We all know that our young people are struggling. I am a counsellor in a sixth-form college and I work with young people at a point of transition in their lives. They鈥檙e trying to get by: making big decisions that they know will impact upon their futures; some with little or no support from home; some managing situations that would challenge the resilience of the highest functioning adults; some dealing with surprisingly long-term low mood and anxiety for such young people and some with emerging mental health difficulties that are new and frightening.
As I meet with my clients for the week, I reflect on the proposals for the new Mental Teams and try to picture them here. The proposal is to upskill existing staff, no need for a clinical training, the paper grandly asserts the similarity in outcomes for interventions by clinical and non-clinical staff. I leaf through the paper looking for a citation to back up such a bold statement 鈥� I find nothing. I鈥檓 incredulous that a mainstay of the proposal 鈥� the staff to deliver the interventions - do not have more explicit research to back up their inclusion? I have spent many years in training and value every minute. I teach an evening class in counselling skills at an FE college, we have a varied selection of students, many from professional backgrounds such as teaching, all of whom need to work on their skills and aptitude before they鈥檇 be safe to work with clients. Like many other counsellors in colleges, I spend a significant amount of time undoing the damage done by well-meaning but ill-informed interventions conducted in schools. I believe that something is not always better than nothing.
The paper proposes in-house interventions for students with mild to moderate anxiety and depression. I think about how simple this sounds and how unusual it is for me to work with someone whose needs are simple and straightforward. My first client is a young man who was referred for anxiety. He had a panic attack in a mock exam and although highly performing on his programme, flunked the exam and his teachers are worried. What would the intervention be? The paper gives no details and I wonder if it would simply focus on the panic attack and anxiety or if there would be room for wider exploration?
In the space that I am able to give him he discloses that his brother and uncle have schizophrenia and he speaks of his worry about his possible genetic heritage. I wonder if he presented to the teacher/mental health team worker how he would be assessed and who would do it? Who would deem him suitable for the intervention and match him with the staff member? My client goes on to tell me that he hears voices and they frighten him, he sometimes self-medicates with cannabis and we consider together whether it might be the cannabis that causes the voices or the voices that make him smoke. We talk about when the voices occur and whether it is when he is under particular stress. He wants to be a doctor and I wonder if he were not speaking to me but with a team member with a dual role whether he would disclose what he has with me? With the person who is to write his UCAS reference? I doubt it. I wonder how a teacher or tutor will manage the boundaries of being a therapist as well? Under the oversight of a senior manager who is unlikely to have any experience as a mental health practitioner? I feel concerned. It takes a while to work towards a referral to CAMHS that my student will agree to and engage with. He is very frightened but agrees to it and I believe that it is testament to our therapeutic relationship and the flexibility that I have been able to show him, that I have gained his consent.
Before I leave that day I need to meet with a tutor to discuss another student. We compare diaries and find that it鈥檚 well over a week until we are both free. Hear parents are coming in and we need to find a room in college for a private meeting, we鈥檙e in luck, unusually there is a room available. I wonder how our mental health team would cope? Where would they see the students for their interventions? Most staff rooms are busy places and not suitable for a private one-to-ones. Most groups have several students who would fall into the mild to moderate anxiety or depression category. When will the teachers with their overstretched timetables have the time to see them individually? I don鈥檛 think that the authors of the report have worked in a college, at least, not one like mine. I believe that our young people deserve qualified professionals to work with them.
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