Mental health groups have criticised a new Netflix drama for its “sensationalised” portrayal of a 17-year-old’s suicide, which they say could encourage young people to take their own lives.
The Samaritans, psychiatrists, and mental health campaigners claim 13 Reasons Why could prompt troubled young people to copy the suicide of its central character, Hannah Baker.
“We have a responsibility to protect children and teenagers,” said Dr Helen Rayner, a psychiatrist specialising in children and adolescent mental health who is also a spokeswoman for the Royal College of Psychiatrists. “Dramatic and detailed portrayals of suicide needlessly put vulnerable young people at risk of copycat behaviour as they see how to carry out harmful or potentially fatal acts.
“Graphic depictions of suicide may only influence a small number of viewers, but the consequences can be tragic.”
Ged Flynn, the chief executive of Papyrus, a charity that seeks to prevent suicide among young people, said parents and young people viewing the series should “be aware that when watching this programme there is a danger that suicide is romanticised and sensationalised”.
The US-set series aimed at young people is based on a novel of the same name by Jay Asher. Selena Gomez, the actor and singer, is among its executive producers. Its 13 episodes depict 13 friends of Hannah listening to a tape she made for each of them explaining the difficulties she faced that prompted her to kill herself.
Dylan Minnette and Katherine Langford in episode two of 13 Reasons Why. Photograph: Beth Dubber/Netflix
Sarah Hulyer, a mental health campaigner, said the show’s portrayal of Baker’s plight was irresponsible.
“Mental ill-health and suicide isn’t pretty and while we need to admit that, we also have a duty to look out for the wellbeing of our younger generations and not encourage unhealthy behaviours. By graphically depicting the protagonist’s suicide method, they’re not helping vulnerable young people; they’re encouraging them,” said Hulyer.
“[13 Reason’s Why’s] creators claimed they were hoping to ‘help’ people struggling with the issues shown in the show, but it’s a storyline that is about revenge suicide, demonises counsellors and includes none of the characters reaching out for help and receiving it, it’s not clear exactly what they think ‘helping’ is,” she added.
While she acknowledged that the show has helped thousands of young people think about the lasting impact of suicide, Hulyer asked: “Does a show that depicts a young girl who uses her own death to inflict pain upon others really deserve to be put on a pedestal?”
The number of suicides in the UK among 10 to 14-year-olds has risen from four in 2010 to 10 in 2015, and among those aged 15-19 from 166 to 221 over the same period, according to the Office of National Statistics.
The Samaritans said 13 Reasons Why exposed failings in the UK’s media regulation. “It is extremely concerning that a drama series aimed at young audiences can be produced outside of the UK and made available to UK audiences and yet not subject to UK media regulation. This is simply not acceptable and creates a barrier to protecting our young audiences i the UK,” said Lorna Fraser, a Samaritans media adviser.
The show’s writer, Nic Sheff – who has been open about his own suicide attempt – said he wanted to jolt viewers and make them realise how awful suicide is.
“When it came time to discuss the portrayal of the protagonist’s suicide in 13 Reasons Why, I of course imediately flashed on my own experience. It seemed to me the perfect opportunity to show what an actual suicide really looks like – to dispel the myth of the quiet drifting off, and to make viewers face the reality of what happens when you jump from a burning building into something much, much worse,” he wrote in a blog for Vanity Fair.
“It overwhelmingly seems to me that the most irresponsible thing we could’ve done would have been not to show the death at all,” Sheff said.
In the UK, the Samaritans can be contacted on 116 123.Papyrus are contactable on 0800 068 41 41 or by texting 07786 209 697 or emailing pat@papyrus-uk.org. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here.
British teenagers are highly motivated about their school work, but are more anxious, more likely to be bullied and are less satisfied with life than many of their peers elsewhere in the world, according to a survey.
Almost a quarter of British pupils who took part in the poll say they are being bullied a few times a month, while more than 14% say they are bullied frequently, making the UK the fourth worst affected of all 34 countries surveyed.
Anxiety levels are also high in British classrooms with seven out of 10 pupils (72%) admitting they feel anxious before taking a test, even if they are well prepared – the third highest in the survey. Girls are particularly badly affected, with 81% reporting anxiety before exams, compared with 63% of boys.
Possibly compounding the problem, UK students are also shown to be highly ambitious and competitive at school, with 90% claiming they want to be the best in whatever they do, compared with an average of 65% across the countries surveyed.
UK students are also among the highest users of the internet, with one in four 15-year-olds admitting to spending six hours online outside school hours on a typical weekday – the second highest of any country, and far higher than previous studies have suggested, prompting experts to call on the government to look at possible links between internet use and wellbeing.
The global survey of half a million 15-year-olds, carried out by the Organisation for Economic Cooperation and Development (OECD), will add to growing concern about the mental health and wellbeing of young people in the UK.
Particularly worrying is the increased risk that disadvantaged teenagers face, according to the survey, with pupils from less privileged families worse affected by high rates of bullying, unhappiness and anxiety than their wealthier peers.
Three in 10 UK pupils from less privileged backgrounds said they had been bullied, complaining of being physically abused by other students, made the target of negative rumours and deliberately left out of things.
There are also wide variations of expectation about higher education. Across OECD countries, 44% of students expect to complete university, but that number rises to three in four students in Colombia, Qatar and the US.
And while students from an immigrant background fare well in the UK, their experiences are less positive elsewhere. In 2015, 12.5% of students in participating countries were from an immigrant background. In some countries, those from an immigrant background were more likely to report feeling like outsiders, which impacts on satisfaction levels.
In the UK, while 42% of pupils polled expect to complete a university degree, less than a quarter of disadvantaged pupils expect to do so, compared with more than two-thirds of the most advantaged pupils.
The study, part of the OECD’s programme for international student assesment, also reveals that young people in the UK experience lower than average life satisfaction. Just 28% describe themselves as very satisfied with their lives, compared with an OECD average of 34%. Girls again fare worse with 28% very satisfied, compared with 33% of boys.
Students in a restaurant in La Candelaria, Bogotá. Colombian teenagers reported high levels of life satisfaction. Photograph: Alex Segre/Alamy
Elsewhere in the world there are huge disparities in life satisfaction among students. While in the Netherlands fewer than 4% are dissatisfied with their life; in Korea and Turkey the figure rises to 20%. In Montenegro and Latin American countries, including Colombia, however, more than one in two students reported high satisfaction levels.
The report also shows that despite reported links between eating a good breakfast and improved attainment, almost 30% of 15-year-olds in the UK do not eat breakfast before school – with the figure rising to more than 35% for the most disadvantaged pupils. Girls once again are worse affected, with more than two-thirds skipping breakfast compared with 22% of boys.
Natalie Perera, executive director and head of research at the Education Policy Institute (EPI), which hosted the launch of the report on Wednesday, said the findings on UK teenagers were stark, particularly for those from poorer backgrounds.
“Disadvantaged pupils are more likely to be bullied than their peers, and are more likely to skip breakfast before school – with the gap between the proportion of advantaged and disadvantaged pupils in the UK doing so the second biggest out of all 34 countries.”
Emily Frith, EPI director of mental health, said: “The findings show UK pupils have lower than average levels of life satisfaction, high levels of anxiety in the classroom, and are more likely to be bullied, compared to children in other countries.
“The government should explore how children’s wellbeing can be improved, including through the education system. It should seek to understand the causal relationship between internet use and young people’s wellbeing, and look to implement a strategy help young people develop the resilience and skills they need to live safe, digital lives.”
Responding to the report, a Department for Education spokesperson said: “These findings show young people have the motivation and desire to go as far as their talents can take them and that their parents are supporting them throughout their time at school.
“Assessment is an important part of education but it is also important that the test period is managed so students feel supported throughout. Our reforms have also put a stop to the endless treadmill of exams for young people, giving them more time to gain a greater understanding of the subject.”
I arrive at my desk just as our manager approaches a colleague suffering from back pain and asks how she’s doing. She replies that she is in a lot of pain. Our manager responds: “I’m not interested; I’m asking if you’re going to meet your deadline. If you don’t complete your work by 10am you can explain to 5,000 people that they haven’t been paid due to your failure to do your job properly.”
I am personally responsible for the distribution of millions of pounds of public money: I pay domestic, portering, maintenance, clerical, nursing and medical staff, senior managers, chief executives and apprentices. My in-tray is brimming with timesheets, expenses claims and new starters to set up.
Among the 43 emails that have arrived over the weekend, there are queries about sickness entitlements, reports of unpaid enhanced hours, and a request for a salary advance “because I’ve spent all my money”.
Tuesday
A team member announces her pregnancy. We are happy for her but it means extra work for the rest of us. Any absences for maternity, paternity, sickness, career breaks and in many cases leavers, are dealt with by sharing out the workload among those of us still present.
I check reports, set up new starters and calm a sobbing teenager who thought she’d be paid the living wage rather than apprentice rate. I have four overpayments to calculate, all due to failure by departmental managers to inform us of two leavers, a reduction in someone’s contract hours and a member of staff suspended. I have to produce a report for each to pass to NHS fraud investigators. The managers apologise to me for the extra work, but leave me to deal with their upset and angry staff.
Wednesday
I plough through a huge report detailing changes to employee records made by HR and departmental managers. To do this thoroughly would take several days but I have an hour so a perfunctory scan and crossed fingers will have to suffice.
I receive a beautiful handmade thank you card from a grateful payee I arranged an urgent payment for after her manager forgot to send us her timesheet for a whole month of night shifts. It is the second one I have received in over 20 years in the job and it will be treasured. I am happy all day.
Thursday
An angry man calls and tells me his expenses payment is wrong again; he insists his claim detailed an overnight stay in a hotel and several hundred business miles. I fax him a copy which displays 22 miles and a 60p parking ticket. He tells me his sister-in-law works in HR at our trust and will have me fired.
Not speaking my mind when my managers and people are rude to me is difficult. Senior managers tell us we are there to support them, middle managers focus on their next promotion and the line managers carry their workload. Their frustration is not reported due to a culture of fear and blame, and is instead directed at us.
A colleague has the flu but is afraid to stay off as it will trigger a sickness review: three short absences in a year, or just one long-term can lead to job loss. I make her hot drinks and cover her work for her.
Friday
An electrical fault has affected our telephone line and for once it is quiet. The peace is short-lived. When the line is repaired, people accuse me of switching off my phone to stop them getting through. I calm each one down and deal with their problems and queries. I notice it is 6.30pm and I have been working for free for the last hour – again.
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Sally will never forget the day she had to section her 13-year-old daughter. “Maisie was already in hospital. She was there because she’d taken an overdose, and she wouldn’t stop talking about death and saying she would do it again. She kept telling me she wanted to die – and I believed her.”
Sally agreed to let doctors formally assess Maisie, and then allowed her to be sectioned and detained in hospital under the Mental Health Act. “I feared for her life. I felt I had no other option.” Maisie had been moved from A&E to the children’s ward to recover from her overdose, but the hospital was planning to discharge her. “I couldn’t risk taking her home,” says Sally. “I didn’t dare. I thought she was going to kill herself. I was terrified.”
Maisie started self-harming when she was 12, shortly after her father died of cancer and Sally suffered an episode of ill health. “Maisie can’t regulate her emotions and she copes by trying to hurt herself. Everybody sees the behaviour, but not what’s behind the behaviour.”
Once Sally had signed the section, she no longer had the power to bring her daughter home again. “I didn’t have a clue how much control over my child I was giving up. After you sign the papers for a section, the doctor has more power than you over what happens to your child, and other professionals will listen to the doctor rather than you.”
She talked to other kids in the hospital. It was a game the children played: what medication are you on?
Maisie was sectioned in a specialist children’s unit for six months. “I thought I had done the right thing, and that Maisie would finally get the therapies she needed. I thought they would fix her. I was wrong.”
Instead, Maisie learned a new way to self-harm. “Maisie copied another girl in the mental health unit.” Her medication was expanded and now includes antipsychotic drugs and antidepressants as well as sleeping tablets. “They’ve given her all sorts – she’s asked for it. She talked to other kids in the hospital. It was a game the children played: what medication are you on?”
One night, Maisie grew so desperate to leave the hospital that she escaped from the ward. “I got a phonecall saying, ‘Maisie’s missing and we don’t know where she is.’”
Maisie had been gone for an hour by the time staff realised she was gone. “She was found at a National Express coach depot by the police, waiting to get a bus home.”
When Maisie was eventually released after six months, Sally felt as though her daughter had done time in prison. “No, actually, it was worse than prison.”
The family recently agreed to take part in a Channel 4 documentary on teenagers with mental health problems in conjunction with the Tavistock and Portman NHS foundation trust, hoping it would raise awareness about the need for better NHS funding. “The government takes advantage of the stigma that surrounds mental illness. That’s why children’s mental health has got such a poor budget.” Sally thinks parents are embarrassed to speak out or complain about the poor care their children receive. “It’s time to change that.”
The documentary shows Maisie’s emotions and behaviour getting out of control again. “I was exhausted, just from trying to restrain her from hurting herself,” says Sally. “It was constant, 24 hours a day. But I had no extra support.”
Sally must keep all Maisie’s medication locked in a safe, along with anything sharp. Over the summer, Maisie started barricading herself in the bathroom so she could self-harm, physically fighting her mother off when Sally tried to stop her. “I was covered in bruises – not that she’d hit me, just while I was restraining her, it would happen.”
Sally asked for more help at home. “But it didn’t materialise. That made me very angry. Maisie disassociates, so when she comes back round and sees I have bruises, she can’t cope, knowing that she’s done that.”
Eventually, in August, Maisie herself asked to go away to an inpatient unit. “I needed to protect my mum,” Maisie explains. “Asking to go away was the only way I could do that.” Her mother, she says, is her rock.
Sally believes the way Maisie was treated from that point on was disgraceful. “I begged the doctors not to section her again, because she would go informally, without the section,” says Sally. “But they said because it’s an emergency admission, no one would take her on an informal basis.”
The head of Maisie’s local adolescent mental health service, who knows Maisie well, felt she only needed two weeks in hospital. But Maisie was sent to a secure paediatric unit 95 miles away from her mother’s home and sectioned for 28 days by a doctor she’d never met before. “As soon as she arrived at the hospital, the doctor there had control over Maisie. He totally dismissed her previous diagnoses.”
In total, Maisie – who is now 15 – has been given 15 different diagnoses over the past three years, ranging from autism to severe depression. After visiting Maisie in the mental health unit, Sally became extremely concerned about her. “Her face was very swollen and all the blood vessels had popped.” It turned out Maisie had been managing to self-harm. “The hospital staff weren’t telling me. I was only hearing because of Maisie.” Sally had never seen her daughter in such a terrible state before and complained to staff. “I don’t think they took me seriously. These people are in powerful positions making crucial decisions for your child. It’s scary.”
The relationship between the parents of mentally ill children and hospital staff can be fraught. “Professionals perceive me as a pain. They don’t have the ability to empathise. I think a lot of it is that they don’t understand. When Maisie’s gone into crisis on a weekend, the hospital doesn’t want her there because there’s nothing medically wrong with her. But there’s nowhere else for her to go if she doesn’t feel safe at home. At those times, it’s like being an alien on that ward, an inconvenience, a nuisance. I’m seen as part of that nuisance. ”
She believes some doctors and hospital staff make judgments about the parents of children with mental health problems. “They think, ‘Bad home.’ Or they think, ‘Mum’s not set enough boundaries.’ There’s a culture of: ‘We can’t help you because it’s your parenting skills.’”
I failed her and I don’t want to fail her again. That’s why I fight like I do
Mental illness is an invisible disease, she says, so people – parents, particularly – need to get more clued up about it. “We were happily going along in our lives and didn’t realise that one day it would affect us. I failed her and I don’t want to fail her again. That’s why I fight like I do.”
Sarah Brennan, chief executive of YoungMinds, says: “We often hear from parents who are furious that they can only visit their children once a week or once a fortnight, because the distances are so far and travel costs are so expensive. It can also be incredibly stressful for young people to be cut off from their families and friends.
“Inpatient care should be a last resort. We need to ensure that help is available locally, in the community, when problems first emerge. Draining money from early intervention is incredibly short-sighted, and just stores up problems for the future.”
Last year, Sally launched a successful petition to get a local mental health unit for children reopened, and convinced her NHS foundation trust to introduce a 24/7 crisis team. But she admits there are days when she struggles, and she is now having counselling. “Maisie’s illness has definitely made me a more confident mum in many ways. However, it’s also made me a very angry person. I don’t trust the system.”
Maisie is back home now. Eventually, after Sally highlighted her concerns about Maisie’s treatment to her MP and got a good package of care put in place for Maisie at home, she was discharged from the hospital. Reunited with her mother and her dog, Honey, she has recently started attending a school for children with autism. But Sally still locks herself in her own bedroom at night with the safe, so that Maisie cannot try to open it while Sally is sleeping.
“It’s hard having Maisie home. I can’t lie to you and say it’s a breeze. But when you’re a parent, you make sacrifices.”
She loves her clever, articulate daughter unconditionally. “I want her to be happy one day. I hope she will be. I always just cling on to hope, and that’s what I tell all the other parents I meet to do, too. Never, ever let go of hope. Because without hope, it’s really bleak.”
She never wants Maisie to be sectioned again. “The most challenging part, as a parent, is feeling absolutely helpless. When a doctor sends your child miles away, for a long time, and you know it will be difficult to bring her home … it’s like torture. It could slowly drive a parent insane.”
•Kids on the Edge: Troubled Girls is on 30 November at 10pm on Channel 4.
In the UK, Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14.
The lack of resources for children’s mental health services in the UK has been described as a “national scandal” after a coroner ruled that neglect and “continuing failures” at one of the largest mental health trusts in England contributed to the death of a teenage boy.
Christopher Brennan, 15, died after being found unconscious at Bethlem Royal hospital in south London in August 2014. He had been admitted to the psychiatric hospital’s adolescent unit six weeks earlier as his family and local mental health services felt unable to keep him safe at home.
Christopher had a history of harming himself, and a deterioration in his mental health over the two years before his death led to repeated hospital admissions.
The coroner found that no formal risk assessment was carried out during his stay at Bethlem hospital, which is run by South London and Maudsley NHS foundation trust, and there was no care plan in place, according to the charity Inquest, which is supporting his family.
South London coroner’s court heard he was also allowed access to a number of items in hospital which he used to self-harm.
On 31 August 2014 Christopher was found unconscious in a communal toilet and later died after suffering a cardiac arrest.
Handing down her ruling on Wednesday, the coroner, Selena Lynch, said: “Christopher’s actions were in part because of cumulative and continuing failures in risk assessment and management. His death was contributed to by neglect.”
The hospital trust offered its “sincere apologies” to his family and said it had reviewed its practices. A spokesman said: “Areas of learning for the trust were identified through a serious incident investigation and we have carefully reviewed our procedures accordingly.
“More recently, the service has been inspected by the Care Quality Commission and care was found to be of a ‘good’ standard. We hope this offers some reassurance to the family that lessons have been learnt from this very tragic event.”
Following the inquest Christopher’s family said: “Losing our beloved son and brother when he was just 15 years old was so painful. Losing him as a result of the hospital’s failure to protect his life is unbearable.
“Chris will never be forgotten and no other child should be allowed to die in this way.”
Christopher was one of at least 11 young people to die in psychiatric units in England between 2010 and 2014, according to Inquest.
Deborah Coles, the charity’s director, said: “Sadly, Chris’s death is not an isolated one. Incredibly, we find that no single body is responsible for collating, analysing or publicising these deaths and that these deaths are not being independently investigated.
“The lack of resourcing of child and adolescent mental health services across the country is a national scandal. The only possible response to this case and the growing public outcry and disquiet around mental health services for children and young people is for an urgent independent review. We call upon the government to now take this necessary step.”
If you want the teenager in your life to eat healthily, telling them it will be good for them in the long term is simply not going to work.
But appealing to their rebelliousness and sense of social justice could make them take notice of their diet, according to a US study that may offer a new approach to tackling obesity and other health problems in the young.
The research suggests that informing teenagers about the manipulative nature of the food industry reduces their preference for sugary drinks and snacks. By contrast, promoting healthy eating based on future health benefits is no more successful than offering no information at all.
“If the normal way of seeing healthy eating is that it is lame, then you don’t want to be the kind of person who is a healthy eater,” said David Yeager, co-author of the research from the University of Texas at Austin.
“But if we make healthy eating seem like the rebellious thing that you do, you make your own choices, you fight back against injustice, then it could be seen as high status.”
Writing in the Proceedings of the National Academy of Sciences, the researchers conducted two studies which, when pooled together, looked at how 536 schoolchildren aged 13 to 15 responded to different conditions aimed at promoting a healthy diet.
Pupils were randomly given either material that promoted healthy eating based on its long-term health benefits or material that revealed how junk food is designed to be addictive, can be deceptively labelled, and is targeted at particular people, including very young children and those from poorer backgrounds. A third group of pupils received either no information or information entirely unrelated to healthy eating.
Teenagers were also asked to engage with the ideas by writing an essay on how they might take action based on the viewpoint put across to them.
The following day, in an apparently unrelated event, all the pupils were given a snack-pack as a reward from the headteacher for hard work – the contents of which they could choose from a list.
“Once you see [healthy eating] as a high status thing to do, people are more willing to do it of their own free will when they have their own choice in a room surrounded by their peers,” said Yeager.
For teenagers who had received material on the negative aspects of the food industry, 43% chose only unhealthy snacks such as crisps or cookies, compared to 54% of those who had received no information, or health-related information. A smaller decrease was seen in their preference for sugary drinks over water, while the overall sugar content of their food and drink was reduced by 9%.
When surveyed, pupils who had been informed about the manipulative nature of the food industry were also more likely to agree with statements relating to autonomy, social status and social justice such as: “When I eat healthy, I am helping to make the world a better place”. Two days after seeing the materials, teenagers in this group were also more likely to be angered by adverts for fizzy drinks and want to avoid them.
The insight, the authors add, could be used for a range of other campaigns, from motivating sick teenagers to take their medications, to encouraging young drivers to be safer on the roads.
The study comes just days after the release of the latest results from the UK’s National Diet and Nutrition Survey, which revealed that 11- to 18-year-olds are consuming more than triple the recommended daily amount of sugar, with only 8% eating five portions of fruit or vegetables a day.
Charlotte Evans, a nutritional epidemiologist at the University of Leeds, welcomed the new research, pointing out that many healthy-eating strategies in the UK focused on preschool and primary school children, rather than teenagers. “Somehow, teenagers have been forgotten about,” she said. “[This] could have the potential of working very well, if you actually target [teenagers’] values and their views on life.”
Aisling Pigott, a registered dietician with the British Dietetic Association, cautioned that the impact of the new approach was modest and that the study should be repeated with a larger number of participants, and followed up over a longer period of time.
But, she added, the approach merits consideration. “What is relevant to the UK and what is quite positive is it takes into account that in teenagers [healthy eating] is a lot about peer mindset, not family or education,” she said, adding that the similarities between the US and UK mean similar effects could be expected among British teens.
The Indigenous leader Tom Calma says he is “shocked” by a Mission Australia survey that found 10% of young Indigenous men and 5% of young Indigenous women rated their usual mental state as “very sad”, compared with just 1% of non-Indigenous people of the same age.
The national Aboriginal and Torres Strait Islander youth report 2016, released on Thursday, asked 1,162 Aboriginal or Torres Strait Islander teenagers aged 15 to 19 to rate their general happiness out of 10, where zero was “very sad” and five was “not happy”.
One in 10 young Indigenous men and one in 20 young Indigenous women rated their happiness as “zero”, compared with one in 100 non-Indigenous respondents.
Calma, a former Aboriginal and Torres Strait Islander justice commissioner who is now chancellor of the University of Canberra, said he was “not easily shocked” but that Mission Australia’s report “rang a loud alarm”, particularly when coupled with high rates of Indigenous suicide.
The suicide rate among Indigenous people aged 15 to 24 is four times higher than for non-Indigenous people of the same age. In children under 14, the rate is nine times higher for Indigenous people than non-Indigenous people.
Calma said the report showed the need for a “fundamental shift” in policies and services aimed at Indigenous youth. “We must re-set the relationship so that Aboriginal and Torres Strait Islander people are genuinely and meaningfully engaged in policymaking,” he said in a foreword to the report.
“It is my hope, as these young people grow to become leaders in their culture, communities and nation that government policies and programs will be made with them and not for them.”
The survey was conducted in 2015 and had 18,727 respondents, of which 6.2% were Indigenous. About 3.5% of the Indigenous respondents said they spoke an Indigenous language at home.
Indigenous respondents were more likely to have an unstable home life, with 30% saying they had spent time away from home in the past three years because they felt they could not go back, compared with 15% of non-Indigenous respondents, and 36% saying they had left home more than 10 times in that period, compared with 25% of non-Indigenous respondents.
Indigenous respondents also showed higher levels of concern about gambling, drugs, discrimination, suicide and personal safety.
Catherine Yeomans, the chief executive of Mission Australia, said the results showed the need for an urgent rethink of how programs and services are delivered to Aboriginal and Torres Strait Islander people. “Australia has a moral, social and economic duty to support all young people to reach their potential,” she said.
“And sadly, this report shows we are failing miserably, with too many Aboriginal and Torres Strait Islander young people falling through the cracks. This is not a sustainable way for us to proceed as a nation and to me it suggests a divided society.”
But the survey also showed high levels of participation in education, with 84.3% of Indigenous respondents saying they were engaged in full-time education and 35.1% saying they planned to attend university. That was higher for young Indigenous women, with 44.8% saying they planned to go to university.
Half of all Indigenous respondents said they were confident of achieving their goals.
Yeomans said services should be calibrated to help young Indigenous people achieve. “Their ambitions are often thwarted by the lack of age and culturally appropriate mental health services, alcohol and drug services and homelessness services,” she said.
“These gaps in the service system are leaving Aboriginal and Torres Strait Islander young people unsupported during the important time of transition to adulthood and should be urgently remedied.”
Prof Field stated a single young patient informed him she had stopped making use of adult providers as she felt the attitude towards her was ‘poor and patronising’. Photograph: Alamy
The NHS is failing disabled and seriously sick teens by depriving them of essential companies this kind of as ache relief when they grow to be adults, the service’s watchdog warns right now.
In a highly vital report published on Monday the Care Quality Commission (CQC) castigates doctors and hospitals for leaving vulnerable young folks baffled and stressed when they begin becoming cared for as grownups by different wellness professionals.
Too numerous of the 40,000 beneath-18s in England with complicated and tough well being wants end up dropping access to key solutions they have relied on considering that childhood – this kind of as help with their mobility, breathing and swallowing – as they undergo what can be a quite challenging “transition” to becoming handled as grownups, the CQC says.
They contain younger individuals with often profound bodily disabilities, continual situations this kind of as diabetes and existence-threatening illnesses this kind of as cystic fibrosis.
Prof Steve Field, the CQC’s chief inspector of main health-related solutions and integrated care, said: “This report describes a wellness and social-care technique that is not functioning, that is letting down desperately unwell youngsters at a critical time in their lives. We have put the interests of a method that is no longer match for function above the interests of the men and women it is supposed to serve.
“In an age exactly where individuals can obtain organ transplants, keyhole surgeries and targeted cancer therapies, it really is actually disappointing that the standard care needs of many young folks with physical disabilities and other prolonged-phrase well being requirements are not currently being met,” added Area, a GP and ex-chair of the Royal University of GPs.
The CQC’s evaluation of care for this kind of younger men and women prior to, during and following the switch to grownup companies identified a host of troubles. They incorporated that “Some children’s health or treatment companies stopped at sixteen but there was no grownup support available right up until they had been 18. This resulted in crucial care getting efficiently withdrawn,” the report says.
The overview, based on the knowledge of 180 young individuals aged 14 to 25 or their dad and mom, identified that “from the standpoint of a lot of households we spoke to, transition by means of health was un-coordinated and often sudden. For some, it caused excellent tension and nervousness.”
In addition, current national advice on how to assistance them is typically ignored or medical professionals are unaware of it. Discipline also found “inconsistent and often poor details and planning from children’s services for younger individuals and their dad and mom about the changes they can expect as they move into grownup solutions. This led to a lack of comprehending of the method of transition.”
One particular parent summed up their child’s transfer to adult health care companies by saying: “From the pond, you are picked up and put in the sea.”
Area explained that a single youthful girl he had spoken to had felt so badly handled by adult providers that she stopped using them. “As a youngster she was being taken care of as a human getting whereas when she was transferred to grownup providers she felt the frame of mind in direction of her was poor and patronising,” he stated. As well many hospital doctors’ attitudes towards younger people who had transferred into their care was “outdated and paternalistic”, he explained.
Anna Bird, head of policy and research at Scope, the disability charity, explained: “Several young disabled people uncover that their good quality of lifestyle can ‘nose-dive’ when they move from childhood solutions into the adult world. They struggle to get their health demands met but also to find perform, to proceed their training and to discover a ideal place to live.”
Prof Gillian Leng, the deputy chief executive of the Nationwide Institute for Overall health and Care Excellence (Good), stated that “for a lot of young people on the cusp of adulthood, moving among overall health and social-care solutions can be a tumultuous and nerve-racking time. A poor transition between youngster and adult solutions can have a profound and prolonged-lasting unfavorable influence on a person’s existence.
“The last thing we want is for young people to fall between the gap in little one and grownup services and not get the support or care they require.” Her organisation is drawing up new advice to assist remedy the issues identified.
Area stressed that the CQC had uncovered some examples of excellent care. Even so, the NHS needed to undertake urgent technique-broad change, with GPs taking part in a essential part in smoothing the transition process, he stated.
There has been a threefold improve in the quantity of youngsters who self-harm in England in the last decade, in accordance to a Planet Overall health Organisation collaborative review.
The Wellness Behaviour in College-Aged Young children (HBSC) report, due to be published in the autumn, will reveal that of the 6,000 younger individuals aged eleven, 13 and 15 surveyed across England – up to a single in 515-yr-olds say they self-harm.
There is no comparative data from other nations as England is the 1st nation to request this query on self-harm since the global review, which is conducted each and every four many years, began in 1983. The selection to include it follows a rise in anecdotal evidence from teachers in secondary schools across the nation.
The last thorough examine of self-harm in England was published by the British Medical Journal in 2002. It surveyed close to 6,000 15- and 16-yr-olds in 41 schools and located that 6.9% of them said they had self-harmed above the past 12 months. This compares with the 2013-14 WHO study, which puts the figure at 20% of 15-yr-olds.
Self-harm contains actions such as cutting, burning and biting oneself. Professor Fiona Brooks, head of adolescent and child well being at the University of Hertfordshire, is the global study’s principal investigator for England. She says: “Our findings are genuinely worrying, and it is [self-harm] significantly worse among girls. At age eleven, each girls and boys report a very good level of emotional wellbeing. But by the age of 15, the gap has widened and we get 45% of adolescent women saying they feel minimal when a week in contrast with 23% of boys.”
She warns of a ticking timebomb unless the rise in bad psychological well being between younger people is addressed. “We do not yet know ample about why this [bad psychological wellness] is but mother and father are busy and stressed, and children’s lives are turning out to be a lot more pressurised. They know they need to have much better grades to get to university, but there’s no assure of a task at the end of it all.”
Brooks believes that young individuals are “turning to techniques this kind of as self-harm to control tension in the short term”.
“Even though there has been a decline in classic danger behaviours like smoking and drug and alcohol abuse, there hasn’t been a transition to much more good wellness behaviours,” she says.
Grace, sixteen, appears to be a bubbly and confident teenager who loves music, singing and netball. She is studying for her GCSEs. Nonetheless, when she was twelve, Grace began self-harming.
“I began cutting my wrists using scissors and razor blades, which I disinfected myself,” she says. “As time went on and I acquired worse, it progressed all the way up my left arm and my upper thighs. I just bandaged it up and left it.”
Many years of cutting have left her with deep scars that she covers up when close to individuals she does not know very effectively. “At my worst, I was hurting myself after a week or even a lot more. Occasionally it was after a month. It just depended what was going on all around me,” she explains. “It calmed me down but then I’d right away want I hadn’t completed it as it hurts and you need to hide it.”
Regardless of celebrities, including actor Angelina Jolie and singers Miley Cyrus and Demi Lovato, going public that they have self-harmed, and a variety of professional-self-harm web sites placing the behaviour on younger people’s radar, Grace says she wasn’t conscious of anybody else performing it. She never ever confided in her mum, but last but not least a teacher noticed.
“I was hauled into the headteacher’s office a single morning, and my mum and my teacher and the head have been all sitting there. I was entirely bowled more than when they said they knew what I’d been undertaking, ” she recalls. As a result of the meeting, Grace retreated more into her globe, self-harmed more and concealed it far better. “Even when I needed to cease, I could not – and it took me longer than I care to admit to get factors underneath handle,” she says.
The nearby youngster and adolescent mental wellness services (Camhs) in Oxfordshire mentioned it could not support Grace due to the fact she had not been formally diagnosed with any issue. She did receive counselling by way of her school, but says it did not aid since she couldn’t relate to the older counsellor.
Even though her mum says she feels she has failed her, Grace does not blame any person for what she went through. “It is no one’s fault. I just wish I’d been capable to cope with issues greater,” she says.
“When I was twelve, my mum was moving in with my now stepdad, I was not acquiring on extremely properly with anyone at college, and the few pals I did have weren’t currently being quite kind. I struggle with adjust, so from all elements it was hard. It had often been me, my mum and my sister, and it was all so new with my stepdad. My real dad worked abroad a great deal so I felt I did not have any person to talk to and I did not have any way of dealing with it.”
Of her gradual recovery, Grace says: “Possibly I just got utilised to the modifications around me and items received better at school. I have a close group of friends, and for the first time I have a best good friend which I have never had before. My family members has been really supportive as well.”
But she adds that getting diagnosed with depression a year ago was a massive relief and she believes that an earlier diagnosis would have helped. “It stopped me currently being baffled about why I felt this way,” she says. “Despite the fact that it sucked to have a label, becoming diagnosed aided me to realise that there was a purpose behind what I was performing and once I dealt with the reasons, I knew I would not have to revert back to self-harm any far more.”
Selfharm.co.united kingdom is a website set up in 1993 to support the emotional and social wants of all younger folks. It gives a forum in which self-harmers can seek guidance and truly feel linked with others going via similar experiences. Grace was asked to pilot its Alumina scheme, which offers weekly on-line meetings with counsellors and medical professionals and she participates in a variety of actions that support to analyse what she is doing.
Rachel Welch, the director of Selfharm.co.united kingdom, says catching the dilemma early makes it simpler to stop. “We know that the earlier you intervene, the less complicated it is to break this habit.”
Technology is enabling youthful people to seek help significantly much more quickly – even within a day of first self-harming, she believes. The Samaritans reports that self-harm is the major reason individuals use its text messaging support, which, it says, is proving hugely helpful to young folks.
Self-harm has only been recognised as a diagnosis across Europe because Could last yr. It is diagnosed as “non-suicidal self damage”. Professor Peter Fonagy, clinical adviser to NHS England’s Enhanced Access to Psychological Therapies programme, says: “Only a little fraction, up to 15% [of people self-harming] ever existing to clinical companies – so it genuinely is only the tip of the iceberg, as is the case with most psychological ailments, where the unmet need is very higher.” He adds that younger individuals who self-harm are much more likely to go to a trusted adult such as a teacher or a policemen or even A&E. “This is why it’s critical that these individuals are offered the right resources to assess the chance and take proper action,” he says. He factors to MindEd.org.united kingdom, an on the internet resource, launched by the Department of Wellness, for anybody working with youngsters and youthful people’s mental health concerns.
Dr Jacqueline Cornish, nationwide clinical director for young children and younger folks at NHS England, who is accountable for the Camhs service, says for those younger men and women who do seek assist from a wellness expert: “It is vital we have the correct companies in area when children, younger individuals or without a doubt grownups need to have them. But this have to be combined with higher public knowing of the factors why an individual may possibly self-harm and how to get assist.”
Brooks believes study is telling us a closer look is required at what has caused this kind of a dramatic improve in self-harm in the past decade. “We need to know what strategies to put in place to support youthful men and women navigate adolescence effectively.”
Grace advises any younger man or woman who is self-harming to “speak to somebody, attain out”. She welcomes celebrities, such as Lovato, who have utilized social media to raise awareness about followers who self-harm. “I never believe they glamorise it. She has dealt with numerous psychological overall health problems herself and now puts her experiences to the excellent of other people,” she says.
Of her own expertise of speaking out, Grace says: “I’ve had overwhelming support. I am in a great place and I can quite significantly say 100% I am not going to go back to it.
Stephen Sutton: ‘It’s nonetheless a case of taking every day as it comes.’
Donations to a cancer charity appeal organised by 19-year-outdated Stephen Sutton, whose fundraising efforts while terminally unwell have brought acclaim from celebrities and a deluge of contributions from the public, were on Sunday on the verge of hitting £3m.
Sutton was diagnosed with bowel cancer aged 15, and remains significantly sick in a Birmingham hospital despite what he has described as a seemingly miraculous recovery from a collapsed lung triggered by strain from a secondary tumour. The teenager, from Staffordshire, originally hoped to increase £10,000 for the Teenage Cancer Believe in.
Sutton has maintained an irregular series of updates to his hugely common Facebook page, describing the minute doctors explained that the collapsed lung could kill him, and gaining however far more tweets from celebrities urging people to donate, with current backers such as Coldplay and David Tennant.
The sum collected, coming from about 200,000 primarily tiny donations, is much more than three instances bigger than any prior single legacy for the Teenage Cancer Believe in, some thing the charity says will transform its perform with younger people.
In a Facebook update on Sunday Sutton, whose loved ones are at his bedside, stated his breathing had deteriorated markedly the previous afternoon, and in spite of receiving oxygen he felt as if he was choking. He then violently coughed up an oval-shaped reliable, after which his breathing improved.
He wrote: “The doctors have discussed what’s happened and the only plausible conclusion is that I’ve actually coughed up a tumour that was blocking my airway. I have had an X-ray this morning which seems to display my proper lung has inflated slightly, suggesting the substance I coughed up was also a substantial pressure that was triggering a restriction on the collapsed lung. Physiologically a tumour breaking away like this is possible, but it all just would seem amazingly surreal – thoughts, I am not complaining!”
He additional: “It’s even now a situation of taking every day as it comes, but at the minute the days just hold on coming!!”
A lot more money was currently being raised through an event on Sunday evening organised by the comedian Jason Manford, which offered out in 4 minutes. “I want all my gigs have been like that. I am telling you I may have to get him to do my PR,” Manford told LBC radio.
Washington and Colorado are the first states to allow the use and sale of recreational marijuana for people who are at least 21. Medical marijuana, usually requiring a doctor’s prescription, is legal in 20 states and Washington D.C. So will that affect teenage drug use?
One of the worries of people who oppose marijuana legalization is that teenagers will have easier access to the drug, making them more likely to use it. It’s an important worry, given that some problems of cognitive development have been seen in people who start smoking pot young. Fortunately, we now have some empirical evidence to help settle the question.
Using 20 years of data from the Youth Risk Behavior Surveillance Survey, researchers saw no discernible difference use after legalization, according to a study of 11 million people in the Journal of Adolescent Health. The researchers looked specifically at states that had legalized medical marijuana, and for which there was enough before-and-after data. They were then compared with a neighboring state that hadn’t legalized the drug. Marijuana use within the previous month was common across the study, with about 21 percent of students reporting it. But there wasn’t a difference between the states with legal weed and the states without it.
Marijuana use among teenagers has mostly remained steady, though it’s the most popular illicit drug among U.S. kids. One in three high school seniors has reported smoking weed in 2012. That year was the first time the survey asked about how teens acquired the drugs. Only 6 percent had their own prescription; about a third acquired marijuana using someone else’s prescription — precisely what worries some legislators.
But because that question is new, and because legalization is new, it’s hard to say whether those kids would have gotten their drugs by other means. However, the study today suggests that while the acquisition methods may have changed, the number of teens hasn’t. Much more data will be required to settle the question for sure, but this is a relieving start.
Far more worrying, certainly, is the believed that some younger females may possibly decide on to rely on the robust doses of hormones in morning-following pills instead of opting for every day contraception that delivers reduced, steady levels (like the pill, hormonal ring, or IUD). Taking the pill, in specific, is subject to extensively various effectiveness based mostly on usage. Having to take pills every single day whether you are getting intercourse or not is a modest chore at any age, and the notion of morning-following possibilities is appealing: take it when you have intercourse, not all the other occasions. But there are some disadvantages.
The quantity of people possibly impacted by this modify, however, might be reduce than we may possibly assume. According to the FPA only one in ten teenagers employed no protection at all the initial time they had intercourse, with most opting for the barrier protection of condoms, which helps protect towards STIs as well as pregnancy. Only 17 per cent of sixteen-19 12 months olds had used emergency contraception in the prior year.
Intercourse training is undoubtedly important but probably not in the way may assume. Younger people are previously hearing about the various methods of contraception and illness prevention accessible to them, and in several situations that is as far as the education goes. If scaring people about pregnancy and condition alone was going to function, would not it have accomplished so currently?
An exciting phenomenon that appears to function in Europe is mentioned by sociology professor Amy Schalet, author of Not Beneath My Roof: Dad and mom, Teens and the Culture of Sex, which compares approaches to sexual overall health training for teens in the US and in the Netherlands. “Coming out of the sexual revolution, the Dutch genuinely decoupled sex from marriage, but they did not decouple intercourse from adore,” Schalet says. “There is a powerful belief in the Netherlands that youth can be in really like — boys as nicely as ladies — that makes sex in a lot of ways look safer and a lot more contained since it is embedded in a relationship.”
Must young females have entry to emergency contraception even before they have sex? Yes, they need to have some accessibility to all pregnancy prevention approaches.
But let us not fail to remember to put every thing in the larger framework: this country nevertheless wants much better and more holistic sex and relationships training that focuses on respect and consent, taught by folks who are qualified and interested in speaking to younger men and women about the topic. It requirements to handle not only the biology and mechanics of intercourse, but also of adore and healthy relationships. And it wants to be constant, taught to everyone. If we had this, the matter of who gets the morning-after pill and when would not be this kind of a worrying believed.
