Sunday, September 14, 2008 Max Pemberton on teenagers’ alarming lack of knowledge concerning mental health issues

Finger on the pulse

Last Updated: 12:01am BST 15/09/2008

'There's no way I'm talking to you," snarls Mark and turns his head away. I swallow hard and try a different approach. "OK," I begin, "it's only a chat. I promise if after five minutes you don't want to talk any more, I'll go away."

Silence. He pulls the covers over his head. I stand motionless by his bed, unsure what to do next.

"Why don't you want to talk to me?" I say. He pulls the covers off his head. "Because I know the sorts of things you lot will do to me." I look at him perplexed. "You'll lock me in a mental hospital," he says. "You'll think I'm mad, but I'm not."

Mark is 16 and has just been diagnosed with cancer. I sit down and explain that no one thinks he's mad and that psychiatrists don't just go round locking people up. I explain that the ward staff are worried about him and it's my job to talk to him about how he's feeling and to try and help.

Of all the jobs I have done, my current post has to be one of the most harrowing. For the past month, I have been working in child and adolescent psychiatry, and part of the job is covering the children's cancer ward.

It's heartbreaking. The grief of the parents, the distress of the children and the feelings of impotence from the cancer specialists are palpable.

In this job there's no hiding behind ordering investigations or prescribing medication. My very raison d'être on the ward is to talk about cancer; to speak about the unspeakable. I admit to finding this very difficult at times.

But, surprisingly, one of the hardest aspects is overcoming the fear and lack of knowledge about mental health issues from both patients and their parents at a time when they have so much to contend with.

This is borne out by a study conducted by Great Ormond Street Hospital, published last week, which found that almost half of school children surveyed could not name a single mental illness. Boys between the ages of 12 and 14 were least likely to be able to name one, and even those that fared the best - 17- and 18-year-old girls - got most of their knowledge from celebrities discussing their own problems in the media.

It revealed a shocking amount of ignorance, despite mental illness being relatively common in young people: around one in 15 deliberately self-harms, with more than 25,000 admitted to hospital each year due to the seriousness of their injuries. More than one per cent are diagnosed with severe depression.

I think this level of ignorance is a reflection of society as a whole. The stigma attached to mental illness is still prevalent. It represents losing control, unpredictability and social deviance. It's spoken about in whispers; a dark, sinister secret. It is one of the last taboos and as a result, adults rarely discuss it in any detail, which further helps to propagate myths and misunderstandings. Is it any wonder that children are lacking knowledge?

Often when I broach the topic of mental health with my patients, I'm met with blank expressions, or ideas that seem to have been lifted straight out of One Flew Over The Cuckoo's Nest. Given that one in four of us will experience a mental illness, surely part of a child's education should include mental health, just as physical well being is now promoted.

"You promise you won't put me in a mental hospital," asks Mark. I nod. He looks down at the floor then back up at me.

"Well, sometimes I feel really sad…" he begins.

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