Childhood PTSD

I’m relieved that the findings in this article on childhood PTSD are being publicised while being desperately sad at the scale of children and young people whose mental health needs are not even being recognised.

I work with may young people who have been through traumatic experiences and also adults who are still suffering from the impact of their childhood trauma.

All of us who work in the field are aware of that cuts in funding to Child and Adolescent Mental Health services and how hard it is for those in need to access services. It’s ironic that this is happening at the same time as more and more research is being done to highlight how many more children and young people need support.

Not dealing with it doesn’t mean the issues go away. They carry on and I have written about this before here. The ACE studies show the life long impact of adverse childhood experiences and many adults are still living with the effects.

These multiple adverse experience are more likely to lead to a form of PTSD called Complex PTSD. When definitions of PTSD were first developed it was for those suffering single event traumas like an accident or war injury. It’s taken a long time for recognition of PTSD in childhood to be caused by abusive situations. For more info on what cPTSD is like I highly recommend this author, Pete Walker.

Separated families

I started reading a twitter thread early today about Meghan Markle’s father being interview on breakfast telly. He was telling the world how she is not in contact with him despite his attempts to communicate with her. 

I made the mistake of reading the comments – its always a risk going into this area of the internet. Thankfully the majority of them were agreeing with my view;  it isn’t anyone else’s business and its not appropriate to have on the tv. However, there were a few that were saying things like “life is too short”, “you only get one Dad” and making rude comments about her for not having contact with him.

Now, like everyone else apart from those directly involved, I don’t know the full story. I do know the stories of many people (including my own) of those who have chosen to cease contact with family members. It’s never an easy choice and it usually comes after years or decades of toxic or abusive relationships. Within those relationships, all parties may have displayed behaviour they are not proud of; they may have tried to repair things unsuccessfully; they may have papered over the cracks again and again. 

Each story will be different. What isn’t helpful is other people who are on the outside passing judgments. They are unwelcome and also potentially damaging and abusive.

I was reminded yesterday of the request by many school for parents not to take photos at school plays because they may contain images of other children who are at risk. With these being put on social media, then they can be traced must easier. I am sure there are people who object to this as their experiences have meant that haven’t had to consider these things. It’s the same with judging separated families.

Without the experiences then it may not be obvious why people make the choices they make. Instead of judging or worse interfering in a way that can put people at risk, try and ask yourself what would lead someone to make a choice like that?

If you haven’t had a family like this, then please recognise what a privilege that is for you. A secure loving family of one of the greatest advantages anyone can have. The evidence on adverse childhood experiences which I have written about before show just what an advantage this gives to you. 

If you have made a choice to remove contact with a family member, then I am sorry you have needed to and I wish you well. 

Young peoples mental health

Have you seen the latest NHS Report on Mental Health in Young People?

Some keys points for me are:

  • One in seven I14.4%) of 11 to 16 year olds were identified with a mental disorder. One in sixteen (6.2%) met the criteria for two or more mental disorders.
  • Of these, the most common are emotional disorders, present in 9.0%. Then behaviour disorders at 6.2%.
  • While between 11-16, girls and boys were equally likely to have a disorder, girls were more likely to have an emotional disorder and boys a behavioural or hyperactivity disorder.
  • Between the ages of 17-19 about one is six (16.9%) had a mental disorder. 
  • However, young women of this age are a high risk group as it was found that nearly one in four (23.9%) had some type of mental disorder, 22.4% had an emotional disorder. 
  • Half (52.7%) of young women with a disorder reported having self-harmed or made a suicide attempt. 
  • The results are further broken down into sexual identity, ethnic group, socioeconomics and social and family context and other factors. 

Adverse Life Events

The report states that “children with a mental disorder were that likely than those without one to have experience certain types of adversity in their lives, like parental separation or financial crisis at home.”

I have written many times about the impact of adversity childhood experiences and this report shows again how significant they can be. What is also worrying is the one in five of the children in the survey waited over six months for contact with a mental health specialist. This is unacceptable when the risk of self-harm and suicide in these children and young people is greatly increased by having a disorder. 

We as a society need to do more.

The impact of childhood trauma

There is more and more research being done on the long term effects of childhood trauma on mental health issues.

Some of the figures are alarming, especially when you consider how hard it is to for children and young people to get access to the necessary mental heath care in this country. The long term costs on a persons overall health and life expectancy are huge due to trauma.

The following article gives some of the details.

http://www.independent.co.uk/life-style/health-and-families/childhood-trauma-effects-life-expectancy-mental-health-relationships-a7470106.html

Privilege, ACEs and Protective Factors

I listened to a podcast recently and someone being interviewed said something along the lines of

“If you are a positive person, positive things happen to you” which leaves the inference that if you are a negative person then negative things will happen to you.

My initial response was one of fury. How dare this bleep bleep bleep person blame all the people who have had terrible experiences for bringing them on themselves due to the wrong mindset.

I work with children and adult survivors whose lives have been incredibly difficult. How on earth could this self-satisfied smug bleeping person think they just needed to be more positive and then things would be ok?

So, I admit, I stewed on this on and off for weeks. Then one day I finally worked out why I hadn’t been able to let it go.

Positive things do happen in general for some people more than others; those are people with privilege.

If you have privilege it’s easy to assume that the good things that happen to you are because of your positive outlook. The problem though is this denies the experience of those without privilege and makes them responsible for the impact that it has on their lives, rather than their lack of privilege which is a problem with society.

What do I mean by privilege? There are much better examples than I can find words for. One of the most powerful is this video https://www.youtube.com/watch?v=4K5fbQ1-zps

This cartoon strip http://thewireless.co.nz/articles/the-pencilsword-on-a-plateshows how those with privilege can really assume it is because of them and their talent, or in the case of the person who set me off on this article it’s because of their positive outlook!

It’s worse though than just not getting a job, it is an enormous health crisis. A study on Adverse Childhood Experiences (ACEs) https://www.cdc.gov/violenceprevention/acestudy/index.htmlby the CDC in America 20 years ago raised the awareness of ACEs and their long-term impact.

Difficult experiences in childhood have a significant impact on our adult health, wellbeing and life expectancy. The image below gives some statistics on the type of events that can happen and the risks to the adult when they have 4 or more. More details can be found at https://vetoviolence.cdc.gov/apps/phl/resource_center_infographic.html

6 or more ACEs means your life expectancy is 20 years shorter and your adult life is more likely to have been blighted by addiction, mental and physical health issues and incarceration.

When we talk about privilege we usually think of rich white males, but it is more than that. Class, wealth and race are some things, but it’s also a privilege to be in the 52% who have not had any ACEs or the 23% who have only had one.

If we allow to go unchallenged ideas about positivity being all a person needs to succeed it means we can turn a blind eye to the 9% of children who are currently experiencing 6 or more aces ACEs and the 9% of adults they will become.

A recent report by the NHS in Wales shows it not just a problem in America but the data applies in the UK as well http://www.wales.nhs.uk/sitesplus/888/page/88504

We are ignoring a massive societal injustice and health issue that impacts all of society in one way or another. Even if it means paying more taxes for supporting those who can’t work, prison costs and the police. No matter how privileged you are, you have some risk of being burgled or robbed in some other way. The people committing those crimes are highly likely to have multiple ACEs. Think what would happen if they had been helped when young?

My challenge to everyone reading this is to think about what their privileges are. Did you have ACEs as well and if so did your privileges help counteract them? In that case, the privileges become a useful protective factor.

I admit for a long time I couldn’t see the protective factors I was privileged to have. I was also one of those people who ignored the impact of the lack of privilege in others. After all, I was poor, a child of Irish immigrants, growing up on estates in Southwark, with a very difficult family history and my ACEs score is quite high. I did well, got a job, built a career. I proved it could be done so why couldn’t others? Maybe they didn’t want to work hard enough.

But I do have privilege and I now am able to see how much that has helped me. In the race of life, I wasn’t at the very back of the line starting off. I had a few steps head start. Not nearly as many as some, but those steps have made a difference. There are probably loads of others I haven’t listed as well.

  • I am white
  • I am able bodied
  • I am straight
  • I am cis gendered
  • I had a Mother’s love
  • I had enough food to eat
  • I had stable and permanent accommodation
  • I was encouraged to read very young
  • I was able to learn quickly and achieve good grades

These privileges helped counteract the impact of my ACE’s, they protected me a lot but not completely, I have scars. I experienced anxiety and depression as an adult, but I know now from the studies that have been done how much worse it could have been.

Count your privilege, respect what they have given you, the advantages and/or protection.

And maybe then you will see what under privilege is as well. Because until those with privilege absorb this, nothing is going to change and millions of people will continue to suffer.