Mind the gap

Freudian slip of the day: I originally typed ‘mind the gay’. Well yes, that too.

Much has been made of the gap between the child and adolescence versus adult mental health services. Possibly to combat this, a huge variety of services have sprung up within the last decade with the aim of helping people aged 18 – 25. There are organisations which provide support groups, free counselling, campaigns, youth mentoring and awareness raising opportunities and so on. It’s all wonderful, and a life line for those who have little other support. But what happens when you reach 26?

By the time you’re 26 and have had a mental health problem (or several) for years, if not a decade plus, things start feeling rather bleak. You are no longer encouraged to hope for full recovery. You are not bombarded with stories of how other people overcame their issues to attend university and discover the cure for cancer. You feel more and more alienated from the increasingly corporate mental health charities, with their shiny case studies of bright young things who got the right help at the right time. The words ‘severe and enduring’ are added to letters and medical notes. You didn’t make it out of the rabbit hole in time, and now your options for the future are beginning to seem rather limited. Time has crept away.

Where are the services for people over the magical age of 25? In recent meetings with other ex service users at the charity I volunteer for (all of us 25+), all have highlighted how important it is to see other people who have managed to get out of crisis mode, and if not recover fully, at least learn how to manage their various conditions. Not manage as in, throw as many drugs at as possible – although there is a place for medication – but by regaining as much quality of life as possible. Whatever that means: being more stable, having an active social life, having a partner, volunteering or working, not feeling like you’re drowning from the moment you wake up until the moment you pass out. Survival ++. I am probably biased, but I feel like this can be especially relevant when it comes to eating disorders, because younger and younger people are written off as chronic and untreatable – sometimes as early as age 18. By the time you get to 26 you’re practically a dinosaur in service user years, which seem to be counted like dog years. God forbid you’re seeking help again in your thirties, forties and beyond. No one seems to understand that sometimes people finally become ready to fight for their lives not at the most opportune moment, not when help is first offered or most readily available – but when the prospect of living ‘like this’ for much longer becomes intolerable, which so often coincides with the point at which help is much harder to come by.

I know the kids are full of promise, and I know we should help as many people as possible escape before their post-adolescent crisis becomes a life long mental illness, and I know it’s not as emotive an issue in the eyes of the public or politics, but how about some funding for targeting this forgotten vulnerable group? Hope shouldn’t be such a rare commodity.

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7 responses to “Mind the gap

  1. ‘Non-coperative’ tends to get added to the stigma of suffering from a mental illness, particularly an eating disorder, the older one gets. It’s as if it somehow magically becomes a choice or a result of stubborn-ness.

    I do wish also that people could be treated as adults when they are older; I’ve found that both myself and my Mum have been talked down to and patronised a lot, as if there is one model for treating people and it’s geared towards teenagers who can be controlled, to a certain extent. I’m not sure that various services know what to do with people who are, on the age spectrum at least, on a more equal footing with the counsellors etc. That also suggests to me that a lot of treatment relationships are based on manipulation and control, but that’s a personal bugbear of mine so I’m not the most objective judge.

    People do desperately want to change at any age. My Mum, fingers crossed, has, at the age of 58. And we’re doing our best on our own; it says something that her worst relapse for thirty years came at the time when she was receiving the most ‘help.’

  2. I completely agree. I think it is so important to have support for children and those under 25, in order to perhaps prevent further difficulties as they get older – but what about those of us who are already past 25?

    Just because you’re 28, 48, or 68 doesn’t mean you can’t improve and change your circumstances. There definitely needs to be a strong support system for those who need it, whatever their age.

  3. There is a CBT worksheet to help give “older” people hope. What more help do you need?

  4. Pingback: This Week in Mentalists – The Good Luck Secret Life Edition « The World of Mentalists

  5. This is really interesting, I’d not thought about it this way. From the other perspective, some people feel that there’s a lack of ‘youth’ specialism in mental health, that CAMHS is much more geared towards teenagers and adult services don’t know how to engage and work with them, and ‘young’ people (16-25ish) fall in a gap between the two services, to be picked up when they’re older (and perhaps worse off). I think you make a good point about eating disorders though, where often services are geared towards young (white, middle-class) women, perhaps perpetuating the image that it’s a problem that teenagers have and you kind of grow out of it. There’s a problem also with early intervention psychosis services, which I think are age 14-30, if someone has their first episode at 31, where do they go?
    I’m not sure whether the answer is to split mental health services more into age specialisms, or moving towards a more ‘ageless’ (a bit of a buzz-word atm) service where everyone is seen together. I’m undecided.

  6. Lorraine Graley

    Couldn’t agree with you more. Daughter is 31 and almost appears to be written off. She is clear and erudite about the help she feels she needs to help her climb out of the anorexia hole….but… there are no services in her health authority to deliver what she needs – family therapy, 1:1 body image (to help her change her thinking and allow her to put on weight), LEAP (to help her engage in healthy rather than eating disordered exercise) etc etc – but – nothing is available to her, only the ‘revolving door’ of restore some weight, discharge, lose weight – there is no second part of recovery available, dealing with the crux of her eating disorder, her mental issues and core beliefs.

    • Hi Lorraine

      I’m sorry your daughter is in such a difficult position. Have you ever been to http://www.aroundthedinnertable.org ? It’s a support forum for parents and carers of people with eating disorders. They might have some ideas for you, many of the members have young children and teenagers with EDs, but quite a few are supporting adults. I do hope your daughter receives more support soon.

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