By David Saunders, Health Editor
In Dispatches: Young, British & Depressed, on Monday 29 July at 8pm on Channel 4, Reporter Sanah Ahsan investigates the UK’s youth depression crisis. 1 in 8 young people aged 5 to 19 have a diagnosed mental disorder, demand for access to mental health services is at an all-time high and antidepressant use is on the increase.
Dispatches asks what’s causing the rise in mental health problems among young people, whether antidepressants are being made available too quickly and whether de-stigmatisation campaigns have had an unintended consequence.
Dispatches conducted a survey of 1,000 16 to 30 year olds in the UK. It revealed:
· 68% think they have had or are currently experiencing a mental health problem.
· 61% think that mental health de-stigmatisation campaigns have been helpful to talk about mental health problems in general
· 62% who think that they have or have had a mental health problem say that de-stigmatisation campaigns have helped them identify it.
But Dispatches discovered that whilst mental health de-stigmatisation campaigns have undoubtedly had a positive impact on society’s ability to talk about their mental health and reduce stigma, some are questioning whether the dial has swung too far and think people are presenting themselves as experiencing depression and anxiety when in fact, they are going through normal human emotions.
Dispatches conducted a survey of 1,000 GPs across the UK,
58% believe an unintended consequence of destigmatisation campaigns has resulted in more people wrongly believing they have a mental health problem.
63% frequently see patients who have self-diagnosed a mental health problem
NHS Consultant Psychiatrist Professor Sami Timimi who works with children and teenagers believes mental health is being diagnosed too quickly in some young people and many are just responding normally to difficult situations.
He said: “We’re promoting the idea that we should talk about things more often and it’s ok to have a mental health problem, but it’s made us afraid of emotions…it’s as if when you experience intense emotions, that’s a sign that you’ve got a mental health problem, that’s a sign that there’s something wrong with you and it’s putting intense emotions into a bracket other than the ordinary things that people experience when they’re growing up. And I think that’s a very unhelpful cultural message. I’d rather that we were popularising the message that growing up is difficult, that we are actually quite resilient, that most people get through these difficult periods in their life.”
Jenny – a young person featured in the programme told Dispatches: “These campaigns are asking people to reach out for help, it’s ok to feel this way, it’s ok like there’ll be help there if you reach out. There isn’t. There isn’t help. And so I actually think it’s dangerous that we’re telling people that and it’s not the case.”
Last year there were 700,000, referrals of children and young people under 19 into mental health services – a 45% increase in two years and two out of three people aren‘t getting the treatment they need. Recent data shows half of children needing specialist treatment waited more than four and a half months after their initial assessment.
Dr Marc Bush from Mental Health charity Young Minds says this is not good enough: “I think what we need is every government to prioritise mental health. There’s been historic underfunding of children’s mental health. Lots of young people and families we talk to say they wait far too long to access a specialist service and sometimes they’re turned away because their level of need isn’t deemed great enough. And that’s really worrying because we don’t want people to end up with complex needs and we don’t want them to end up in a place of crisis.”
Dispatches: Young, British & Depressed also reveals that as the mental health system is overstretched, more young people are turning to antidepressants. Data obtained by Dispatches reveals:
In 2018-19 nearly 7.6 million people in England were prescribed antidepressants
That is a 10% increase in 3 years, and a 3.5% increase in a year.
For children, there is only one antidepressant for which clinical guidelines say the benefits outweigh the risks. Guidelines advise they should only be prescribed following assessment by a psychiatric specialist and alongside psychological support.
Data obtained by Dispatches reveals:
The number of under 18s prescribed antidepressants had its biggest yearly increase for three years.
In 2018-19, 55,210 under 18s were prescribed antidepressants – seeing the biggest yearly increase since 2015 (+2.4%)
NB: These raw figures are lower than previously reported because of a new statistical model the NHSBSA use to avoid inaccurate reporting in the past by double counting patients between age groups.
The Dispatches survey of GPs across the UK revealed:
· 86% agree antidepressant prescribing across all age groups has increased due to lack of access to other services.
· 39% of GPs do prescribe to under 18s but only 1% of them think it’s the best treatment for depression.
Parveen – aged 18 – was referred by her GP for adult talking therapy but on account of the waiting time was prescribed antidepressants as an interim measure . She told Dispatches: “The therapist said to me on the phone, I’m not gonna lie to you, the waiting list is like five to six months. I went back to my GP. She was just sort of like OK well I’m going to prescribe anti-depressants. I was thinking why am I being given antidepressants because I just want to talk to someone but I didn’t have that and I wasn’t getting access to it. So I took them for two days and the second day, I remember that was the first time I self-harmed. And it was self-harm with, like, the intent to take my own life. And my mum found me and then called the ambulance. “
Three months after Parveen tried to take her own life, she’s learned her treatment has been delayed again.
Some young people find antidepressants are a useful and helpful part of their treatment, and many people do not experience any negative side effects and have positive experiences on the drugs. However Dispatches investigated the potential withdrawal effects from antidepressants that some people can experience when they stop taking them. Current clinical guidelines on withdrawal from antidepressants state that symptoms are usually mild and last a week.
Dr James Davies, from University of Roehampton, has been leading a study charting some patients’ experiences of withdrawal from antidepressants. He told Dispatches: ”We found that antidepressant withdrawal is far more common, severe and long lasting than our current national guidelines acknowledge…these guidelines say that withdrawal is invariably mild, resolving over about a week. The research shows however that about half of people who take antidepressants experienced withdrawal. Up to half of those report that withdrawal as severe, and a significant proportion experienced withdrawal for far longer than one week, for many weeks and in some cases months and beyond.”
He added: “What we often see are people either staying on the medications because it’s difficult to stop or when they do stop, those painful withdrawal reactions are being misread or misdiagnosed and the drugs are being reinstated. In the most severe cases we’ve seen people commit suicide as a consequence of not being able to bear the severity of the symptoms.” [xvi]
22 year-old Peter decided to come off antidepressants after three months. He followed his doctor’s advice to skip a pill every other day, but the next day he began experiencing severe effects. He told Dispatches: “I just noticed this kind of sudden feeling of being completely faint and just as if I was about to collapse. And it would just last in a short burst for about half a second. By the end of the day I couldn’t move my head. Anytime I’d move my head to the right I’d get this this shocking sensation on my entire body I almost felt as if I was going to die. It was much more intense than I ever could have imagined it would have been.”
He added: “It took me o
ne month to lower the dosage to come off and even to this day I still have kind of withdrawal symptoms or the occasional brain zap. The GP told me when I was coming off that, you know it might be a bit hard but they didn’t really tell me when I was going on it.”
People who are already taking antidepressants should not stop taking them without seeking medical advice.