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RCPCH statement on Child Mental Health

1st September 2020

Mental health issues are increasingly common among children and young people—suicide is now the leading cause of death for both males and females aged five to 19 years old, and one in eight people among this age group is currently living with a mental health condition. 

Children and young people in vulnerable groups are even more at risk, including LGBTQ+ people, low income households, children in care, and those with parental mental health issues, special educational needs, on child protection plans, or in the criminal justice system. 

Underinvestment in mental health is a longstanding concern. This has been amplified by the pandemic due to the extra stress caused by prolonged school closures, social isolation, adverse social and environmental circumstances, and a lack of access to usual support services. 

RCPCH’s Assistant Officer for Mental Health and Wellbeing, Dr Karen Street, says: “Our key message is that our patients’ mental health is our business. There is a joint responsibility to provide necessary services across the children’s workforce. 

“In the wake of COVID-19, many children and young people will have greater mental health support needs. As services begin to recover, the time is ripe to connect across the entire child health workforce and local, regional, and national boundaries. Together, we can work to develop improved and integrated mental health services.” 

In its statement, the College includes a number of recommendations, including: 

  • All paediatric teams should have a nominated lead for mental health. 
  • Paediatric training must include promotion of wellbeing in children and young people and management of common mental health issues. 
  • Paediatricians with higher exposure to issues need more extensive training and support. 
  • Paediatricians should not be expected to work in isolation when managing severe cases of mental illness. 
  • Use of mental health screening tools in higher risk people should be considered. 

The College will also continue to support mental health through its activities, including: 

  • Having an Assistant Officer for Mental Health on its Health Improvement Committee. 
  • Working with NHSE and HEE to implement of the NHSE Long Term Plan. 
  • Developing training through its Child Mental Health Specialty Advisory Committee. 
  • Developing the Progress curriculum for all paediatric trainees to include mental health. 
  • Partnering with MindEd to produce a paediatric ‘learning path’. 

Read the College’s full position statement on the role of paediatricians in mental health here

The RCPCH’s Spring Meeting 2020 has become an Online Conference

The RCPCH’s Spring meeting, scheduled for April 2020, was regretfully cancelled due to the COVID-19 pandemic. But now the the meeting will go ahead online, with different sessions running between the 25 September and 13 November 2020.


PMHA Joint Workshop: ‘Difference and Self’

The PMHA had planned a joint workshop with the British Association for Paediatricians in Audiology, themed ‘Difference and self’.

This workshop will now be delivered in webinar form. Chaired by Dr Winfred Baddo and Dr Sheila Peters, this free, live online event will feature guest lectures and abstract presentations, with opportunities for delegates to ask questions. 

Date: Tuesday 13th October
Time: 2 – 5 pm

To register, click on the link below:

https://www.rcpch.ac.uk/news-events/events/conference-webinar-difference-self-mental-health-audiology

The posters which had been accepted for the workshop, are now available to view online. Visit this link:

 https://eposters.rcpch.ac.uk/ 

(You’ll need to register but RCPCH membership is not needed for this).
You’ll find the posters in the ‘mental health’ section.  Please view the posters, register for the webinar, and spread the word!

Dr Sheila Peters: Immediate Past Convenor of PMHA

RCPCH: State of Child Health 2020

In March, the RCPCH published its ‘State of Child Health 2020’ report. This landmark report provides a snapshot of infant, children and young people’s physical and mental health. 

The RCPCH say: “On 4 March 2020, RCPCH launched our new State of Child Health. The update provides the latest data from our 2017 indicators, alongside evidence for new indicators, including: looked after children, mental health, youth violence, young carers and the child health workforce. Alongside this, we’ve spoken to 2,000 children and young people to find out what makes them feel “healthy, happy and well”.

We’ve outlined our key asks for each of the UK Governments, which we hope will ensure delivery of key policy decisions to improve child health outcomes.

The State of Child Health 2020 Report utilises comparable UK data across 27 child health and wellbeing indicators to produce a range of associated recommendations aimed at improving outcomes. It builds on the 2017 Report which provided an unprecedented snapshot of how infant, children and young people’s physical and mental health was faring across the UK.  

Click below to read the report:

http://www.rcpch.ac.uk/state-of-child-health

The Importance of Human Contact Today

During the interval of a recent concert by the Orchestra of the Age of Enlightenment, Dr Dickon Bevington, Consultant Child and Adolescent Psychiatrist, gave a thought provoking, and topical talk:

The Importance of Human Contact today, about Mentalization, Attachment and Kindness.

About Dr Dickon Bevington:

Dr Bevington is the Medical Director at the Anna Freud National Centre for Children and Families and a Consultant Child and Adolescent Psychiatrist in Cambridgeshire and Peterborough NHS FT where he leads CASUS, an outreach service for complex substance using youth. He is also a Fellow of the Cambridge and Peterborough CLARHC, a collaboration based in Cambridge University dedicated to developing leadership and research in health and social care.

Dr Bevington’s consultant career started in adolescent in-patient psychiatry, but he now concentrates on developing and delivering innovative home-based or street-level out-reach interventions for complex, co-morbidly burdened young people who are socially excluded, using mentalization to underpin both the therapeutic and the organisational approach to this work. In this respect, together with Dr Peter Fuggle, he is the co-lead for the Adolescent Mentalization-Based Integrative Treatment (AMBIT) project.

Dr Bevington trains and lectures internationally on MBT and AMBIT, and has published a number of papers and chapters in the eld of mentalization and multimodal outreach approaches, most recently with Dr Fuggle. He is also co-author of “ What works for whom: a critical review of treatments for children and adolescents” which is a review of all treatment trials in the past 10-15 years across the world.

Take a look at the Anna Freud Centre website for more information about this field of Child Mental Health.

For a great resource for on-line learning, click on link below: https://www.annafreud.org/mental-health-professionals/anna-freud-learning-network/

Staying Sane in the Times of Covid-19

An article by Dr Emma Blake, Consultant Paediatrician, now Chair / Convenor of PMHA

Well, in these crazy times – with universal maelstroms – all of us are trying to cope with our personal whirlpools. Being a front line medic, whilst coping as a “full time” parent and teacher; trying to keep yourself, your kids and everyone else around you sane – it’s not manageable, is it?

I wish I had all the answers. Medice, cura te ipsum. Heal thyself. But no-one knows the cure for Covid-19, no immunisation – even against the anxiety and psychological impact of it. As a paediatrician, mother of four, with “shielded” vulnerable relatives; suddenly homeschooling three children and trying to get a “gap-year” son trapped in Vietnam back to the family;  I, like the rest of us, am trying to juggle all the balls whilst wearing minimal / flimsy PPE.

At the PMHA (Paediatric Mental Health Association) we are trying to find resources to support parents who are doing the best they can to care for their children’s health, education and emotional needs at home. A popular PMHA Facebook post (which has currently reached over 9.6 million people!) suggests taking the pressure off ourselves with regard to home-schooling or children; to try to take the stress out of the situation as much as possible.

Enjoy the time together – “cuddle up and read, read, read” etc. The best way to de-stress kids is to de-stress ourselves (often easier said than done). Obviously older kids (GCSEs and A Levels) need more structured work (thank you teachers!), but the principle is the same – our kids will remember what this felt like at home. They will remember the emotions and relationships.

We are seeing an increase in mental health presentations to paediatric wards – when we are doing our best to keep people safe at home. However, not all young people are safe at home. Abuse is escalating, domestic violence and parental mental health / substance abuse difficulties are worsening. As paediatricians, we need to be more aware of mental health and safeguarding issues, more than ever. The most vulnerable children are more hidden from view – and we are waiting for a tsunami (not only from Covid-19 ventilated elderly – but also young people who have had to cope with the “perfect storm”at home).

In addition to our Facebook page; the PMHA, along with Serena Haywood (St Georges) and Simon Chapman (Kings) have also developed a website – Indoor Explorers – to try to bring together resources to support parents at this difficult time.

If you have any useful resources for parents or professionals at this time – please share them with us at ContactPMHA@gmail.com

Dr Emma Blake,
Child Mental Health & General Paediatric Consultant,
Designated Doctor for Safeguarding Children, Isle of Wight,
Vice Chair PMHA and Chair of Child Mental Health (CSAC) at the RCPCH

Where is the voice of the child in weighing the cost of this pandemic?

Frontline paediatricians have written to the editor of the British Medical Journal, advocating for the rights and safeguarding of children 

“We call upon Government to move quickly and decisively to try and repair the harm suffered by young, vulnerable people during this pandemic. Failure to do so will come at a price too high.”

To read the full text of the letter, click below:

https://www.bmj.com/content/369/bmj.m1669/rr-5

Another interesting article in The Guardian

We should be overhauling the school system, not rushing to send children back

By Suzanne Moore on Monday 18th May, 2020.

“The emotional and social development of our children is paramount, not a rushed, unsafe return to constant invigilation.”

Click here to read the whole article:
https://www.theguardian.com/commentisfree/2020/may/18/we-should-be-overhauling-the-school-system-not-rushing-to-send-children-back

Let us know your comments or thoughts …

UNICEF Report: Children in Lockdown – What Coronavirus means for UK children

“Children’s lives have been turned upside down by coronavirus. For some children, with the right support and resources, the situation will
be manageable, but for others the effects of the pandemic will cast a long shadow over their lives. The response to coronavirus already is exposing the fragile situation that many children and young people live in. Hundreds of thousands of children who rely on school, health and social systems and the support of the voluntary sector are being left unprotected as these systems are weakened. Thousands more, unknown to the system, will likely find themselves in need of support over the coming weeks, but as yet remain invisible to authorities…

Click here to read full report.

The PMHA will be at the Royal College of Paediatrics conference (28th April)

A short post to say that the PMHA is going to be at the annual Royal College of Paediatrics meeting on Tuesday 28th April 2020.

The PMHA session is linked with the British Association of Paediatricians in Audiology (BAPA).

The theme of the PMHA / BAPA joint session is ‘difference and self’. Sound intriguing? Why not come along to find out more.

We look forward to seeing you there!