Dublin: BREAKING the SILENCE: 8: Mental Health: Child Addiction Services Should Be Separate From Adult Services

10 Feb

CHILD ADDICTION SERVICES SHOULD BE SEPARATE FROM ADULT SERVICES:

Over 1,900 children, u

nder the age of 18 years sought addiction treatment in Dublin during the 1990s (Smyth & O’Brine, 2004). They accounted for 20% of all new attendances, according to data from the Health Research Board. Although the main drug of misuse fluctuated dramatically over the decade, heroin accounted for 43% of all presentations by children.

The majority of children who misuse drugs and alcohol do not access treatment. The European School Survey Project on Alcohol and Drugs (ESPAD; Hubbell etal, 2000) found that one-in-three 16-year-old Irish schoolchildren had smoked cannabis and one in seven was a current cannabis smoker.

The national Survey of Lifestyles, Attitudes and Nutrition (SLAN) found that rates of cannabis and alcohol misuse among teenagers were similar across all socio-economic groups. (Department of Health and Children, 2003c). A survey of agencies working with teenagers has indicated that the threshold for entry into addiction treatment is viewed as too high and the geographical spread of treatment services makes treatment difficult to access. (Vitale & Smyth, 2004).

Research indicates that the treatment of adolescents with addiction problems results in improvement for both the adolescent and the family, while at the same time delivering cost savings to wider society (Gossop et al, 2003). International research on adolescent addiction has identified parameters for best practice in this area. Surveys have been conducted of the views of service users, service providers and service referrers in Ireland (Department of Health and Children, 2004). This body of knowledge concludes that adolescent addiction services should:

 

Be child centred; be family orientated; be locally delivered, in a building separate from adult addiction services; offer a range of evidence-based medical, psychological and social interventions; actively collaborate with other agencies (e, g; education, probation, mental health); deliver after-care in conjunction with partner agencies; and deal with alcohol problems as well as drug problems.

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www.spunout.ie & www.citywide.ie & www.teenline.ie & www.letsomeoneknow.ie & www.console.ie & www.3ts.ie & www.aware.ie 

Young People Get Depressed Too:

Very few, if any, young people suffering from depression will recognise it for what it is – an illness. They will feel confused, withdrawn, unable to concentrate, fatigued and isolated. Self esteem will suffer and they may blame themselves for being a ‘failure’. School work will fall behind and some mat drop out of education altogether, those who struggle on may not realise their full potential, and some will sink into complete despair.

Until fairly recently it was thought that young people were not affected by depression. Now we know better. Studies have shown that 1% of children in the 10 to 14 years age group, suffer from severe depression and that figure is even higher in the 14 to 19 year old age group. When our predominantly young population is taken into account it becomes clear that a very great number of our young people are suffering the effects of depression in addition to the other pressures associated with childhood and transition into young-adulthood. It is important to get the message across to these young people that they are in fact suffering from a treatable illness. They need to know that help is available; that it is not the fault of the sufferer no more than if they suffered from any common physical illness. Depression is a worldwide phenomenon and has no respect for age, culture or creed. Life is worth living and they can be assured that the outlook for those who seek treatment is excellent.

The successful management of the illness will allow the sufferer to lead a full, productive and happy life. Crucially, the relevant information regarding the illness and the range of treatments that is available should be made available to the sufferer and his/her family at the earliest possible point, so that lasting damage to education, important pro-life social-skills and loss of self-esteem may be avoided and important life opportunities can be availed of, before they slip away. Information as part of a structured and integrated health-education programme which would be used in all schools and would be similar to the

AWARE ‘BEAT THE BLUES’ programme available in some schools.

  That way a generation of young people would emerge with a good basic understanding of mood disorder-problems but without the traditional bias against mental illness that perpetuates the stigma attached to it.

Unfortunately, the AWARE project can only reach a fraction of the young people who need information and help to overcome their illness.

The signs and symptoms of depression in children may be a sad or unhappy mood. Children under the age of 11 years don’t say that they are depressed*

(*Authors note: A child or young person at this stage of their development, is not and can not be aware of psychiatric or psychological illness or how that illness is manifesting itself within their person.

This is a point of critical importance from the inception of the illness or (illnesses), right through each stage of deterioration in the child’s condition until professional intervention brings the illness under control).

The parent / caregiver, teacher, youth-worker or friend will have to be guided by the child’s looks, moods and attitudes as depressed teenagers may experience boredom, lack of pleasure, no interest, and feelings of guilt for the negative happenings in their lives.

The possibility of physical or sexual abuse must be considered, drug or alcohol abuse may be present and eating disorders such as bulimia or anorexia-nervosa are common amongst teenagers.

Depressed teenagers often have a sense of hopelessness, worthlessness and suffer from a lack of concentration.

School work may be affected and grades decline, resulting in drop-out or/and educational failure which represents a major problem with adolescents, unable to study depressed adolescents feel hopeless. Young children, who experience anxiety because of parental separation, may regress and behave as if they were even younger.

Aggression can be common in such cases, because ’children cannot articulate what they are feeling’. Physical symptoms may also be present, (e, g; headaches or tummy-pains. Reluctance or refusal to go to school is common. Psychotic symptoms may develop such as, loosing touch with reality or hearing voices. Suicidal thoughts and behaviours can be present amongst depressed teenagers.

When we suspect that a child (under 18 years of age) may be suffering from depression, talk ‘with them, listen to them’, try to remove as many stress-factors as possible from their everyday lives, ’become their friend, someone who cares’. In that way you can make the difference to a child, just one of the 75% of people who suffer in silence with one of the cruellest, isolating and lonely illnesses known to mankind.

Dr Patrick McKeon. Chairman of AWARE stressed during AWARE’S 1997 DAWN campaign that “to fundamentally tackle the problem of suicide, it appears society will have to undergo a radical review of its attitude to depression and its treatment”. An estimated 200,000 people in Ireland suffer from depression, but just 25% seek professional help.

The one-in-ten children age between 13 and 18 years that suffer with clinical depression are the ’cold hard facts’ that compels us to see the image of childhood depression through the changing attitudes brought about and made possible in no small way by the courage of AWARE’S ‘Youth Panel’ who through their communication with other young people, they have encourage youthful sufferers of depression to seek help without feelings of guilt, shame or fear of discrimination, as the stigma that in previous generations surrounded mental illness is lessened by an increasing public awareness of such illness.

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