by Dr Zeshan Qureshi, Paediatrician
More information about Dr Qureshi can be found on his website
Being a paediatrician is an absolute privilege and a core part of my identity. Over 15 years, I have been trained to understand how to halt pathology before it progresses to irreversible morbidity and mortality. I come from a family of doctors dedicated to looking after those in most need, and at their most vulnerable. There is no area more stark for this than children’s mental health.
As a paediatrician, by the time I see children at risk of suicide, they have already self-harmed, and been presented to the Emergency Department, having had a near miss. After medically stabilising them, they are handed over to the community adolescent mental health services, in the hope that something can be done to address the underlying factors that led to mental health problems, or at the very least prevent further worsening of their condition.
However, without the necessary staffing, funding, and resourcing of the NHS, and without the necessary wider social care, doctors are impotent. It means we are desperately playing catch up, with vulnerable children having long waiting times, and a high symptom threshold to meet for intervention.
There is a need for better early identification of young people in trouble across primary and community services, with better coordination amongst those working in education, health, social care, and youth justice. For those that do get identified as being at risk, there needs to be greater capacity within health systems to manage the problem. This isn’t just expanding the number of healthcare professionals, but it is also identifying and reversing the societal factors that have led to an increased risk of a mental health problems.
Mental health needs to achieve parity with physical health, and those involved in looking after children are crying out for greater support. No children should go through the awful experience of attempted suicide, and no healthcare professional should have to manage it, when it is a condition that is preventable.
A report from the independent Mental Health Taskforce to the NHS in England, February 2016, states a ‘five-year forward view for mental health services’ promising ‘the biggest transformation of mental health care across the NHS in a generation’, recognising children and young people as a priority group for prevention and early intervention, however this hasn’t yet translated to a noticeable difference on day-to-day clinical practice. My hope is that the focus, in terms of funding and resources, is tackled now so that as paediatricians we can do our jobs the best of our abilities.