Healthwatch Blackpool Children & Young People Emotional Well-being Report October 2015 www.healthwatchblackpool.co.uk
Introduction Earlier this year “Future in Mind: Promoting, protecting and improving our children and young people’s mental health and wellbeing” was published. This described an integrated whole system approach to driving further improvements in children and young people’s mental health outcomes with the NHS, public health, local authority, voluntary and community sectors all working together. Each Clinical Commissioning Group (the people responsible for the development and commissioning of local health and care services) in the country is expected to develop a Local Transformational Plan which will identify how they plan to improve and “transform” services and support for children and young people. This will cover a whole spectrum of services from prevention to interventions, for emerging and existing mental health issues as well as transitions between services. In order to do this successfully it is important that the needs and issues of the children and young people of Blackpool are sought, understood and communicated to those responsible for developing the plans. Research, consultation and analysis has already begun in our local community and we are aware of a number of forthcoming consultation and engagement exercises that are planned for the New Year, including an event at Blackpool Zoo in January 2016. With these exciting plans underway - and in view of the importance and concerns that were expressed around mental health issues during our April/May 2015 survey. We felt it would be worthwhile to conduct some independent consultation with our local children and young people which can also be considered by our commissioners and those involved in the transformation plan for Blackpool.
Our aim: To identify issues that affect the emotional wellbeing of the children and young people of Blackpool. The coping strategies they adopt, the support mechanisms in place and their suggestions on how we can improve the support available.
Our approach: We developed a series of questions with a small group of young people to help us to capture and quantify the aims of our research. This was then “tested” during a focus group and refined using their input and suggestions. We recognised and were told by the young people that a lengthy survey is not particularly engaging so we did limit the questions we asked and at their suggestion included an artistic element whereby the children and young people could express their understanding of mental health in graphics or picture format. Some of the pictures have been included in this report. We approached pastoral teams within the local high schools to request their support in promoting the survey amongst their pupils. We hoped we might be able to have “drop-in” sessions within the schools and advertise the survey link on their websites and through social media but were unsuccessful in establishing any meaningful connections or engagement. This may have been a timing issue as the survey was launched in early September just at the start of a new term. We did however use school twitter feeds to promote our survey to pupils and were successful in engaging people through Facebook. In addition to the “on-line” engagement we linked in with a number of young people’s groups and forums including the Boys and Girls Club, Victoria’s Voice, Headstart and Pupil Referral Units where we were able to attend and talk directly with children and young people to gather their views and experiences. We received a total of 207 responses from males (44%) and females (56%) aged 11 – 18 which includes qualitative and quantative information, of which the key points are detailed in this report. Thank you to: Dave Blacker and the young people at Blackpool Boys and Girls club, Rachael Slater, Hayley Mills and the rest of the staff at Headstart. Christine McKenzie-Townsend. Linda Jones and Steven Edwards at Lancashire Care Foundation Trust. Disclaimer Please note that this report relates to views collected over the specific dates 1st September – 31st October 2015. Our report is not a representative portrayal of the experience of all members of the community just the 207 who completed our survey.
Healthwatch Blackpool – Children and Young People’s Mental Wellbeing We were interested in finding out the sorts of issues that affect the children and young people (CYP) of Blackpool. We asked them to indicate the types of problems that they perceive to be a concern or worry for young people and whether they have actually directly experienced this issue. What issues do young people face? The biggest issue that was identified through our survey was around body image alongside self-confidence and self-esteem. Almost half of the CYP reporting that they worried about their looks often or all of the time, an issue affecting mostly females (70%). It was recognised that other people also had body image issues but their perception of whether this was an issue for others was much lower. Over a quarter felt they didn’t fit in with their friends, and 9% had issues around their gender and sexual identity.
Significant numbers (44%) worried as a result of internal pressures - expectations placed on themselves which affected their emotional wellbeing (making them unhappy or sad) often or all of the time. Just over half of the CYP reported that bullying was a concern, either face to face or through social media. The numbers of people who reported to have been directly bullied were slightly lower - 35% said that they had directly experienced face to face bullying and 23% had experienced bullying through social media, these figures are significant and concerning. It is interesting to note that 65% of those who had experienced bullying were female. Peer pressure also emerged as an issue with over a quarter of the young people reporting that they had experienced their friends putting pressure on them to do something they didn’t want to do, making them unhappy often or all of the time.
Significant numbers of the CYP worried about school, exams and the future. 38% of the young people that we surveyed said that schools placed expectations on them that affected the way they feel (made them unhappy or sad) often or all of the time. Over half worried about exams and results and 40% worried about what they were going to do upon leaving school all of the time or often. These figures are in keeping with the age ranges of the respondents (42% were aged 14 – 16) which might suggest that years 9 – 11 are a period whereby pressures of school and the future have the most effect on CYP’s emotional wellbeing.
Emotions and Effects We were interested in the feelings that were evoked and the effects of issues the CYP were experiencing or had experienced with the most common being sadness, anger, frustration, sleep issues and poor school performance/concentration at school. How do young people feel about these issues?
77% reported feeling anger 79% of those felt angry because of bullying they had experienced
81% reported they feel sad 89% of the CYP told us they felt sad because of body image issues Over 1 in 4 felt sad because they were concerned about not fitting in with their friends
72% of our CYP have experienced sleep issues
76% have lost sleep as a consequence of worrying about exams 64% reported to have bad dreams or nightmares 64% reported to have bad dreams because of bullying. or nightmares because of bullying 82%ofofthose thosewho who have experienced 82% have experienced bullying bullying said they had said they had trouble trouble sleeping sleeping 76% have lost sleep worrying about exams
73% said they felt frustrated 77% feel frustrated about the pressures of exams and expectations from school
51% said their issues affected their school performance 62% said school performance was affected as a result of bullying. Almost a third of the CYP we surveyed found it difficult to concentrate at school because of problems at home.
Coping strategies and support mechanisms We all react differently to issues and experiences and adopt a variety of techniques to help us to cope. We were interested in finding out what support networks the CYP turned to and any other strategies they adopted to help them to deal with issues in their lives. How do young people cope with their issues? Almost half of the CYP we surveyed told us that they would mainly turn to their parents or friends for support with their issues. Over half of the CYP said they would never approach their pastoral team or teacher for support with 1 in 5 preferring to look for answers on the internet. Almost a third said that they would never seek support from others instead preferring to write down their worries or concerns. Many of the respondents talked about going to their room, listening to music and playing on their phones/iPads and games consoles were popular strategies to deal with issues. Almost 1 in 8 CYP (aged between 11-16) have taken drugs or alcohol to deal with their issues Around a quarter of CYP have self-harmed: 42% of those have issues around their body image 41% have experienced bullying of some form.
“I like to write things down, nobody has to see it but it makes me feel better” “I listen to music, think about all the positives in my life and try to forget the bad and if it doesn't work I try to talk with my best friend. It helps me become calm again.” “I go upstairs and play on my phone or do some crafts to get it out of my mind.”
“I normally talk to my family or just try to calm myself down or play with my friends or just read.”
What more could be done to support young people? .
The children and young people of Blackpool who completed our survey gave us a variety of suggestions as to how they could be better supported to deal with their issues and experiences now and in the future. The message that came through loud and clear was that they wanted somebody who would listen to them, be able to empathise and understand how they were feeling. Many reported that they didn’t feel able or want to talk to their teachers, peer mentors was suggested by a number of the CYP. “Try to be more understanding and don't judge us because it doesn't help. If we are telling you why we feel this way don't interrupt because it gets harder to explain the second time.” “People might want to listen to you instead of making accusations about how you’re feeling” “The school judge you for everything!! If you feel sad they are like GROW UP. No. I will not talk to the school ever” “Some-one to talk to that isn't always busy” “A younger person who is a support pastoral carer” “Don't pressure us into talking, we'll gain the confidence sooner or later. Don't patronize us, it makes us feel worse. Don't treat boys with mental health issues differently to girls, we all have the same feelings” “I think having like a calm down room or things like that in schools where young people can go if they are feeling really stressed or anxious or frustrated. I think it would help a lot of people and improve their mental health.”
What is mental ill health? Finally, we wanted to understand if children and young people understood what mental ill health was which might give us an insight into their potential for identifying signs in themselves and others. The responses would suggest that most of the children and young people in Blackpool (aged between 11– 18) who completed this survey had a basic to good understanding of what the term mental health relates to. 19% (almost 1 in 5) reported that they felt they may have an undiagnosed mental health condition.
“When people cut themselves and are aggressive” 14yr old male
“When you have trouble completing everyday activities” 13yr old female
“Something is wrong with your brain” 14yr old male
What is mental health?
“Where you go crazy” 11yr old female “A burden in your life that just can’t be fixed permanently” 14yr old female
“Not being in control of yourself” 11yr old female
“Something that can’t be seen physically for people to understand” 14yr old female
“Getting angry too easy feeling upset or worthless” 14yr old female
Summary of findings
Issues around self and body image, bullying and the pressures of school and exams are the most common issues for the children and young people of Blackpool who completed our survey.
As a result of experiencing a whole range of issues, the CYP reported feelings of sadness, anger and frustration. Many experienced sleep issues and many felt that their school performance had been affected as they found it difficult to concentrate at school when experiencing difficulties in their lives.
Almost 1 in 4 of our children and young people have self-harmed, and almost 1 in 8 have used drugs or alcohol as a result of experiencing issues or difficulties in their lives.
Most people do have support networks they can turn to in times of need and it was reassuring to find that many turned to their parents or friends. Only a minority of the children felt able to talk to their school or teacher if something was worrying them.
19% of the children and young people felt that they might have a mental health issue.
Many of the children and young people reported that they felt people didn’t listen to them and understand them. They didn’t have any definitive answers as to how support could be improved but a number suggested it would be helpful to talk to a peer who might understand how they are feeling.
Diversity and Ethnicity Data Ethnicity White Asian White British White Other Asian Other Black British Chinese Polish Mixed White and Black Caribbean
0.5% 92.86% 2.04% 1.02% 0.51% 1.02% 0.51% 1.53%
Age 11 12 13 14 15 16 17 18
27.78% 6.57% 20.71% 22.22% 15.15% 4.55% 1.52% 1.52%
Gender Male Female
44% 56%
We asked young people to draw what they thought of when they think of mental health:
