Young
minds at risk
Julian Smithells reports on the annual conference of the NAMH which was concerned with the vulnerability of adolescents and their need for special consideration in the field of mental health.
research with working adolescents tb?
Adolescents make up the most psychiatrically underprivileged section in the community. We have hardly any people or special facilities to treat them when they seek help and surprisingly little specialised knowledge about the problems and difficulties which they face in growing up. These were points made at the annual conference of the National Association for Mental Health held in London on February 23 and 24. Its theme, 'Young minds at risk', was calculated to make headlines, and it did. E. M. Eppel, Senior Lecturer in Developmental and Educational Psychology, University of Sussex, examined some of the developmental tasks facing the adolescent. First, he had to understand and accept the bodily changes at puberty which sometimes led to 'agonised self-consciousness'. More crucial was the adolescent's need to establish emotional independence from his parents so that he could make the choices and decisions appropriate to adulthood relatively
In his
Parental
leavers who had become recognised as during their school careers, to see how they fared aflf1 to maintain contact with them. This information, collated centrally in a way which would permit anal)'' sis, would show the size of the problem. But, the professor told delegates, we also action. For instance, the number of places for the adult subnormal in sheltered workshops ba been seriously under-estimated and he thought even the 29,000 places planned for 1974 would short of the need. Well run sheltered
untrammelled by infantile emotional ties. concern
Some adolescents found themselves firmly held by 'emotional grappling hooks' while others were helped and rehearsed in the necessary task of achieving autonomy. Too much intense parental concern could block the movement towards autonomy; too little could make the young person feel abandoned and insecure. Many adolescents appreciated parental sup-
port.
Mr. Eppel said some people felt it was both inevitable and desirable that many adolescents sought support in their interim stand against the adult world among people of their own age. Others, however, believed the teenage culture provided a weak and unsatisfactory solution to the adolescent's tasks by draining off necessary tensions into an encapsulated world characterised by conformity and lack of individuality.
own
speaker had found that the need to establish a wort able and acceptable system of values was not tbc prerogative of the most articulate and highly educated 'Most of our subjects showed a genuine, if confused concern with moral issues, with questions of socfr1 justice, violence and discrimination.' They were ofte" acutely conscious of the difficulty of living up their ideals, and of the extent to which they might fa'
t(|
short of what
Severely
they expected of themselves.
disabled
Professor Jack Tizard, Professor of Child Develop' ment at London University's Institute of Education said the majority of mentally handicapped pupils l^1 school able to work and live in the community ordinary people, but many had a hard time of it. Mot1 radical action was needed to help the severely disable for whom ordinary employment in the open was scarcely possible. We lacked reliable estimates their numbers and the first task confronting a authority should be to assess the number of
markej loc^ scho0^
handicapp^
,
need^ requif^ tb^
workshop5,
community's specialist medic3j social work facilities and providing education^ cultural opportunities for the handicapped, cot^
closely linked with
the
and and be the cornerstone of our welfare services. ? Professor Tizard did not believe that cost was major obstacle: 'Rather, we have to convince peop'
1
Young
minds at risk
that what
we are
that is
Indictable
is worthwhile; and the way worthwhile.'
doing
to make it
to
offences
P. R. Boyd, research and clinical assistant in charge of the adolescent unit at the Academic Departof Psychiatry, Middlesex Hospital Medical School, provided disquieting evidence of the growing dumber of young psychiatric casualties and of the inadequacy of the facilities provided to help them. The number of young people aged 14-20 found Suilty of indictable offences had doubled in the last fline years, he said, and many offenders suffered pers?nality disorders. The number of first admissions to Psychiatric hospitals in the age group 10-19 had risen r?m 1,500 in 1956 to over 4,500 in 1964. The suicide rate in male adolescents aged 14-20 had begun to drift in the last few years and in 1965 had reached ^ Per million of the population within this age group, to the Home Office, there had been no heroin addicts in the under 20 age group up 1959, but by 1965 there were 134. rBoyd said expert provision for the disturbed Youngster was urgently needed, but there were hardly Units or people equipped even to assess the need, quoted from a letter to The Times in which ProDenis Hill had said it would be difficult to find dozen suitable senior psychiatrists in the whole of ^ ?"{tain who were experienced in work with malujusted adolescents and able to teach and train to do this work. hat psychiatric facilities did exist for the disturbed .descent? There were at present only ten adolescent in England and Wales and they provided a total about 195 beds, or four beds per million of the ?Pulation, whereas the Ministry recommendation 20-25 beds per million. Psychiatric provision at schools was equally inadequate?an average three psychiatric sessions per school, per month, uult psychiatric units could seldom offer the time or e expertise to the adolescent outpatient who quickly that his needs would not be met adequately by e usual interview in the ordinary psychiatric outdepartment. 'Waiting lists are of little value the adolescent and in my opinion should not exist,'
ment
farming
^PWards
^cording
j^gistered
per
^hers
JUts
aas ^Pproved ^Used
tQ\ent
Dr. Boyd. ^ called for 6
a
?lescent
taue^Se
more
comprehensive approach
to
treatment. Adolescent mental care was an w*"ck kac* to be studied, experienced and
Vi
sessions the afternoon session of the first day speakers ^ Sented slides on the conference themes. Mr Michael
prering
ane, formerly
headmaster of Risinghill School, anc* now *ecturer in education at London to^ au^ience about the problems of ad v lescents caused by the discrepancies between at ^hool, and in the outside world. Dr. W. H. n gave an illustrated talk on the Wessex S'onal Hospital Board adolescent psychiatric unit,
t
col?
'
??es'
,
A]]Uu^ ^eC.
of which he is a director. Dr T. A. I. Rees, Medical Officer of Health for Plymouth, spoke about an adult subnormal training centre in his area.
'Huntingdon
scheme'
On the second day Mr. F. R. Gibbins, a social worker for handicapped pupils at the Education Department of Huntingdon and Peterborough County Council, described the 'Huntingdon Scheme' under which communication with handicapped children, their homes and schools is built up some two years before they are due to leave school and is maintained nominally for a further two years after they have left. He said that he had found that the dull and deprived youngster tended to come unstuck at work when there was not enough to do, and when there were two or more people in charge who might give contrary
instructions.
Dr. Pamela Mason, Consultant Psychiatrist to the Home Office, reaffirmed that adult treatment patterns could be the reverse of therapeutic for the adolescent and called for fresh thinking about the concept of treatment. There was a need not only for beds, but
for emergency centres, day hospitals, night hospitals, and specialised arrangements for short-term and longterm care and aftercare. Educational psychologist and author James Hemming said the resources for a 'network of care' for young people already existed in our school system. He wanted to see more inter-communication between members of staff and between schools and guidance clinics and the school psychological service.
Masterly
survey
The final
speaker at the conference was the Rt. Hon. Roy Jenkins, M.P., Home Secretary, who provided a masterly survey of the roles of the statutory services? the probation service, approved schools, prisons and borstals?in providing appropriate training and,
where necessary, treatment, for the young offender. But, he said, nobody could suppose that court pro-
ceedings were an adequate test of the need for action by society. The problem was to develop an effective system of identifying and helping young people with problems before they became offenders. Research had shown that delinquency, for instance, was not an isolated entity, nor delinquents a clearly definable type of person, and research therefore needed to be based on a wider front than delinquency
alone. Mr. Jenkins told the conference it was a basic function of government to provide a healthy physical and social environment in which a sense of community, responsibility and self-help could flourish. It was also its function to 'pick up the pieces' when things went wrong. What governments could not do themselves was to create, by direct action, improved human qualities, and a better quality of community life. The extent of the risk to young minds in this country today was connected very closely with the quality of our
society. ID
minds at risk
Julian Smithells reports on the annual conference of the NAMH which was concerned with the vulnerability of adolescents and their need for special consideration in the field of mental health.
research with working adolescents tb?
Adolescents make up the most psychiatrically underprivileged section in the community. We have hardly any people or special facilities to treat them when they seek help and surprisingly little specialised knowledge about the problems and difficulties which they face in growing up. These were points made at the annual conference of the National Association for Mental Health held in London on February 23 and 24. Its theme, 'Young minds at risk', was calculated to make headlines, and it did. E. M. Eppel, Senior Lecturer in Developmental and Educational Psychology, University of Sussex, examined some of the developmental tasks facing the adolescent. First, he had to understand and accept the bodily changes at puberty which sometimes led to 'agonised self-consciousness'. More crucial was the adolescent's need to establish emotional independence from his parents so that he could make the choices and decisions appropriate to adulthood relatively
In his
Parental
leavers who had become recognised as during their school careers, to see how they fared aflf1 to maintain contact with them. This information, collated centrally in a way which would permit anal)'' sis, would show the size of the problem. But, the professor told delegates, we also action. For instance, the number of places for the adult subnormal in sheltered workshops ba been seriously under-estimated and he thought even the 29,000 places planned for 1974 would short of the need. Well run sheltered
untrammelled by infantile emotional ties. concern
Some adolescents found themselves firmly held by 'emotional grappling hooks' while others were helped and rehearsed in the necessary task of achieving autonomy. Too much intense parental concern could block the movement towards autonomy; too little could make the young person feel abandoned and insecure. Many adolescents appreciated parental sup-
port.
Mr. Eppel said some people felt it was both inevitable and desirable that many adolescents sought support in their interim stand against the adult world among people of their own age. Others, however, believed the teenage culture provided a weak and unsatisfactory solution to the adolescent's tasks by draining off necessary tensions into an encapsulated world characterised by conformity and lack of individuality.
own
speaker had found that the need to establish a wort able and acceptable system of values was not tbc prerogative of the most articulate and highly educated 'Most of our subjects showed a genuine, if confused concern with moral issues, with questions of socfr1 justice, violence and discrimination.' They were ofte" acutely conscious of the difficulty of living up their ideals, and of the extent to which they might fa'
t(|
short of what
Severely
they expected of themselves.
disabled
Professor Jack Tizard, Professor of Child Develop' ment at London University's Institute of Education said the majority of mentally handicapped pupils l^1 school able to work and live in the community ordinary people, but many had a hard time of it. Mot1 radical action was needed to help the severely disable for whom ordinary employment in the open was scarcely possible. We lacked reliable estimates their numbers and the first task confronting a authority should be to assess the number of
markej loc^ scho0^
handicapp^
,
need^ requif^ tb^
workshop5,
community's specialist medic3j social work facilities and providing education^ cultural opportunities for the handicapped, cot^
closely linked with
the
and and be the cornerstone of our welfare services. ? Professor Tizard did not believe that cost was major obstacle: 'Rather, we have to convince peop'
1
Young
minds at risk
that what
we are
that is
Indictable
is worthwhile; and the way worthwhile.'
doing
to make it
to
offences
P. R. Boyd, research and clinical assistant in charge of the adolescent unit at the Academic Departof Psychiatry, Middlesex Hospital Medical School, provided disquieting evidence of the growing dumber of young psychiatric casualties and of the inadequacy of the facilities provided to help them. The number of young people aged 14-20 found Suilty of indictable offences had doubled in the last fline years, he said, and many offenders suffered pers?nality disorders. The number of first admissions to Psychiatric hospitals in the age group 10-19 had risen r?m 1,500 in 1956 to over 4,500 in 1964. The suicide rate in male adolescents aged 14-20 had begun to drift in the last few years and in 1965 had reached ^ Per million of the population within this age group, to the Home Office, there had been no heroin addicts in the under 20 age group up 1959, but by 1965 there were 134. rBoyd said expert provision for the disturbed Youngster was urgently needed, but there were hardly Units or people equipped even to assess the need, quoted from a letter to The Times in which ProDenis Hill had said it would be difficult to find dozen suitable senior psychiatrists in the whole of ^ ?"{tain who were experienced in work with malujusted adolescents and able to teach and train to do this work. hat psychiatric facilities did exist for the disturbed .descent? There were at present only ten adolescent in England and Wales and they provided a total about 195 beds, or four beds per million of the ?Pulation, whereas the Ministry recommendation 20-25 beds per million. Psychiatric provision at schools was equally inadequate?an average three psychiatric sessions per school, per month, uult psychiatric units could seldom offer the time or e expertise to the adolescent outpatient who quickly that his needs would not be met adequately by e usual interview in the ordinary psychiatric outdepartment. 'Waiting lists are of little value the adolescent and in my opinion should not exist,'
ment
farming
^PWards
^cording
j^gistered
per
^hers
JUts
aas ^Pproved ^Used
tQ\ent
Dr. Boyd. ^ called for 6
a
?lescent
taue^Se
more
comprehensive approach
to
treatment. Adolescent mental care was an w*"ck kac* to be studied, experienced and
Vi
sessions the afternoon session of the first day speakers ^ Sented slides on the conference themes. Mr Michael
prering
ane, formerly
headmaster of Risinghill School, anc* now *ecturer in education at London to^ au^ience about the problems of ad v lescents caused by the discrepancies between at ^hool, and in the outside world. Dr. W. H. n gave an illustrated talk on the Wessex S'onal Hospital Board adolescent psychiatric unit,
t
col?
'
??es'
,
A]]Uu^ ^eC.
of which he is a director. Dr T. A. I. Rees, Medical Officer of Health for Plymouth, spoke about an adult subnormal training centre in his area.
'Huntingdon
scheme'
On the second day Mr. F. R. Gibbins, a social worker for handicapped pupils at the Education Department of Huntingdon and Peterborough County Council, described the 'Huntingdon Scheme' under which communication with handicapped children, their homes and schools is built up some two years before they are due to leave school and is maintained nominally for a further two years after they have left. He said that he had found that the dull and deprived youngster tended to come unstuck at work when there was not enough to do, and when there were two or more people in charge who might give contrary
instructions.
Dr. Pamela Mason, Consultant Psychiatrist to the Home Office, reaffirmed that adult treatment patterns could be the reverse of therapeutic for the adolescent and called for fresh thinking about the concept of treatment. There was a need not only for beds, but
for emergency centres, day hospitals, night hospitals, and specialised arrangements for short-term and longterm care and aftercare. Educational psychologist and author James Hemming said the resources for a 'network of care' for young people already existed in our school system. He wanted to see more inter-communication between members of staff and between schools and guidance clinics and the school psychological service.
Masterly
survey
The final
speaker at the conference was the Rt. Hon. Roy Jenkins, M.P., Home Secretary, who provided a masterly survey of the roles of the statutory services? the probation service, approved schools, prisons and borstals?in providing appropriate training and,
where necessary, treatment, for the young offender. But, he said, nobody could suppose that court pro-
ceedings were an adequate test of the need for action by society. The problem was to develop an effective system of identifying and helping young people with problems before they became offenders. Research had shown that delinquency, for instance, was not an isolated entity, nor delinquents a clearly definable type of person, and research therefore needed to be based on a wider front than delinquency
alone. Mr. Jenkins told the conference it was a basic function of government to provide a healthy physical and social environment in which a sense of community, responsibility and self-help could flourish. It was also its function to 'pick up the pieces' when things went wrong. What governments could not do themselves was to create, by direct action, improved human qualities, and a better quality of community life. The extent of the risk to young minds in this country today was connected very closely with the quality of our
society. ID
