health problems). You will recall a parent describing the route through which her daughter was able to receive the support she needed for her mental health in Audio 2. This included a GP consultation followed by therapeutic counselling.