Editorial

Citation

Caan, W. (2014), "Editorial", Journal of Public Mental Health, Vol. 13 No. 2. https://doi.org/10.1108/JPMH-03-2014-0010

Editorial

Article Type: Editorial From: Journal of Public Mental Health, Volume 13, Issue 2

I began writing this on International Women's Day (8 March 2014). The EU has just published its survey of over 42,000 European women, and their experiences of violence or similar human rights abuse (European Union Agency for Fundamental Rights, 2014). Here in the UK the incidence of physical and/or sexual violence towards women and girls (from age 15 upwards) is 44 per cent. The National Institute for Health and Clinical Excellence has just issued guidance on domestic abuse (NICE, 2014) but its noble aspirations for evidence-based commissioning of care pathways and of trans-disciplinary, inter-agency training seem a long way from implementation. Where social conditions are seriously undermining health, Public Health professionals have a duty to make bold advocacy, such as the approach called Health in All Policies (Tillmann et al., 2014). If readers are inspired to address the human rights abuses among women and girls, do not start with too many preconceptions: even in the palace of a King, I read that four captive Princesses have been held against their wishes for 13 years (Gayle, 2014). Recently their mother's complaint was passed to Rashida Manjoo, the UN special rapporteur on violence against women.

Among adolescents, experiences of physical or sexual abuse or just sharing their home with a violent parent are major risk factors for youth suicide (Sellen, 2014). It is rare to see real trans-disciplinary, inter-agency training, but I went to the launch of Sellen's Action Learning Pack on suicide, which aims to support just such training. Voluntary agencies like NSPCC (2014) lead the way here on training about abuse and its assessment. English policy on suicide prevention (DH, 2014) is targeted on people known to have a history of self harm. Self harm is very common in certain settings, such as the Youth Justice system, and one can only hope the Department of Health will now invest in better psychological support for socially excluded groups like young offenders (Nursing in Practice, 2013). Back in 1992 when the UK strategy The Health of the Nation introduced a Mental Health target for suicide reduction I shared the common preconception that the quality of psychiatric services would determine success. However, a 30 year research study (Dougall et al., 2014) shows the critical opportunity for intervention may be during admissions to acute, general hospitals, not in psychiatric wards. In the UK, primary care doctors (GPs) are the most likely to know the medical history of patients and their acute hospital episodes. In a proactive initiative, the Mental Health Foundation (2014) has just produced practical advice for service users on how to talk about their mental health to a GP.

This issue of JPMH contains a range of papers on vulnerable populations, social exclusion and mental health. Bucchianeri and Neumark-Sztainer offer a Public Health perspective on body dissatisfaction that should influence both policy and practice. Ground-breaking research by Wickham on mechanisms by which relative deprivation could damage mental health makes a fresh contribution to our understanding of Health Inequalities. Growing up in deprived, harsh and chaotic circumstances can bring a life-long burden of mental disorder, but children are seldom prioritised in mental health planning (Oliva and Lavis, 2013). The research by Salter and Williams reveals the promise of Family Intervention Teams to change the trajectory of young people's lives.

At present in the UK levels of anxiety in childhood seem to be rising rapidly (Nursing in Practice, 2014). Childhood anxiety may have a greater impact on wellbeing in adulthood than was previously recognised (Milrod et al., 2014). Some schoolchildren aged 12 who have been followed up as a birth cohort (Singh et al., 2014) showed sub-clinical “psychotic-like” symptoms and these symptoms are associated with bullying and frequent changes of school. Caring in childhood for a parent with mental illness is associated with anxiety and victimisation at school. The JPMH is a stakeholder in the Who Cares? project making educational films for schools, about such Young Carers, which aims to reduce anxiety and promote inclusion (Kidstime Foundation, 2014).

The developing child seems to be especially sensitive to feelings of disadvantage, humiliation or rejection. Research in the UK for the Prince's Trust (2011) found that 26 per cent of young people from poor backgrounds believe “People like me don’t succeed in life” compared to only 5 per cent of young people from affluent backgrounds. The greatest challenge for Public Health advocacy is to actively involve such alienated young people in new forms of emancipation. For example, if deprivation stunts the development of young brains, can our Society create settings and stimulating activities (e.g. Caan, 2013) in which they grow?

Exclusion Zone

Too many people

Feel like Also Rans

Within the Human Race.

Right from the start line

Britain's “born losers”

Already know their “place”.

Yet, mental wellness

Can renew like Spring,

Hope in each, Human, face.

Woody Caan

References

Caan, W. (2013), “To boldly go ‘brain training’”, BMJ, doi:10.1136/bmj.f7441

DH (2014), “Progress on suicide prevention”, News release, 17 January, Department of Health, London

Dougall, N., Lambert, P., Maxwell, M., Dawson, A., Sinnott, R., McCafferty, S., Morris, C., Clark, D. and Springbett, A. (2014), “Deaths by suicide and their relationship with general and psychiatric hospital discharge: 30-year record linkage study”, British Journal of Psychiatry, doi:10.1192/bjp.bp.112.122374

European Union Agency for Fundamental Rights (2014), Violence Against Women: An EU-Wide Survey, FRA, Vienna

Gayle, D. (2014), “Prisoners at the palace: Saudi princesses plead for help as they claim they are being held by the king against their will”, Daily Mail, available at: www.dailymail.co.uk/news/article-2576600/Prisoners-palace-Saudi-princesses-plead-help-claim-held-king-against-will.html (accessed 10 March 2014)

Kidstime Foundation (2014), “The “who cares?” project”, available at: http://kidstime.thedigitalacademy.com/projects/the-who-cares-project (accessed 19 May 2014)

Mental Health Foundation (2014), How to Talk to Your GP About Your Mental Health, Mental Health Foundation, London

Milrod, B., Markowitz, J.C., Gerber, A.J., Cyranowski, J., Altemus, M., Shapiro, T., Hofer, M. and Glatt, C. (2014), “Childhood separation anxiety and the pathogenesis and treatment of adult anxiety”, American Journal of Psychiatry, Vol. 171 No. 1, pp. 34-43

NICE (2014), “Domestic violence and abuse: how health services, social care nad the organisations they work with can respond effectively”, NICE Public Health Guidance No. 50, available at: http://guidance.nice.org.uk/ph50 (accessed 3 February 2014)

NSPCC (2014), Assessing Children and Families, Factsheet, NSPCC, London

Nursing in Practice (2013), “Young offenders “failed” by mental health”, News, 12 December, available at: www.nursinginpractice.com/article/young-offenders-failed-mental-health-services (accessed 19 December 2013)

Nursing in Practice (2014), “Increase in young people with anxiety”, News, 21 February available at: www.nursinginpractice.com/article/increase-young-people-anxiety (accessed 27 February 2014)

Oliva, L. and Lavis, P. (2013), Overlooked and Forgotten, Children and Young People's Mental Health Coalition, London

Prince's Trust (2011), Broke, not Broken: Tackling Youth Poverty and the Aspiration Gap, Prince's Trust, London

Sellen, J. (2014), Youth Suicide Awareness. Encouraging Reflective Practice: Action Learning Pack, Wellbeing Projects, London

Singh, S.P., Winsper, C., Wolke, D. and Bryson, A. (2014), “School mobility and prospective pathways to psychotic-like symptoms in early adolescence: A prospective birth cohort study”, Journal of the American Academy of Child & Adolescent Psychiatry, doi:10.1016/j.jaac.2014.01.016

Tillmann, T., Baker, P., Crocker-Buque, T., Rana, S. and Bouquet, B. (2014), “Shortage of public health independence and advocacy in the UK”, Lancet, Vol. 383 No. 9913, p. 213