Jake Bailey: Prevention better than intervention with mental health issues

Helping improve a young person's mental and emotional health starts with being there for them. Photo / 123rf

I don't need to tell you that New Zealand's youth are struggling with mental health issues. They are struggling more than ever before, and more than any other OECD country. In case you've missed it, we've got the highest suicide rate in the developed world, and not by a slim margin either. Our suicide rate is five times that of Britain, for example. It's so bad that other countries are talking about our suicide rate, perhaps more than we have been ourselves until recently.

Based on those numbers, it is likely you know of a child or teen who is represented in the painful statistics on youth suicide or mental health issues we tragically hear about.

There's an effort currently being given to increasing access to frontline mental health care workers, like psychologists. While this will undeniably help, it will also take time, and so it's not surprising that results from the Youth 2000 series found the majority of NZ secondary school students with mental health problems obtain the help they need not from mental health practitioners, but from the relationships they form with supportive adults.

Consequently, I figure every adult in New Zealand has a duty to know what they can do to help a young person with mental health needs. You need to have the ability to be someone else's turn-to in times of need, because lives depend on it. It is based on skills, and not responsibility stemming from blood or chance.

Here, I have written a few things I believe you should know, that I know are important from my own experiences. This knowledge is only cursory, and there's much more to supporting mental health than these things I'll list. I'll write much more on this over the coming weeks.

Firstly, there is the importance of prevention, rather than intervention. There are lots of things you can do to promote a child or teen's well-being on a day-to-day basis, that become prevention strategies. Prevention is always better than intervention, and small things can make a big difference. To prevent someone from developing mental health issues, the evidence shows that you need to support them when they are young to feel accepted, connected and understood. This should provide some dividends as they grow older and continue forward in life.

Intervention strategies are needed in situations where things are growing more dire. This seems like common sense - that serious times would call for serious measures, and adults will sometimes need to accept their limitations and seek external help for others. But unfortunately, often this isn't the case, and some families desire to fix it all themselves. Embarrassment prevents people from speaking out, wanting to avoid feeling unfounded shame about exposing their situation to an expert.

The dire need to diminish stigma around mental health is another conversation entirely.

Some families close down, shut the problem in, and attempt to solve it themselves. But do you attempt to sort a tooth filling on your own, or do you go to the dentist?

Secondly, there are protective factors and risk factors. Protective factors enhance resilience, while risk factors diminish it. Having a sense of belonging and enjoying good relationships are factors that will help protect your mental health. Childhood trauma and social isolation are risk factors, and will put your mental health at risk.

It's worth noting that effective prevention strategies can modify these risk factors. This is a big deal. It proves an adult can improve a young person's mental, emotional and behavioural health and become a prevention strategy in their life, even when the hand they have been dealt is stacked against them, just by being involved with them. That's a powerful thing.

While this doesn't mean you should mollycoddle youth, it does mean you should be there for them and make them feel supported. Resilience is created to a large degree by relying on people around you in tough times, and by feeling like you are able to do so.

Thirdly, you need to know what to look for so you know when a situation may be becoming a mental health issue, as opposed to a general stress-related problem. This is a tough one that relies not just on knowledge but judgment, instinct plus analysis. It's about knowing when to move from prevention to intervention - easier said than done when the young person is covering up what is inside, and may be more skilled at hiding their weaknesses and vulnerabilities than you are at uncovering them.

If you're stuck trying to decide whether a crisis is an "I got slack so I didn't do my assignment in time and now I have to suck it up and face the consequences" situation, or an "I'm above my head slipping into a very dark place and I can't find my way out" situation, ask yourself a few questions.

Have you seen changes in their thinking (like more self-criticism, trouble concentrating, frequent negative thoughts, changes in school performance), changes in their feelings (disproportionate reactions to situations, excessive gloom, worry, guilt, fear, sadness, anger, helplessness, hopelessness, or loneliness), changes in their behaviour ("I don't recognise this person anymore") or any physical changes (in weight, sleep and energy)? If so, maybe just take a moment to ask them how they're doing, and how they're really doing.

Truth be told, there is not a recipe in the world anyone can write. Mental health is so individual that there cannot be a one-size-fits-all approach. At the end of the day, it's all about planning an approach, doing the best you can at the time. Evaluate. Modify. Repeat. Don't give up, or take it personally when you get it wrong.

We all have a responsibility to change the stats, and it will take all of us to do so.

WHERE TO GET HELP:

If you are worried about your or someone else's mental health, the best place to get help is your GP or local mental health provider. However, if you or someone else is in danger or endangering others, call police immediately on 111.

OR IF YOU NEED TO TALK TO SOMEONE ELSE:

• LIFELINE: 0800 543 354 (available 24/7)
• SUICIDE CRISIS HELPLINE: 0508 828 865 (0508 TAUTOKO) (available 24/7)
• YOUTHLINE: 0800 376 633
• NEED TO TALK? Free call or text 1737 (available 24/7)
• KIDSLINE: 0800 543 754 (available 24/7)
• WHATSUP: 0800 942 8787 (1pm to 11pm)
• DEPRESSION HELPLINE: 0800 111 757