Sunday, 30 April 2017

Failing our children is failing to secure their future

I am a single mum to my 8 year-old son and 12 year-old daughter. We live in a lovely house, in a beautiful coastal town. I work hard to keep us in our home: I work part time as a nurse in A&E; I have my budding business teaching mindfulness and meditation to adults and as a Connected Kids™ tutor and trainer; and I do airbnb. In combination, I probably work around 70-80 hours a week, with the majority of those hours unpaid. 
Having experienced homelessness as a child and the effects this had on the mental health of my mother, I conscientiously  work at my connection to my children. I want to know what's happening in their lives, so in an effort to do so, we eat our meal together at the table, talking about our day. Sometimes they don't want to talk to me, as they would prefer to eat dinner in front of the TV. I indulge that in them sometimes, but I don't like it. The evening meal we share together is often the only time we get to discuss the good and the bad stuff that has happened in our day. I listen to them telling me all about their boring lessons, their exciting lessons, the current Year 7 politics (in an often surreal realm all of its own, I can assure anyone who isn't in the know); I listen and laugh at the daft jokes they learned. 
I listen to their worries and we try to problem-solve together. I tell them snippets of what I deal with in my work in A&E. They always want to know these two things:

1. Whether anyone vomited down the back of my scrub top (this is a real trauma, which I will never, ever forget)
2. Whether I saw lots of blood and gory stuff (what is it about gore with kids?!)

 They also love to hear about the work I do with my mindfulness clients. I do lots of fun stuff with kids to help teach them how to connect with their feelings and to train their minds. My kids like to hear the success stories, to hear what stuff we do. I like to tell them, because it makes me feel proud. It also teaches them that I can do the stuff I do because I believe in what I do and love to see the positive results. Having said that, I did once take my daughter along to a meditation talk with her teachers on their staff development day. Seeing her mum in work mode freaked her out. I tried not to take it personally when she told me she didn't like me in work mode.
After dinner our routine involves a bedtime read. I am proud of the fact that my 12 year-old still wants me to read to her each night, as we all snuggle up together and read a book. We take it in turns to read, nowadays: a great and privileged thing indeed. I love to hear my 8 year-old read to me, especially as up until about a year ago, to him books were "boring" and I'd be lucky to get him to read a paragraph. Now he reads pages. 
We've read and discussed all sorts - from Michael Morpurgo's Warhorse, to David Walliams' Grandpa's Great Escape; Malala Yousafsai's I am Malala; fairly soon bedtime reading is going to evolve into the evening bookclub, where I am determined to keep this up for as long as possible; or at least until the masses of homework and exam revision bleeds into that precious time we have as a family each night. 

This concerns me on three levels: 

1. As a parent - I value and treasure the little time we do have as a family. As a single parent I am often acutely reminded of how difficult family life can be: to try to manage the every day stuff can be a challenge, let alone when a curve-ball sploshes into the mix. So single-handedly helping my children with their homework and exam revision, on top of my own work and home life frankly boggles my brain. I'm not sure how I'm going to fit everything in and still have time to connect with my children on a level that doesn't involve the angst of maths, science and English, creating a 3D model of a WW2 allotment or somehow cleverly illustrating inequality in the Victorian social classes, as I navigate through the hardships of being a mother to one or two teenagers on every level, whilst  I deal with my own existential crises. Meditation is going to take on an even greater role in my life!

2. As a healthcare professional - stress, anxiety, depression, self-harm, eating disorders - mental health problems amongst children and young people is increasing. The findings of the Office for National Statistics Insights into Children's Mental Health and Well-being (October 2015) report on the most up to date, comprehensive data from 2004 showed that:
  • 1 in 10 children aged between 5-16 years had a clinically diagnosed mental health disorder, with 11% of boys and 8% of girls with a mental health diagnosis
  • the prevalence of mental health issues increased with age
  • Girls were more likely to have emotional problems
  • boys were more likely to have conduct or hyperactivity problems
  • The study also found that children with mental health disorders were more likely than those without to have time off school, including unauthorised absences, and were less likely to have close networks of friends or family
In response to this, in 2015 a new measure of children's mental health was added: the Strength and Difficulties Questionnaire (SDQ) from the UK Household Longitudinal Survey (Understanding Society) which showed that:
  • 1 in 8 children aged 10-15 who reported symptoms of mental ill-health in 2011-2012 had measured a high total SDQ
  • Children who quarrelled with their mother more than once per week were three times more likely to report a high or very high SDQ
  • One third of children who were relatively unhappy with their appearance reported a high or very high SDQ
  • Children who spent more than three hours on social media websites on a normal school night were twice as likely to report high or very high SDQ, compared with those who spent less than three hours on social websites
The conclusion, according to the well-being measures of Understanding Society survey, was that bullying and quarrelling with mothers had the strongest associations with mental ill-health. This is consistent with the findings from academic research and previous national surveys of children's mental ill-health. In my work as a nurse I frequently see the results of mental ill-health and see the constraints in managing them, particularly for access to Children and Adolescant Mental Health Services (CAMHS) which is a variable feast in terms of access to, and support from this service. According to The Lightening Review (2015) from the Children's Commissioner :
  • 28% of children were turned away from CAMHS without being offered help, although this varied across the country, suggesting that there is a postcode lottery of mental health service provision across England
  • Waiting times to be seen were widely variable - between 14 days to 200 days, again, depending on the region in England
  • 3,000 children were referred to CAMHS with a life-threatening condition, such as attempts at suicide, self-harm, anorexia and psychosis - of which:
    • 14% were not allocated any help
    • 51% went on a waiting list
    • some waited for over 112 days for access to services

3. As a mindfulness tutor for children. In my work in schools and privately, I see a vast number of children and teens with various mental health issues. I know that what I teach works - I have seen the evidence for myself and audited my work; parents and teachers report improvements in the students I work with. As an individual, I feel great that my skills are helping those I work with. On an operational level, it frustrates me, because there is so little money available for schools and organisations like the NHS to provide this level of support. 

I am so passionate about the work I do with the children I work with. I jump up and down with joy when I see a child come through a dark period in their life through using mindful activities and learning to meditate in order to manage emotions, make sense of feelings, or overcome anxiety or fear; conversely I jump up and down in frustration when I feel like I'm struggling to be seen or heard by the powers that be: too often mindfulness is still regarded as "soft" and not as effective as medicines to treat children's mental ill-health. What is it going to take to enable collaboration between these disciplines and enable a team-around-child approach to mental well-being in schools and in the NHS? 

I can promise you that I am at the front of the queue, waiting - if not chomping at the bit - to get mindfulness training into the clinical setting for paediatric staff to use as a clinical tool in delivering patient care. The Mindfulness All Party Parliamentary Group (MAPPG) found evidence that mindfulness training helps children and young people learn to regulate emotions, improve problem-solving, reasoning and memory (MAPPG Mindful Nation, p.30). As well as reduce stress and depression and improve emotional and behavioural regulation, the MAPPG recommend mindfulness training in the education sector to schools, as well as in healthcare, the workplace and in the criminal justice system.

With the education and healthcare sectors feeling the financial pinch and ever increasing need for clinical intervention combined with a lack of training for education staff in managing mental ill-health in pupils; the effects of the decreasing numbers of nurses thanks to Brexit and the scrapping of student nurse bursaries, I am concerned about how we as professionals and as parents can help children and teams work through mental health problems, let alone teach good techniques for coping strategies and life-skills for managing stress and anxiety throughout their lives. Three out of four teachers feel that they are unable to access the support to help their students manage mental health problems. 

If we fail to prepare our children, we are failing to help them secure a positively-assured future. We cannot let this happen. As parents, teachers or healthcare professionals, despite the growing problems we face in tackling this, we have to continue to fight against the grain of resistance, in order to do as much as we possibly can to help these children and teens. We have a duty to do everything we can, and it starts with making that connection with them, in whatever small way we can, and build on it from there. 

Nikki Harman, RGN, Connected Kids™ mindfulness tutor and trainer
www.innerspaceproject.com
innerspaceproject1@gmail.com



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