Lasting impressions

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Early trauma can have a devastating effect on children, leaving them more likely to misuse drugs and alcohol. We need to be ready to help at this formative stage, say Addaction and YoungMinds.

Children who experience trauma are more likely to misuse drugs and alcohol – a situation that needs to be tackled urgently by local commissioners, say Addaction and YoungMinds. The two charities have joined forces to publish Childhood Adversity, Substance Misuse and Young People’s Mental Health, a briefing paper and action plan that aims to help young people avoid high risk substance misuse and further trauma from being criminalised.

The paper has been sent to all clinical commissioning groups across the country and urges local commissioners and providers to do more to tackle the issue, including making drug and alcohol education universal across all schools.

Among key issues, it highlights that children who have experienced four or more adverse childhood experiences – like abuse, neglect, domestic violence, taking on adult responsibilities or living in households where people misuse substances – are twice as likely to binge drink and 11 times more likely to use crack cocaine or heroin.

If children regularly use substances from an early age, it can substantially impact their neurobiological and cognitive develop­ment, as well as affecting their ability to learn skills to self-soothe or self-regulate when faced with further emotional stress. Ultimately, this has a negative impact on their physical and mental health.

More than 200,000 children in England now live with at least one adult who is alcohol dependent, which can have a significant impact on their parenting abilities and make it more likely they’ll expose their child to adversity and trauma – often leading to an intergenerational cycle.

As their substance misuse escalates, young people can find themselves face to face with the police or youth justice system, where neither their mental health, nor the trauma they have faced is adequately addressed.

‘Young people get a rough ride in the media with sensationalist headlines about drug or alcohol use,’ says Addaction’s chief executive Mike Dixon. ‘It’s vital we stand up and highlight that for some young people, use of drugs or alcohol is their attempt to numb or cope with trauma or emotional distress. We can better support young people if commissioned services are trauma-informed and if professionals understand why and how young people use substances.’

Rick Bradley is operations manager of Addaction’s Mind and Body programme, aimed at young people at risk of self-harming. ‘We must ensure young people can talk openly about mental health and substance use without fear of being judged and stigmatised,’ he says. ‘Talking to peers has helped the young people on the Mind and Body programme realise it is okay not to be okay all of the time, with three in four reporting an improvement in wellbeing. We hope we can inspire and empower other young people to follow their lead.’

‘We know that children who have had a difficult start in life are far more likely to develop long-term mental health problems, and drugs and alcohol misuse may often play a role in this – that’s why it’s crucial that commissioners invest in early intervention to ensure that the children most at risk get the right support quickly,’ says Dr Marc Bush, chief policy adviser at YoungMinds.

‘It’s also vital that professionals working in A&E departments or in specialist drug and alcohol services have the skills they need to explore whether young people are self-medicating as a way of managing painful feelings and memories. We need to dig beneath the surface and make sure we address the cause of dangerous behaviour in young people, and not just the symptoms.’

To read the full briefing click here

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National Young Person’s Conference success

Young people from all over the UK came together for Addaction’s recent National Young Person’s Conference at The Oval cricket ground.

The event was a chance for young people to speak frankly about their experiences growing up, how they find accessing the support on offer at Addaction and more generally within mental health and substance misuse services.

While drug and alcohol issues among young people have been broadly in decline since 2001, self harm is increasingly common. The conference gave young people the chance to talk to staff and professionals about why that might be, and what life’s like for a teenager right now.

A panel of young people offered their thoughts including:

• ‘When people say it’s “just my hormones” I think: but maybe it’s not. Listen, maybe I actually am going through something.’

• ‘As a teenager I feel I have to be strong and confident… if I were to break down in tears randomly, I think I’d get judged.’

• ‘I think it’s difficult having to balance out your school life, social life, and getting enough sleep. Especially if you have a weekend job. They say you’re supposed to have eight hours sleep. But that can actually be hard.’

• ‘Family wants you to do well, so the pressure they put on you can make you feel really stressed. And like you’re also putting pressure on yourself. I feel like the stress is real but you need to find that balance between working hard and having fun – believing in yourself that you can do well.’

• ‘At primary school, you can rely on the adults and older children to look up to. When you’re in secondary school, suddenly it’s you – you are that older child people need to look up to. And expectations come from teachers, parents and ourselves.’

• ‘I feel like there’s two kinds of stereotype, where you’re either really stressed and working hard to do well all the time, or you’re not doing any work at all and you’re lazy… and it’s more complicated than that.’

The event also marked the release of the expert briefing, Childhood adversity, substance misuse and young people’s mental health. Sarah Brennan, chief executive of YoungMinds, outlined the premise of the report, emphasising that while we are seeing the stigma around mental health shift, ‘for young people it’s still tough’.

In a talk on ‘health, social function and wellbeing’, Professor Harry Sumnall of the Centre for Public Health commented that ‘the role of good policy is to provide positive, supportive healthy environments – young people waiting 19 weeks to be seen by CAMHS is a political issue’. Shirley Cramer of the Royal Society for Public Health then shared #StatusofMind, a recent report from the RSPH and the Young Health movement, examining the positive and negative effects of social media on young people’s mental health.

The biggest cheer of the event was for a short film Step Out of the Crowd, put together by Addaction’s Mind and Body staff and service users. In it, young adolescent men talk about self-harm, the importance of talking about their feelings, and their hopes for the future.

Visit Addaction’s YouTube channel to see the film or the Facebook page to watch the talks.

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Addaction and YoungMinds are calling for local commissioners to ensure that local services provide support for children and families by:

Making sure all young people at primary and secondary school receive universal-level, age-appropriate drug and alcohol education and psychoeducation, looking at risks, relationships and how to build resilience for decision-making. This should be delivered by those with a good knowledge of child adversity, trauma responses, mental ill health and substance use.

Introducing route enquiries about childhood adversity at A&E, urgent care, and specialist drug and alcohol services.

Investing in early intervention models. Research is clear that the age a young person starts using substances is a strong predictor of the severity of their use later on in life. Early intervention should initially be targeted at children with a known risk factor or in a vulnerable group, eg looked-after children or young offenders.

Building targeted support for parents and the whole family to promote recovery from addiction, alongside addressing adversity the children have been exposed to.

Establishing inter-agency collaboration to make sure all a young person’s needs are met, while recog­nising any trauma and adversity they’ve experienced.

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