Are we failing our children?

So much of the time I think people assume that those with mental health problems are bad parents however it’s difficult to say whether these people would also assume that this would make their children more likely to have mental health problems of their own. Whether this is the case or not the revolution that is continuing to put money behind the ant stigma campaign and parity of esteem legislation is showing a vast increase in mental health awareness than I remember from my childhood. The last generation seemed blissfully ignorant of any mental health problems and it seems that we, have gone far out of our way to bring it into the public domain may be trying to make up for what we feel were their mistakes. And since in all other cases early intervention has been seen to be important in reducing severity and improving long term health it would seem a likely conclusion for mental health too.

Every so often I wonder if I really have the big picture, do I actually know what the state of mental ill health is in the UK and how it is changing. For instance now the anti-stigma campaign has released it’s evaluation report we see that the only group that didn’t show any positive change were the untargeted people in the medical professions ( see this article or get the full report from here)

But what is the changing face of mental health or is it even changing?

The new and improved Minimum mental health dataset 2013found here, details the information collected about accessing of specialist mental health services within the UK. Pease read the report for full details as I am only going to highlight a few things now.

For a start there were fewer numbers of people being admitted to hospital since they started recording however there were over 1.5 million people in contact with specialist mental health services in 2011/12 a rate of 1 person per 32 in England. An increase since the last report although they make pains to suggest that changes in data recording will account for some of the rise, from 2789 per 100,000 in 2010/11 to 3033 per 100,000 in 2011/12.

People in contact with specialist mental health services have a mortality rate that is 3.6 times as high as the general population. And sadly when you break that down by age you find that that largest difference is in the 30-39 age group where the mortality rate is 5 times as high as the general population.

It also shows that 33.8% of people using services are aged 65 or over (530,833), compared with 16.3% in the latest population data. Please note that most of these cases are attributed to the organic cluster groups and account for illness such as dementia and alzheimer's.

Figure 3 page 11 of the report, shows there are two peaks in service users one around 40-45 and the other 80-84 The table below shows the basic percentages of under 65 users in the different age ranges and shows that there are slightly skewed peak in the data suggesting more youths and children are accessing services that older adults.

Age range	Total number	Percentage of under 65
un15	16,091	2
15-24	173,579	16
25-34	231,154	22
35-44	256,768	24
45-54	234,095	22
55-64	152,203	14

If you look at the clustering data, it shows that the vast majority of people in the organic groups are over 65,  and that people accessing services for all other mental illnesses decline drastically after 45. This suggests that the stresses associated with being a certain age and/or getting treatment may affect peoples need for services apart from illness in the organic cluster. However the possible lack of diagnosis of other illnesses for the over 65 or need for treatment for other mental illness may cause the data to look like this. Remember this data does not log people accessing primary care for common mental health problems like depression or anxiety.

Unfortunately the data doesn’t really help understand whether there is increasing number of youths and young adults accessing services than previous years, nor does it help understand if the peak at 40-45 in this year is moving up or down the age range.

However it could just be that those who are suffering from mental health problems are just not accessing specialist services at all since it be that GP’s are choosing not to refer people.

Certainly when I last went back I was put through as an urgent case because my GP was worried about how long it would take to get me seen and didn’t want my condition to worsen, however I doubt she would have been so keen to refer if it wasn’t for my diagnosis and history of secondary care and I might add success with secondary services such as talking therapy in stabilising my condition.
In fact there are so many factors contributing to whether people access services it’s difficult to tell. For instance we all know that waiting list and expectations of recovery can affect whether people are referred, however accessing services means that these people got treatment but does not say anything about whether there is a waiting list for them nor does it tell you how many people were refused. This might be important as these people were deemed in need by their GP.
And like I said before this dataset only covers specialist mental health services which are usually not used for those with common mental health problems.