With thanks to the young and the brave

In the last few weeks two teenagers approached our service to ask for support. With touching and articulate requests, they let us know they were suffering and gave voice to their distress in order that we, my colleagues and I, may hear this and be able to help. Partly because of these young peoples’ eloquence, but more because of their courage, their stories have stuck in my mind.

Often, young people don’t particularly want to come to CAMHS. It’s unfamiliar, it’s full of new people and it often means talking about things that are difficult. Generally then, I spend a lot of my initial sessions with new families trying to engage wary children and skeptical teenagers, while parents look on with crossed fingers. Young people actively asking for help from CAMHS can be a little out of the ordinary.  

You might think that adults are different, that with more maturity and self-awareness comes more openness and humility. Except, it’s not that easy. Asking for help makes us vulnerable, even if we aren’t explicit about the subtext: we are struggling and cannot cope. Being honest when things are tough bares raw emotions, fears and maladaptive coping strategies - or worse, a lack of coping strategies - to the world. We are exposed. 

In this vulnerable state, the world is often not kind. In modern, Western societies at least, we punish those who express their deepest emotions and show the deepest distress. We judge them, call them crazy, or weak. We medicate them, we minimise their difficulties, or we keep them waiting for treatment. We pit them against each other in a fight for the finances and housing they need to survive. In the worst cases, we take them away from their families against their will and sometimes forcibly medicate, feed and restrain them. No wonder that we prefer to try and keep calm, carry on and keep our distress to ourselves. 

Much is made about the personal characteristics that make people less likely to seek help: being male, a young adult, from a BAME background and valuing self-reliance, to name just a few. However, we talk less about the social factors that encourage (or discourage) support seeking. Fewer researchers are asking what kind of societies welcome emotional openness.

The thing about working with young people though, is that they often hold a purer version of hope, something that is often eroded in adults with more knowledge of health systems and experiences of being let down. Hope in young people, while perhaps a little naive, is telling of the vision they have of how the world should be. 

So when brave and desperate teenagers approach CAMHS for support I wish I could tell them their vision is real, that their hope will be realised. I wish I could reassure them that the service they will receive for the price of their vulnerability will be timely, smooth and effective. I wish I could tell them that the people around them as they go through life will always be understanding of their problems and respectful of their courage in speaking up. I want to say that because they were honest, it will be easier. 

But the truth is it won’t be. By recognising that they’re struggling and asking for help, they do put themselves in a better position for recovery, whatever that means to them. However, they also open themselves up to the stigma of being a mental health service user and the injustice of being judged for their proactive stance on wellbeing. They face under-funded, overstretched services that make people feel as though they are not worth helping, even while me and my colleagues are fighting against lack of time and resource to show that they are. 

You are.

But then again, maybe I am showing my age and weariness. Maybe I should learn from those teenagers and have more hope for our society. Even though there is still a lot of work to do, people are sharing more of their inner worlds with each other and receiving more open-minded, accepting responses. Asking for help is slowly being more valued and the people who do it are being recognised as the capable, self-aware individuals they are. Maybe then, over time, the giving and receiving of help will become so common that it eventually becomes normalised, as it should be. Perhaps in 10 or 20 years time I won’t be surprised by people asking clearly for what they need and deserve. It won’t be something I feel propelled to write about as a rare and moving event. 

Until then, to those two strong teenagers I’ve spoken to in recent weeks, let me tell you that I admire your ability to speak out during such tender and turbulent years. I am twice your age and still I am not as able as you to say when I need help. It feels unfair to ask more of you, but nonetheless I urge you to try and guard that piece of hope that encourages you stand up for yourself and your needs. I urge you to try not to let it become embittered and disillusioned by the life experiences to come. 

Remember that this month, you gave yourself the honour of listening to your own voice and acting on what you heard. You deserve that. 

You are worth it.