55. Saving the early intervention service, till later.

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An uneasy meeting at a fancy dress party.

It’s official. Children cost too much. Childcare costs more than a mortgage. If you have children they might stop you going to work, and they eat a lot too. Shouldn’t people be told this sooner? Worse than that, children don’t come with any kind of guarantee, and more of them seem to be going wrong. If Toyota had made them there’d be a recall. And soon a Commons Committee on young people’s mental health will start its proceedings.

Though there are rumours that mental health problems among teenagers have increased, there has not been a proper survey since 2004, when the world was very different. It’s hard to believe, but they didn’t even have Instagram in those days, let alone Whatsapp. People wore top hats and tail coats and travelled by horse, particularly the women.

There are lots of theoretical reasons why it’s got worse to be a teenager. Legal highs are widely available, the Harry Potter series came to an end, and no-one is far enough beyond suspicion to take over hosting Jim’ll Fix It, unless Desmond Tutu can be persuaded. Large numbers of youngsters have been sent to remote labour camps, or universities as they are now known. Employment opportunities as footballers and TV presenters, the only jobs worth having, have largely dried up.

Sadly, if a generation of teenagers became psychotic or depressed, no-one would really notice. Part of the blame belongs to British psychiatry and its strange tradition of age discrimination. For some reason we have different specialists for young, adult and older people, as though they were totally different forms of life – like eggs, caterpillars and butterflies respectively.

There’s a kind of reason for that, in that young people don’t really get the same kind of mental illnesses as adults. Psychotic conditions are very rare in children, or so we thought. ‘Early intervention’ services were an attempt to plug the gap, at least for older teenagers who seemed to be showing signs of schizophrenia. Early intervention was a laudable aspiration, but didn’t get much beyond that, since there was no litmus test for psychosis. The services were overwhelmed to an extent, by the numbers of children with emotional disorders, such as so-called ‘borderline’ personality; problems that,in a sense, flow from children being treated as commodities instead of people.

To cut a long story short, another tonne of anti-psychotics wended its way to the sewerage system, some of it via people. The early intervention services have been pruned back rather savagely, before they had a chance to flower. Doubtless the Commons Health Committee will come to regret this. In the meantime, services for teenagers are largely restricted to a skateboard area and free condoms at the library, for those who are brave enough.

When the large mental hospitals were closed down, some people warned that community services would be much easier to cut. It’s to do with visibility. Some of the asylum hospitals were the size of aircraft carriers; quite likely some of them had their own Harrier Squadron. They certainly had farms, ballrooms and cricket pitches. Everyone has noticed they’ve gone.

The coalition government has been quite tough on aircraft carriers, and luckily there won’t be one to send to the Crimea. But having a carrier with no aircraft to go on top is a major embarrassment. It’s like a Christmas cake without the marzipan, let alone the little decorative church and snowman. Similarly, having a hospital full of closed wards looks a bit wasteful. But if a care assistant only comes half as often, for half as long, or doesn’t visit at all, no-one really notices.

And if your psychotherapist turns out to have one years training at a community college, rather than the 25 year apprenticeship in Vienna and the multiple doctorates you’d expected, it’s hardly a big deal to anyone. Low tech services have a soft underbelly, as do many of the people who work in them – too much driving about eating petrol station sandwiches.

As the community mental health services are scythed back, we hear only a few muffled squawks from politicians. Nick Clegg (deputy prime minister and Britain’s answer to Al Gore) popped up in January, stating that mental health must be given parity with physical health. ‘We have got to take this out of the shadows’, he said. And we can expect a further survey on teenagers’ mental health, probably conducted by social media. But does the government have any coherent plan for teenagers, or are they considered, as a Bond villain might say, ‘expendable’? After all, they don’t vote and they don’t pay much tax. As a species, humans have a reasonable life expectancy at birth, which is a miracle, considering we ride bicycles, but perhaps this is set to change. It’s a bit ominous that youngsters are now being told that world war one was a useful outing.

With the demise of early intervention teams, there should be a move for adult and child psychiatrists to work together more closely, but I see no signs of this. They just drive a totally different kind of Audi.

During vacations I always got a child psychiatrist to cover my work, which he did brilliantly. I doubt whether I’d fare so well with his patients, unless he wanted half of them put on depot injections, and a tonne of complaint letters from parents. And I’m not sure if they still have sandpits to play in, so I wouldn’t know whether to bring my own bucket and spade.

Maybe a reverse takeover is in order, where children’s services take over and everyone is regarded as a child. This is perhaps the only way that children can get treated equitably. The danger is Ofsted staging a coup and taking over the government. And everyone would have to have a CRB check, just to meet anyone else at all. Treating everyone like children has worked well in lots of countries – you know who you are, nanny states.  Perhaps Nick Clegg could consider this. Otherwise, teenagers, like Hank B Marvin, are just going to have to ‘stay in the shadows’.

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