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Introduction
How common are mental health problems in young people?
Stigma and mental health
The legal framework and guidance
Every Child Matters (2003)
The Children Act (2004)
The Children's Plan
The Mental Health Act (2007)
The National Service Framework for Children
The educational context
The National Healthy School Status (NHSS) programme
Social and Emotional Aspects of Learning (SEAL)
The Targeted Mental Health in Schools Project
Promoting children's social and emotional wellbeing in primary education
Factors that contribute to mental health problems in children and young people
Asylum seekers and refugees
Bereavement
Black and minority ethnic groups
Bullying
Disability
Divorce and separation
Domestic violence
Emotional, sexual and physical abuse and neglect
Gay and lesbian young people
Living in care
Living with a parent with a mental health problem
Poverty
Prison
Young carers
Mental health problems in children and young people
Anxiety
Attention deficit hyperactivity disorder (ADHD)
Autism and Asperger's syndrome
Bipolar disorder
Depression
Eating distress
Obsessive-compulsive disorder (OCD)
Schizophrenia
Self-harm and suicide
Sleep problems
Substance misuse
Treatment
Consent to treatment
Counselling and psychotherapy
Psychiatric drugs
Child and adolescent mental health services (CAMHS)
Useful organisations
Further reading
References
This factsheet has been written for the wide variety of adults, often non-specialists, who work with young people such as those in schools, health settings, youth work, care and social work settings.
It is not possible in a factsheet of this kind to include detailed information about all the issues that affect the mental health of children and young people. However, Mind has produced factsheets and booklets on many of these areas of interest, which are detailed under the relevant headings. Mind has also produced a factsheet for young people: Young person's introduction to mental health. The booklet Understanding childhood distress is also relevant.
A comprehensive list of organisations that provide information and support is provided at the end of this factsheet.
Note: Some of the language used in this factsheet reflects the sources referred to. The use of such language does not automatically imply Mind's acceptance of it.
The Office for National Statistics (ONS) reports the following main findings from its most recent survey. [1] In 2004, one in ten children and young people (10 per cent) aged 5-16 years had a clinically diagnosed mental disorder:
The survey found few changes from the ONS's previous survey, in 1999.
In the more recent research, boys were more likely than girls to have a mental health disorder. Among 5-10 year olds, 10 per cent of boys and five per cent of girls had a mental disorder. In 11-16 year olds, the figures were 13 per cent for boys and 10 per cent for girls.
The survey identified significant socio-demographic variations in the incidence of mental health problems in children and young people; for example, mental health problems were twice as prevalent in lone-parent families and also significantly higher:
Stigma marks an individual as being different from others; for children and young people this often sets them aside from their peers. Stigma has a negative impact on a person's sense of self-worth. Misconceptions and false beliefs about mental illness are likely to be absorbed by the young person, with potentially devastating effects. Young people who are affected by a mental health problem will sense other people's fear and are often rejected by peers. This can lead to isolation, strong feelings of shame and a sense of hopelessness. Such feelings increase the chances of self-harm and suicide in young people. Further information about stigma and mental ill-health can be found here.
This green paper was published alongside the report into the death of Victoria Climbié, a young girl who was terribly abused and eventually killed. The Every Child Matters government initiative sets out a national framework for change at a local level, to meet the needs of children and young people, to maximise potential and minimise risk. Concern for the physical and emotional health and safety of children and young people is key among the five desired 'outcomes'. More information can be found at www.everychildmatters.gov.uk.
The Children Act (2004) consolidated the Every Child Matters green paper into law and provides the legal underpinning for the transformation of children's services. It emphasises multi-disciplinary working, the removal of duplication of services, increased accountability and improved inspection of local authorities. Further information can be obtained from the Department for Children, Schools and Families (DCSF).
The Children's Plan sets out goals for the next ten years which will lead to more integrated services and which place the needs of children, young people and their families first, even when these cut across traditional institutional and professional structures. Further information and the full document can be obtained from the DCSF.
The Mental Health Act (1983) had no lower age limits, and there were no specific provisions in the Act relating to children. In theory, therefore, children and young people could be treated or compulsorily detained under the Act. The new Mental Health Act (2007) made significant changes to the 1983 Act. Importantly with regard to young people, the act charges primary care trusts with a responsibility to provide 'age-appropriate' services for children. This includes guidelines for good practice around the hospital environment and the use of Child and Adolescent Mental Health Services (CAMHS) in the assessment process. An overview of the Mental Health Act (2007) can be obtained from the Department of Health.
Standard 9 of the National Service Framework - The mental health and psychological wellbeing of children and young people (2004) states that all children and young people, from birth until their eighteenth birthday, who are affected by mental health problems should have access to 'timely, integrated, high-quality, multidisciplinary mental health services' to ensure effective assessment, treatment and support, for them and their family. The full guidance can be obtained from the Department of Health.
The NHSS Programme, which replaced local schemes, introduced more rigorous and nationally consistent criteria. For a school to achieve the healthy school status it is required to meet criteria in four themes, one of which relates to emotional health and wellbeing and is, in effect, a preventive approach to the mental health of school children. Full guidance can be found here.
SEAL was initially introduced into junior schools in 2005 and then middle, special and secondary schools in 2007. SEAL is a whole-school approach to promoting social and emotional skills, which aims to involve all members of a school community and cover all aspects of school life. In this way, SEAL can play an important part in promoting the mental health and emotional wellbeing of children and young people. Detailed information can be found here.
The DCSF announced this new project in 2007, and the first 25 pilot authorities have been announced. Each local authority and corresponding primary care trust is expected to work with a number of secondary schools and their feeder primary schools to deliver support to those children and young people who are at risk of developing or who already have a mental health problem. Details of the project can be obtained from the DCSF.
This guidance, produced by the National Institute for Health and Clinical Excellence (NICE) in March 2008, contains the main recommendations for promoting the social and emotional wellbeing of primary-school-aged children. The paper explains the importance of a concern for wellbeing in the prevention of mental health problems developing later in a child's life. A variety of documents relating to this guidance can be obtained from NICE.
NICE is currently developing similar guidance for secondary school children.
Asylum seekers and refugees have most often left their country of origin because of war, instability or because their human rights have been abused. Children and young people who arrive in this country under such circumstances face an uncertain future. They face difficulties such as language barriers and racism from the host community. Children will have lost all that was familiar to them, including family, friends and culture. Their mental wellbeing may have been affected by witnessing atrocities, or they may have been victims themselves.
Further information can be obtained from the Health for asylum seekers and refugee's portal (www.harpweb.org.uk) and the Refugee Council (see Useful organisations).
Children may experience the death of a grandparent, parent or sibling. While some appear to cope well, others may face a more complicated or unresolved kind of grief, which may be long and lead to depression and other kinds of mental health problems. [2] Mind's booklet Understanding bereavement discusses the issues relating to bereavement in children and gives details of organisations that provide information and direct support for children coping with bereavement. Winston's Wish is a charity specifically for bereaved children and young people (see Useful organisations).
Young people who experience racism or discrimination on account of their race, colour or religion are at increased risk of developing mental health problems. Families may experience racism or prejudice in housing, education or employment, compounding disadvantage. Stereotyping can lead to racist comments or even violence. Young people from minority ethnic groups may feel isolated and lack a sense of belonging. Young people of mixed parentage may experience additional identity and peer-related issues. Black and minority ethnic young people are over-represented in the mental health system, and they may experience forms of institutional prejudice that affect their future life chances. [3] South Asian young women are more likely to attempt suicide than young men and women from other minority ethnic groups.
Mind has produced factsheets about different minority ethnic groups living in Britain. The Mental Health Foundation also provides information, and the website has links to relevant organisations. YoungMinds provides information specifically relating to young people (see Useful organisations).
For most young people, being bullied is a transient experience; however, severe or persistent bullying can have long-lasting and devastating effects on a young person's mental health. [4] The emotional consequences of bullying include a sense of inferiority, helplessness and fear. Above all, bullying is an attack on a child's self-esteem. The young person may feel worthless and a failure. Sleep can be affected, often punctuated by bad dreams and nightmares. Persistent bullying can lead to self-harm and has been associated with suicidal ideation. The charity Kidscape was established to tackle bullying and sexual abuse of children (see Useful organisations).
Children and young people who have a physical disability often face isolation from other children, and may experience low self-esteem. They may also become depressed or feel anxious about the future and their relationships. The Disability Discrimination Act recognises that mental health problems are not confined to those with physical or sensory impairment. Mind has produced a booklet Disabled people and mental health support services and a briefing paper Legal briefing: Disability Discrimination Act.
Useful information on mental health and the Disability Discrimination Act can be found here.
A significant number of children and young people see their parents divorce or separate. In most cases, they are able to manage this transition well, especially when they are supported by adults and friends in their lives. However, when a child is less resilient or support is not available, they may begin to experience difficulties at school, and some become aggressive. A child may go through a process akin to mourning following their parents' divorce or separation. Parents may be unable to offer the kind of support the child needs, and the child's world and security may be severely affected, leaving him or her anxious, angry, and insecure about the future. A child may also experience denial and strong emotions such as guilt, shame, abandonment and rejection. [5] YoungMinds, the Royal College of Psychiatrists and Relate all produce useful leaflets and advice about the effects of divorce/separation on children, and how to help (see Useful organisations).
Children who witness domestic violence may find themselves in a state of constant fear and anxiety for the safety of a parent, or indeed their own wellbeing. They may experience a sense of loss for 'normal' family life. They may feel angry towards one or both parents and may be confused about where their loyalties lie. They may express anger through aggression towards peers and adults, although girls are more likely to 'internalise' their feelings. Relationships are inevitably affected and children may become withdrawn and isolated or try to dominate others in an attempt to control their world, which mostly feels out of control.
The charity Women's Aid is the key national charity working to end domestic violence against women and children (see Useful organisations).
Children who have been physically abused live in constant fear of the abuse happening again.
Emotional abuse often takes the form of humiliation, belittling, rejecting, showing little interest in a child, and constant criticism. It is sometimes associated with parents who misuse alcohol, street drugs or other substances. Long-term emotional abuse can have a more debilitating effect on a young person's development.
Sexual abuse is often accompanied by confusion, shame and feeling dirty. Young people who have been sexually abused sometimes self-harm and may even attempt suicide. Long-term effects on the mental health of young people who have been abused include relationship problems (especially the fear of intimacy), and self-hatred may continue well into adult life. Sexual abuse is also linked with promiscuous behaviour and prostitution. Sometimes a child may fear that they too will become an abuser.
Any adult who works with children or young people and who suspects that a young person may be at risk or has been abused must share this information with an appropriate agency, e.g. social services.
Mind has produced a resource factsheet on sexual abuse, which provides details of organisations that provide support and information for people who have been abused.
Kidscape, ChildLine, the NSPCC and YoungMinds all provide information and support (see Useful organisations).
Adolescence can be particularly challenging for gay, lesbian, bisexual and transgender young people. This is the time when young people form personal identities, and a young person's mental health may suffer if they do not get adequate support from families and friends. Problems can be exacerbated by the prejudices of others and a society that is sometimes judgemental and condemning. As well as ridicule, young men and women may face real or imagined threats of violence as a result of homophobia. [6] The young person is sometimes told that this is a 'phase' they will grow out of, which can result in denial or the suppression of feelings. Gay and lesbian young people are over-represented in statistics on self-harm, depression and suicide.
Mind's factsheet Lesbians, gay men and bisexuals and mental health describes issues that affect gay and lesbian young people and gives details of organisations that can provide help and support. Two other Mind publications may also be useful: Understanding gender dysphoria (web only) and How to cope with doubts about your sexuality. The Queer Youth Network and Stonewall provide useful information and support (see Useful organisations).
According to government figures from 2005 [7] about 61,000 children were being looked after by local authorities, representing approximately 0.5 per cent of young people up to the age of 18 years. Some children and young people find themselves in care for short periods while others are placed long term; some children are adopted into new families.
Children find themselves in care for a variety of reasons: they may have experienced abuse or neglect, possibly because of alcohol or drug misuse by their parents. A parent may be unable to care for them for a variety of reasons, or may have died. Clearly, a child taken into care has to establish new relationships with peers and care workers or foster parents. Such children are more likely to come from disadvantaged homes where there has already been additional risk. By definition, children in care have often already experienced traumatic events in their lives, so it is not surprising that they are more likely to develop mental health problems than those in stable family environments. Sometimes the experience of care can contribute to a child's already fragile self. Continuity in the care of children is vital in the maintenance of good mental health.
The following report provides an overview of the mental health of young people looked after by local authorities: The mental health of young people looked after by local authorities. The British Association for Adoption and Fostering, Barnado's and YoungMinds also provide information and support relating to looked-after children (see Useful organisations).
Some children and young people live with a parent who has a serious mental illness, such as depression, personality disorder or schizophrenia. The child may be affected by their parent's often reduced capacity to cope as a parent, and also by the parent's illness directly. Both parents and children may feel isolated and unsupported, which can lead to distress. Furthermore, living with a parent with a significant mental illness increases the chances of a young person developing mental health problems themselves.
Mind has produced a booklet How to parent when you're in a crisis. The Mental Health Foundation provides a wealth of information on parental mental illness.
A close link between poverty and mental health problems is well established. [8] This can work in two ways: people with low incomes are more likely to experience poor mental health, and those with mental health problems are more likely to be living in poverty. Low income is likely to compromise housing and educational opportunities and leads to generally poor living conditions. Children and young people's relationships are likely to suffer because of the stress associated with low income.
The Child Poverty Action Group and the Joseph Rowntree Foundation are involved in tackling child poverty (see Useful organisations).
The Prison Reform Trust has argued that too many young people with mental health problems end up in prison. As many as 9 out of 10 young people in prison are thought to have at least one or a combination of mental health problems. [9] These include personality disorder, psychosis, neurotic disorder or substance misuse; schizophrenia and bipolar disorder are also found. Many young people who end up in prison have already experienced multiple disadvantages and often not completed full-time education. Some young people in prison have experienced a range of traumas, including sexual abuse. A significant number have self-harmed or attempted suicide. Suicide and attempted suicide in prison by young men remains a serious concern. The experience of prison, the loss of liberty, being away from family and friends, and threats of violence will tend to exacerbate already complex problems.
Children and young people also suffer when a parent or close family member is sent to prison. When a parent is incarcerated, the effect of such parent-child separation may be similar to a sudden bereavement. As well as possible practical problems relating to care, loss of income and the loss of the adult as a role model, children may experience a wide range of feelings, which at times can become quite overwhelming. A child may believe that 'they' have been 'bad', that they are to blame for what has happened, and therefore may be traumatised by feelings of guilt. They may become embarrassed or feel the stigma associated with imprisonment and are therefore less likely to seek support. This can also be the case when embarrassment is felt by the wider family and the child is affected by a 'code of secrecy' leaving them confused and frustrated. In addition, children and young people with a parent in prison may feel anger towards the adult who has let them down or apparently 'abandoned' them. More information can obtained from The Prison Reform Trust and Rethink (see Useful organisations).
It is difficult to get an accurate picture of the number of young people who are in a caring role, partly because much of this work is hidden and unrecognised and partly because young people do not often seek help with this role. [10] However, looking after an ill parent or sibling places considerable strain on a child or young person. As well as experiencing physical problems, caused by lifting for example, the young person may face emotional and social problems such as isolation, stress and stigma because home life is different from that of their peers.
The Princess Royal Trust for Carers has established YCNet, a web forum for young carers (see Useful organisations).
This section describes a range of mental health difficulties under separate headings; however, it is important to remember that diagnosis is often complex and mental health problems may exist alongside each other. It is also important to guard against the labelling of children and young people as having a mental illness, especially where difficulties may be seen as part of the difficult task of growing up and where transitory problems represent a normal response to issues in a young person's life.
Anxiety may be seen as a state of heightened awareness or fear about real events or imagined dangers. Anxiety is characterised by feelings of uneasiness, nervousness, dread or fear. A degree of anxiety in is quite normal and may also be necessary for people to remain alert to potential dangers. However, when anxiety becomes excessive and persistent or debilitating, it can indicate a problem.
Further information regarding anxiety disorders can be obtained from Anxiety Care, Anxiety UK (see 'Useful organisations') and many of the other organisations working in mental health. Mind also produces a booklet Understanding anxiety. The 'Stressed out' project set up by Anxiety UK is designed to support young people who are experiencing anxiety and stress.
Anxiety in children and young people can come in a variety of forms:
Generalised anxiety disorder
Generalised anxiety disorder is 'generalised' in the sense that there is often no focus but an ongoing dread; a fear that something bad is going to happen. The child begins to feel 'out of control' and starts to exhibit a number of physical problems such as stomach aches, headaches and problems with sleep. Relationships are affected and schooling may be interrupted.
Hypochondriasis
Hypochondriasis involves the fear of having a serious or fatal disease, despite evidence to the contrary. It can take the form of persistent physical expressions of difficult emotions, e.g. stomach aches, headaches and nausea. Hypochondriasis is often associated with young adulthood, though it is found increasingly in younger children. Information can be obtained here.
Phobias
A phobia is a kind of anxiety disorder that involves a strong and excessive desire to avoid an object, person or situation that in itself presents no actual danger. In this sense, phobias are irrational and sometimes difficult to comprehend. They become a problem when they prevent a person from functioning normally and maintaining normal relationships. Phobias are common in children and young people.
Mind has produced a booklet Understanding phobias. More information can be obtained from Anxiety UK (formerly the National Phobics Society).
Separation anxiety
While it is normal for a young child to be upset when left by his or her primary caregiver, this anxiety in older childhood or adolescence may indicate that something is wrong. Separation anxiety can return when a young person experiences change, such as that caused by the illness of a parent, changing school, the divorce or death of a parent, or moving house. Symptoms include excessive crying when a parent leaves, fear that harm may come to the parent or that they may not return, problems with sleep and refusal to go to or stay at school. Separation anxiety is distressing for the parent as well as the child.
Anxiety UK provides information on separation anxiety.
ADHD affects about two per cent of children of school age - mainly boys. [11] Young people with ADHD become bored and distracted easily, and may have difficulty playing with other children. They are often disorganised, have difficulty listening for long periods and are easily distracted by other children or external stimuli. They may have difficulty taking turns when playing or in the classroom, and engage in risky activities with little regard for their safety or that of others. When frustrated they may express anger in aggressive ways; for example, slamming and kicking doors or shouting. It is not hard to see why ADHD is directly associated with school failure, exclusion and poor future prospects.
Mind has produced a booklet Understanding attention deficit hyperactivity disorder. The National Attention Deficit Disorder Information and Support Service provide a wealth of useful information (see Useful organisations).
Autism is a lifelong developmental disorder (not a mental illness) that affects a young person's ability to relate to others. The main difficulties experienced by a young person with autism are known as the 'triad of impairments', which include difficulties with communication, social interaction and 'social imagination', which, among other difficulties, affects a young person's ability to read the emotions of others, predict social behaviour; understand the concept of danger and engage in imaginative play. [12] The term 'autism' covers a spectrum of disorders, including Asperger's syndrome. People with Asperger's syndrome may have difficulties in social relationships and communicating, and limitations in social imagination and creative play.
The National Autistic Society provides a wealth of information on autism and Asperger's syndrome (see Useful organisations).
Bipolar disorder (which used to be known as manic depression) is a serious illness characterised by abnormal shifts in mood. It rarely occurs before late adolescence and can be difficult to diagnose. Manic symptoms include elevated mood, inflated self-esteem, decreased need for sleep, hyperactivity, shortened attention span, and ideas and thoughts that are out of control; feelings of euphoria are disproportionate to events in the young person's life. Depressive periods are associated with deep sadness and unhappiness, a loss of interest, inactivity, irritability and sometimes a preoccupation with death and dying.
Mind has produced a booklet Understanding bipolar disorder (manic depression). Information and support can also be obtained from MDF the BiPolar Organisation (see Useful organisations).
Depression is characterised by ongoing sadness, irritability and feelings of anxiety, guilt and a sense of worthlessness. It is deeper and more persistent than feeling low. If left untreated, depression can have serious implications for a young person and their family. School performance is likely to be adversely affected as the young person loses motivation and energy and has difficulty concentrating. Young people who are depressed find it hard to establish and maintain friendships and they may turn to alcohol and drugs as a means of coping. Eating habits are often affected, with the young person either over- or under-eating. Sleep patterns are also likely to be affected. Sometimes the child's depression manifests itself as anger, violence or rage. Depression in young people is treatable, especially where there is early diagnosis and treatment and support from family and friends.
NICE has produced guidance on depression in children and young people.
The Depression Alliance provides useful information, as do Mind, the Royal College of Psychiatry and YoungMinds (see Useful organisations).
Anorexia nervosa
Anorexia nervosa is an eating disorder that can have serious physical and psychological consequences. It mainly affects girls, though it is increasingly being found in boys. [13] Normally starting around the mid-teens, it can continue well into adulthood. The young person often has a distorted body image and has a morbid fear of putting on weight. A young person with anorexia is not without an appetite, but they self-inflict weight loss by cutting out calorific foods, most often fats. Anorexia has little to do with 'looking good' or simply dieting: often it is more to do with deep-rooted emotional problems and difficult feelings. Controlling their weight can feel like bringing control back into a young person's life. Anorexia is often associated with low self-esteem, depression and perfectionism.
Bulimia nervosa
Bulimia is an eating disorder that mainly affects girls but is increasingly being found in boys. It often begins in the mid-to-late teens. It is associated with the alternation between eating foods high in calories (binge eating) and self-inflicted purging, which can take a number of forms, including self-induced vomiting and the use of laxatives and diuretics, in order to maintain a desired body weight. Bulimia is often a secret condition with actions hidden from family and friends. In common with anorexia, it is often symptomatic of underlying emotional difficulties and carries with it a sense of shame and guilt.
Binge eating
Most people overeat occasionally; however, habitual overeating may indicate an eating disorder. Young people with a binge eating disorder eat extreme quantities of food, often when not hungry, causing great physical discomfort. The young person feels embarrassed and guilty about the eating and often feels that things have become out of control. Overeaters Anonymous provides support and information (see Useful organisations).
Mind has produced a booklet Understanding eating distress. Support and information about these eating disorders is available from the eating disorders charity, beat (which also provides a specific service for young people), YoungMinds (see 'Useful organisations') and the Institute of Psychiatry (www.eatingresearch.com).
People with OCD are disturbed by recurring thoughts (obsessions) or a need to engage in repetitive and ritualised behaviours (compulsions). OCD may take the form of excessive hand washing, repeated checking, touching, hoarding and collecting, counting, and/or a need for symmetry and order. Carrying out compulsive acts offers only temporary relief, however, and the child may become consumed by fears about dirt and contamination by germs, death, illness, a lack of order, or the belief that something bad may happen if they do not perform these acts. OCD can cause major difficulties for a child and the adults in their world.
Mind has produced a booklet Understanding obsessive-compulsive disorder. OCD Action, OCD-UK and OCD-today provide information and support (see Useful organisations).
Schizophrenia is a serious, complex and often disabling mental health problem. Although it is rare in young people, some children exhibit signs at an early age. The symptoms of schizophrenia take the same form in young people as in adults. These include unnatural suspicions and fear of other people (paranoia); difficulty distinguishing what is real from fantasy, which may include hearing voices (hallucinations); and false beliefs, e.g. that they have been visited by aliens (delusions). Young people with schizophrenia perceive the world differently from others; they are withdrawn, have thought disorders and are sometimes devoid of emotion.
Mind has produced a booklet Understanding schizophrenia and a booklet My name is Pete, which explores in pictorial form a young person's experience of psychosis. Further information can be obtained from Rethink (formerly the National Schizophrenia Fellowship); information on childhood schizophrenia can be obtained from the Institute of Psychiatry (see Useful organisations).
Self-harm
Self-harm (also referred to as self-injury) often involves cutting with blades, glass or any object with a sharp edge. Injury may also be inflicted by rubbing, burning, scratching, swallowing objects, pinching or picking at the skin. Overdosing and misusing drugs may also be regarded as forms of self-harm. Self-harm is most often an expression of deep-rooted emotional problems that a young person has difficulty expressing in less harmful ways. It can be seen as a form of communication and has been described as an 'inner scream'. [14] Paradoxically, self-harm is often a means of coping with difficult feelings and, some argue, lessens the desire to attempt suicide. In this sense, it represents restraint, and may therefore be seen as a survival strategy. Nevertheless, self-harm is distressing for families, teachers and friends who see the results and feel helpless.
NICE has produced guidance on the treatment of self-harm.
Mind has produced two booklets on self-harm: About self-harm: a guide for young people, and Understanding self-harm.
The National Self-harm Network and www.selfharm.org.uk/default.aspa (provided by The National Children's Bureau) provide support and information (see Useful organisations).
Suicide
Suicide is the third main cause of death in young people after illness and accidents. Attempted suicide is often referred to as parasuicide. Girls attempt suicide more often than boys, though young men's attempts are more likely to be fatal. Suicide is linked with depression, loss, failure and abuse, when often a young person cannot see another way out of their despair. Fortunately, statistics show that the suicide rate in young people is beginning to decrease, [15] though it is certain that many young people consider suicide as an option at some point. Young people who attempt suicide often give indications to those around them that something is seriously wrong.
Mind has produced some publications on suicide:
It is not uncommon for children and young people to experience difficulties with sleeping, which may take the form of nightmares, night terrors or sleepwalking. As with all sleep problems, such difficulties do not necessarily indicate an underlying problem, and sleep disturbance can be caused by a television programme or a scary story. Sleep problems can have biological causes and may result from poor drinking and eating habits. However, if a problem continues, especially in an older child or teenager, there may be an underlying emotional cause.
Mind has produced two booklets: How to cope with sleep problems, and Mind troubleshooters: sleep problems.
The age at which young people start drinking alcohol has decreased significantly in recent years, [16] partly because of the ready availability of alcohol from supermarkets and other outlets. Alcohol misuse can have serious physical and medical consequences and often leads to psychological dependence. There are strong links between alcohol misuse and violence and risky sexual behaviours in young people.
The taking of illegal and legal drugs can be physically addictive, and there use in young people should be taken seriously. Certain drugs such as cannabis have been linked with depression and psychosis in some susceptible young people. [17] Drugs may be taken by young people to escape from emotional problems that would benefit from more appropriate, conventional interventions.
Volatile substances that are misused include paint, aerosols, glue, cigarette lighter refills, petrol and chemical thinners. These work directly on the brain to induce a sense of relaxation and ease tension, but they also impair judgement and self-control. Solvents are sometimes taken by young people who are trying to deal with complex mental health problems.
Mind has produced many leaflets on drugs (including street drugs) and 'dual diagnosis' - substance misuse by someone who has a mental health disorder.
The following organisations can provide information and support: Alcohol Concern, Alcoholics Anonymous, DrugScope, Re-Solv (a charity dedicated to the prevention of volatile substance abuse, which also has a specific website for children) and 'Talk to Frank' (information for young people about drugs). See Useful organisations for further information.
Children under 16 years of age can receive medical treatment, including treatment for mental disorders, when a parent gives consent. If a child is in care, the local authority takes the parent's place. A child can give consent for their own treatment if they are deemed to be 'Gillick competent'; that is, they are considered to have sufficient understanding to make such a choice. A person over 16 years of age is considered to be an adult and can therefore make their own decisions about treatment. [18]
Mind has produced a useful booklet Mind rights guide 3: consent to treatment. More details about this complex legal issue can be obtained from the Department of Health. Information on the capacity to make decisions about mental health care can be found in The Mental Capacity Act 2005. [19]
In addition to drug therapy, mental health professionals are encouraged to use a range of 'talking therapies', including the following.
Cognitive behaviour therapy (CBT)
The principle behind CBT is that it is possible to change our lives through changing our beliefs about ourselves. CBT focuses on the inter-relationship between cognitions (mental processes) and behaviour. Practitioners who use the approach believe that behaviour is learned and can therefore be 'unlearned'. Patients are encouraged to question the way they think and, as a consequence, to take control of their behaviour, and therefore their life.
CBT has been found to be particularly effective in the treatment of depression, OCD, phobias, anxiety and a range of other neurotic disorders, and is emerging as an important therapeutic option.
Person-centred counselling
Person-centred counselling, developed by the US psychologist Carl Rogers, is based on the idea that, given the right conditions, people will grow and develop. This way of working avoids analysis and being directive, and places the emphasis on the relationship between the counsellor and the client. Carl Rogers identified three 'core conditions' that he believed would lead to change, namely: unconditional positive regard (acceptance of the client and avoiding judgement), congruence (where the counsellor is in touch with his or her own feelings and is able to be authentic with the client) and empathy (which involves seeing the world through the client's eyes). [20] Similar, non-directive approaches are often used by non-specialists or volunteers working with children and young people.
Psychodynamic therapy
Psychodynamic approaches usually focus on unconscious thoughts, deep feelings and inner conflicts. Child psychotherapists are often asked to work with children and young people who are clinically depressed or who have unresolved grief or eating disorders. Other approaches used with children include 'solution-focused' models [21] and family therapy.
More detailed information on counselling and psychotherapy with children and young people can be obtained from The British Association for Counselling and Psychotherapy, Youth Access, the Royal College of Psychiatry and the British Association for Behavioural and Cognitive Psychotherapies (see Useful organisations).
Creative therapies: art, music, drama and play
Some specialist therapies involve creative approaches to help children and young people to express their feelings and problems, using a variety of media. Such ways of working can be particularly helpful for young people and very young children who have difficulty expressing their feelings using language alone.
Mind has produced a factsheet Arts therapies. Further information can be obtained from the following organisations:
Psychiatric drugs include: ADHD medications, antidepressants, antipsychotics, mood stabilisers, anti-anxiety drugs and medications to improve sleep. [22] Like all medication, psychiatric drugs are associated with a risk of side effects.
The use of psychiatric drugs for children and young people is controversial. There is some acceptance that, when used appropriately and after a full assessment and diagnostic process, drugs can help to relieve unwanted symptoms and enable a person to cope better. Concerns include the use in children of drugs developed and licensed for use in adults, the risk of dependency, and the over-use of psychiatric drugs. It is always recommended that use of medication in children and young people is accompanied by psychotherapy or counselling.
Mind has produced booklets and factsheets on a range of psychiatric drugs. Further information can also be found in the British National Formulary for Children. The organisations listed under specific conditions will also be able to provide information about relevant medicines.
The aim of CAMHS is to provide comprehensive multidisciplinary mental health services for children, young people and their families. There are two aspects to this. First, child and adolescent mental health is considered to be 'everybody's responsibility' - anyone who works with young people, not just those whose primary role is in mental health, has a responsibility for children's emotional health and wellbeing. Second, there are specialist services to provide mental health support. These services involve health professionals such as doctors and psychiatrists, child and adolescent psychotherapists, social workers, clinical psychologists and psychiatric nurses. More information can be obtained from: www.everychildmatters.gov.uk/health/camhs/
The following key organisations provide information, advice and a range of publications relating to the issues discussed in this factsheet.
Mental Health Foundation
London Office, 9th Floor, Sea Containers House, 20 Upper Ground, London SE1 9QB
tel: 020 7803 1101
email: mhf@mhf.org.uk
website: www.mentalhealth.org.uk
MindinfoLine
Mind, PO Box 277, Manchester M60 3XN
tel: 0845 766 0163
email: info@mind.org.uk
Royal College of Psychiatrists
17 Belgrave Square, London SW1X 8PG
tel: 020 7235 2351
website: www.rcpsych.ac.uk
YoungMinds
48-50 St John Street, London EC1M 4DG
tel: 020 7336 8445
website: www.youngminds.org.uk
The organisations listed below can provide information and support about more specific issues.
Action for Prisoners' Families (APF)
Unit 21, Carlson Court, 116 Putney Bridge Road, London SW15 2NQ
tel: 020 8812 3600; 0808 808 2003 (helpline)
email: info@actionpf.org.uk
website: www.actionpf.org.uk
Provides information about support services for prisoners' families and raises awareness of relevant issues surrounding prisoners' families.
ADHD Information Service (ADDISS)
PO Box 340, Edgware HA8 9HL
tel: 020 8952 2800
email: info@addiss.co.uk
website: www.addiss.co.uk
Provides information and resources about attention deficit hyperactivity disorder (ADHD) and related learning and behavioural disorders for affected individuals, parents, teachers and health professionals.
Alcohol Concern
64 Leman Street, London E1 8EU
tel: 020 7264 0510
email: contact@alcoholconcern.org.uk
website: www.alcoholconcern.org.uk
Acts as the national umbrella body for 500 local agencies tackling alcohol-related harm and offers help to the families and friends of those with alcohol-related problems. It plays a key role in promoting and advising on the development of national alcohol policy and in promoting public awareness of alcohol issues. The website includes a directory of local alcohol support services.
Alcoholics Anonymous
PO Box , 10 Toft Green, York YO1 7ND.
tel: 01904 644 026; helpline 0845 769 7555
website: www.alcoholics-anonymous.org.uk
A worldwide self-support network to help people recover from alcoholism. Information about regional and local services can be obtained via the website or local telephone directories.
Anxiety Care
Cardinal Heenan Centre, 326 High Road, Ilford IG1 1QP
tel: 020 8262 8891; helpline 020 8478 3400
email: enquiries@anxietycare.org.uk
website: www.anxietycare.org.uk
Anxiety Care is a registered charity based in East London that specialises in helping people to recover from anxiety disorders (including phobias and obsessive-compulsive disorder) and to maintain that recovery. Services include mutual support groups, support and structured recovery groups, confidence building groups, a home visiting service, telephone helpline, and one-to-one counselling.
Anxiety UK
Zion CRC, 339 Stretford Road, Manchester M15 4ZY
tel: 0161 227 9898 (admin); helpline: 08444 775 774
email: info@anxietyuk.org.uk
website: www.anxietyuk.org.uk
Provides an extensive range of services for people living with anxiety disorders, including one-to-one therapy. The 'Stressed out' project is designed to support young people who are experiencing anxiety and stress.
Association of Child Psychotherapists (ACP)
120 West Heath Road, London NW3 7TU
tel: 020 8458 1609
email: admin@acp.uk.net
website: www.acp.uk.net
The professional organisation for child psychotherapy in the UK.
Barnado's
Head Office, Tanners Lane, Barkingside, Ilford IG6 1QG
tel: 020 8550 8822
website: www.barnados.org.uk
Barnado's is one of the UK's leading children's charities, committed to freeing children from poverty, abuse and discrimination. Key areas of work are in counselling, fostering and adoption, vocational training and disability inclusion groups.
Beating eating disorders (beat)
103 Prince of Wales Road, Norwich NR1 1DW
tel: 01603 619 090 (admin); helpline 0845 634 1414; beat youthline 0845 634 7650
email: help@b-eat.co.uk;
beat youthline: fyp@b-eat.co.uk
website: www.b-eat.co.uk
beat is a charity providing help and support for people with eating disorders and their families. The young people's website (FYP) is specifically for young people.
British Association for Adoption and Fostering (BAAF)
Head Office, Saffron House, 6-10 Kirby Street, London EC1N 8TS
tel: 020 7421 2600
email: mail@baaf.org.uk
website: www.baaf.org.uk
BAAF provides support and advice and campaigns for better outcomes for children in care, working with everyone involved in adoption and fostering across the UK.
British Association for Counselling and Psychotherapy
BACP House, 15 St John's Business Park, Lutterworth LE17 4HB
tel: 01455 883 300
email: bacp@bacp.co.uk
website: www.bacp.co.uk
The work of BACP ranges from advising schools on how to set up a counselling service, assisting the NHS on service provision, working with voluntary agencies and supporting independent practitioners. BACP also participates in the development of counselling and psychotherapy at an international level.
The British Association for Behavioural and Cognitive Psychotherapies (BABCP)
Victoria Buildings, 9-13 Silver Street, Bury BL9 0EU
tel: 0161 797 4484
email: babcp@babcp.com
website: www.babcp.com
The leading organisation for CBT in the UK. The website provides comprehensive information about CBT and a register of therapists.
Carers UK
20 Great Dover Street, London SE1 4LX
tel: 020 7378 4999; 0808 808 7777 (helpline)
email: info@carersuk.org
website: www.carersuk.org
Provides information, advocacy and network of local groups for carers of all kinds
ChildLine
tel: 0800 111 111
website: www.childline.org.uk
ChildLine provides help on all issues relating to children's emotional and physical wellbeing.
Child Poverty Action Group (CPAG)
94 White Lion Street, London N1 9PF
tel: 020 7837 7979
email: info@cpag.org.uk
website: www.cpag.org.uk
The CPAG campaigns for the abolition of child poverty in the UK and for a better deal for low-income families and children.
The Children's Society
Edward Rudolf House, Margery Street, London, WC1X 0JL
tel: 0845 300 1128
website: www.childrenssociety.org.uk
The Children's Society is a charity that provides help and support for children who are struggling to cope with the pressures of everyday life.
Department for Children, Families and Schools (DCFS)
Sanctuary Buildings, Great Smith Street, London SW1P 3BT
tel: 0870 000 2288
email: info@dcsf.gsi.gov.uk
website: www.dcsf.gov.uk
The DCSF is the government department responsible for issues relating to children.
Department of Health
www.dh.gov.uk
Provides health and social care policy, guidance and publications for the NHS and social care professionals.
Depression Alliance
212 Spitfire Studios, 63-71 Collier Street, London N1 9BE
tel: 0845 123 23 20
email: information@depressionalliance.org
website: www.depressionalliance.org
Provides information and support services to people affected by depression, via publications, support services and a network of self-help groups.
DrugScope
Prince Consort House, Suite 204 (2nd Floor), 109/111 Farringdon Road, London EC1R 3BW
tel: 020 7520 7550
email: info@drugscope.org.uk
website: www.drugscope.org.uk
DrugScope is the UK's leading independent centre of information and expertise on drugs, whose aim is to inform policy development and reduce drug-related harms - to individuals, families and communities. The website includes a special area (D-World) for 11-14 year olds, a directory of drug services in England and Wales, and an extensive database of articles and books.
Family Action
Southern Office, 501-505 Kingsland Road, London E8 4AU
tel: 020 7254 6251
website: www.fwa.org.uk
Family Action (formerly known as the Family Welfare Association) is a UK charity tackling some of the most complex and difficult issues that face families today - including domestic abuse, mental health problems, learning disabilities and severe financial hardship.
Gingerbread
tel helpline: 0800 018 5026
website: www.gingerbread.org.uk
Gingerbread is an organisation for lone-parent families.
Institute of Psychiatry
website: www.mentalhealthcare.org.uk
The Mental Health Care website provides information and support for people experiencing mental illness, including most of the conditions covered in this factsheet and with specific information about mental health in young people.
Joseph Rowntree Foundation
Head Office, The Homestead, 40 Water End, York YO30 6WP, UK
tel: 01904 629 241
email: info@jrf.org.uk
website: www.jrf.org.uk
The Joseph Rowntree Foundation aims to examine the roots of poverty and disadvantage, and to identify solutions, to find ways to empower communities to have control of their own lives, and to contribute to the building and development of strong cohesive and sustainable communities.
Kidscape
2 Grosvenor Gardens, London SW1W 0DH.
tel: 020 7730 3300; 08451 205 204 (helpline)
website: www.kidscape.org.uk
Kidscape is a UK charity established specifically to prevent bullying and child sexual abuse.
MDF the BiPolar Organisation
Castle Works, 21 St George's Road, London SE1 6ES
tel: 0845 634 0540
email: mdf@mdf.org.uk
website: www.mdf.org.uk
Works with people affected by bipolar disorder / manic depression to take control of their lives.
National Autistic Society
Head Office, 393 City Road, London EC1V 1NG
tel: 020 7833 2299 (admin); helpline 0845 070 4004
website: www.nas.org.uk
Champions the rights and interests of all people with autism and provide individuals with autism and their families with help, support and services.
National Children's Bureau (NCB)
8 Wakley Street, London EC1V 7QE
tel: 020 7843 6000
website: www.ncb.org.uk
A charitable organisation that acts as an umbrella body for organisations working with children and young people in England & Northern Ireland. Young NCB is a free-membership network for children and young people to discuss issues, including many of those covered by this factsheet. The NCB also runs www.selfharm.org.uk, an information resource for young people who self harm, their friends, families, and professionals working with them.
The National Self Harm Network
PO Box 7264, Nottingham NG1 6WJ
website: www.nshn.co.uk
Provides support, distraction and information for individuals and their friends, families and carers. Also campaigns to raise awareness of the issues relating to self-harm, working with professional organisations, including schools and universities. Also provides an online support forum
NCH
85 Highbury Park, London N5 1UD
tel: 0845 762 6579
website: www.nch.org.uk
NCH (formerly known as National Children's Homes) is a national charity that supports vulnerable and excluded children and young people.
NHS Direct
tel: 0845 4647
website: www.nhsdirect.uk
NHS Direct provides health advice to the general public, available 24 hours a day.
NSPCC
Headquarters, Weston House, 42 Curtain Road, London EC2A 3NH
tel: 020 7825 2500; Child Protection Helpline 0808 800 500
email: help@nspcc.org.uk
website: www.nspcc.org.uk
The aim of the NSPCC (National Society for the Prevention of Cruelty to Children) is to end cruelty to children. The NSPCC runs community-based projects, working with children, young people their families and also works to achieve cultural, social and political change. The NSPCC runs the Child Protection Helpline and ChildLine (details above).
OCD Action
Davina House Suite 506-507, 137-149 Goswell Road, London EC1V 7ET
tel: 0870 360 6232 (admin); help and information 0845 390 6232
email: info@ocdation.org.uk
website: www.ocdaction.org.uk
A UK charity for people affected by OCD spectrum disorders, including body dysmorphic disorder. The website also provides information about OCD in young people.
OCD-Today
PO Box 500 98, London SE6 9DJ
text message help: 07786 206 715
email: admin@ocdtodayuk.org
website: www.ocdtodayuk.org
Provides information and support for people with OCD and their families, friends and carers. The website provides a wide range of information for children and young people.
OCD UK
PO Box 8955, Nottingham NG10 9AU
tel: 0845 120 3778 (admin)
email: admin@ocduk.org
website: www.ocduk.org
A national charity that provides support services and campaigns for improved access and quality treatment and care for children and adults with OCD. Provides a booklet, OCD for kids.
Overeaters Anonymous
PO Box 19, Stretford, Manchester M32 9EB
tel: 07000 784 985
email: oagbnsb@hotmail.com
website: www@oagb.org.uk
A fellowship of individuals recovering from compulsive overeating.
ParentLine Plus
tel: 0808 800 2222
website: www.parentlineplus.org.uk
Parentline is a charity that works with and for parents. The website includes information on emotional wellbeing and a forum for parents to discuss problems.
Princess Royal Trust for Carers
Unit 14, Bourne Court, Southend Road, Woodford Green, Essex IG8 8HD
tel: 0844 800 4361
email: info@carers.org, help@carers.org
website: www.carers.org and www.youngcarers.net
Youngcarers.net (YCNet) is web forum for young carers, including advice on living with a parent with a mental illness.
Prisoners' families helpline
tel: 0808 808 2003
website: www.prisonersfamilieshelpline.org.uk
The Prisoners' Families Helpline is a free and confidential service for anyone who is affected by the imprisonment of a close family member or friend. Provides information for families and friends of prisoners.
Queer Youth Network
c/o Lesbian & Gay Centre, 49-51 Sidney Street, Manchester M1 7HB
tel: 020 30 70 11 94 (admin); youth line 0870 383 4796
email: info@queryouth.net
website: www.queeryouth.org.uk
The national organisation for young people who are lesbian, gay or bisexual, or who are questioning or confused about their sexual orientation.
Refugee Council
Head Office, 240-250 Ferndale Road, Brixton, London SW9 8BB
tel: 020 7346 6700; Children's Panel Advice Line; 020 7346 1134
website: www.refugeecouncil.org.uk
Gives help and support to asylum seekers and refugees and works to ensure that their needs and concerns are addressed.
Relate
tel (central office): 0300 100 1234
website: www.relate.org.uk
Relate is primarily involved with relationship advice and counselling, including support and advice to families on coping with separation and divorce. Details of local Relate offices can be found in the telephone directory or via the website.
Re-Solv
Head Office, 30a High Street, Stone, Staffs ST15 8AW
tel: 01785 817885
email: youthliaison@re-solv.org
website: www.re-solv.org
A charity operating throughout the UK, solely dedicated to the prevention of solvent and volatile substance abuse. Provides factsheets and resources for schools. Re-Solv also provides a site for young people: www.sniffing.org.uk.
Rethink
Head Office, 5th Floor, Royal London House, 22-25 Finsbury Square, London EC2A 1DX
tel: 0845 456 0455 (information); advice line 020 8974 68 14
email: info@rethink.org or advice@rethink.org
website: www.rethink.org
Rethink is a charity working with people affected by severe mental illness, providing services, support and information.
Samaritans
PO Box 9090, Stirling FK8 2SA
tel: 08457 90 90 90
email: jo@samaritans.org
website: www.samaritans.org.uk
Samaritans provides confidential support, 24 hours a day, for people experiencing any level of distress or despair, including those who may be feeling suicidal. Support is available by telephone, email or letter or face to face.
Sainsbury Centre for Mental Health
134-138 Borough High Street, London SE1 1LB
tel: 020 7827 8300
email: contact@scmh.org.uk
website: www.scmh.org.uk
The Sainsbury Centre for Mental Health aims to improve the quality of life for people with mental health problems by influencing policy and practice in mental health and related services, focusing on criminal justice and employment and supporting work on broader mental health and public policy.
SANE
1st Floor Cityside House, 40 Adler Street, London E1 1EE
tel: 020 7375 1002 (info); saneline 0845 767 8000
email: sanemail@sane.org.uk; info@sane.org.uk
website: www.sane.org.uk
SANE aims to improve the quality of life for people affected by mental illness, by raising awareness and respect, undertaking research, and providing help and information to those experiencing mental health problems, their families and carers. Saneline offers support mainly for carers but also service users in crisis situations; can provide information on local services, treatment options, etc.
Social Emotional and Behavioural Difficulties Association (SEBDA)
Room 211, The Triangle, Exchange Square, Manchester M4 3TR
tel: 0161 240 2418
email: admin@sebda.org
website: www.sebda.org
SEBDA's membership consists of teachers, educational psychologists, education officers and social, care, youth and mental health professionals who work with or for children and young people said to have SEBD.
Stonewall
Tower Building, York Road, London SE1 7NX
tel: 020 7593 1850 (office); info line 08000 50 20 20
email: info@stonewall.org.uk
website: www.stonewall.org.uk
Stonewall campaigns to achieve equality and justice for lesbian, gay and bisexual (LGB) people and also runs an information service, including an information line. 'Education for all' is a campaign to tackle homophobia and homophobic bullying in schools. The website provides links to other organisations working with LGB youth.
Talk to Frank
tel: 0870 77 66 00
email: via website
website: www.talktofrank.com
Information about drugs for young people, including anonymous email support.
Teenage Health Freak
website: www.teenagehealthfreak.org
Provides information aimed at teenagers on a wide range of issues, including mental health and emotional wellbeing.
Trust for the Study of Adolescence (TSA)
23 New Road, Brighton BN1 1WZ
tel: 01273 693 311
email: info@tsa.uk.com
website: www.tsa.uk.com
The TSA aims to improve the lives of young people and their families by enabling the individuals and organisations that work with young people and families to provide better services. TSA's work covers five main areas: health and emotional wellbeing; learning and education; parenting and family life; youth social action and participation; and youth justice. A recent research project has been on the needs and experiences of parents of young people with mental health difficulties.
Winston's Wish
tel: 01242 515 157
helpline: 08452 03 04 05
email: info@winstonswish.org.uk
website: www.winstonswish.org.uk
Winston's Wish is a charity that helps bereaved children and young people rebuild their lives after a family death, offering practical support and guidance to families, professionals and anyone concerned about a grieving child. The organisation has particular experience of supporting children and young people who have been bereaved by suicide (1 in 5 calls to their helpline is about death by suicide). Winston's Wish produces a booklet - Beyond the rough rock - specifically for children bereaved by suicide.
Women's aid
PO Box Bristol 391, Bristol BS99 7WS
tel: 0117 944 4411 (admin); helpline 0808 2000 247
email: info@womensaid.org.uk
website: www.womensaid.org.uk
Women's aid is a national charity working to end domestic violence against women and children.
Youth Access
1-2 Taylors Yard, 67 Alderbrook Road, London SW12 8AD
tel: 020 8772 9900
email: admin@youthaccess.org.uk
website: www.youthaccess.org.uk
A national membership organisation for information, advice, counselling and support services for young people. The website provides a directory of agencies that provide information, advice, counselling and support services for young people, carers and professionals.
Mind factsheets and legal briefings (available on Mind's website at www.mind.org.uk/information)
Mind booklets (available to read here or to purchase from Mind Publications on 0844 448 4448 or at publications@mind.org.uk)
Other publications
[1] Office for National Statistics (2004) Mental health of children and young people, 2004: summary report. http://www.statistics.gov.uk/downloads/theme_health/GB2004.pdf
[2] Royal College of Psychiatrists (2008) Mental health information: bereavement. London: Royal College of Psychiatrists.
[3] Mind (2008) News, policy and campaigns: Census supports mind's concerns over racism in the NHS at www.mind.org.uk/News+policy+and+campaigns/Press=archive/censusracism.htm
[4] Anti-bullying Campaign Questions and answers at www.antibullying.net/knowledge/knowledgenew.htm
[5] Simple Free Law Advice (2006) Effects of divorce on children at www.sfla.co.uk/children.htm
[6] Avert (2008) Homophobia, prejudice and attitudes to gay men and lesbians (2008) at www.avert.org/homosexu.htm
[7] Department for Children, Families and Schools (2006) Children looked after at 31 March by gender and age, 1995-2005 at www.dcsf.gov.uk/rsgateway/DB/VOL/v000454/index.shtml
[8] British Medical Association (2006) Poverty and deprivation-key causes of mental health problems in children, Tuesday 20th January 2006, at www.bma.org.uk and www.patient.co.uk/showdoc/40001485/
[9] Prison Reform Trust (2006) Young people with mental health problems in prison. www.prisonreformtrust.org.uk/subsection.asp?id=314
[10] BBC News (2006) Young carers 'fear seeking help' Tuesday 7th November 2006 at www.bbc.co.uk/1/hi/education/6121716.stm
[11] National Office for Statistics (2004).
[12] National Autistic Society (2008) Asperger Syndrome-the triad of impairments at www.nas.org.uk/nas/jsp/polopoly.jsp?d=212
[13] Beat (2008) Boys and eating disorders at www.b-eat.co.uk/YoungPeople/WhatisanEatingDisorder/Boysandeatingdisorders
[14] Mind (2007) Understanding self-harm
[15] National Office for Statistics (2008) at www.statistics.gov.uk
[16] Alcohol Concern (2004) Factsheet 1: Young People's Drinking at www.alcoholconcern.org.uk/files/20070809_170143_Young%20people%people%20summary%20%20July%20200
[17] BBC News (2002) Cannabis linked to depression, 22 November 2002 at www.bbc.co.uk/1/hi/health/2498493.stm
[18] Department of Health (2001) Seeking consent: working with children. London: Department of Health
[19] Mental Capacity Act 2005 at www.opsi.gov.uk/ACTS/acts2005/ukpga_20050009_en_2
[20] Counselling Resource (2008) An introduction to the person-centred approach at http://counsellingresource.com/types/person-centred/index.html
[21] O'Connell, B. (1998) Solution-Focussed Therapy London: Sage Publications.
[22] Mind (2005) Making sense of coming off psychiatric drugs.
This factsheet was written by Mark Prever, September 2008.
Mark Prever is a counsellor, supervisor, trainer and writer with a particular interest in the mental health of children and young people.