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Aug 2014 by PCI College

Mind Our Youth - Understanding Child & Adolescent Suicidal Behaviour & Mental Health

Anne Burke, counsellor/psychotherapist and PCI College lecturer will give a public lecture on Wednesday 10th September to mark World Suicide Prevention Day. Here she talks about the issue and outlines some of the key themes of her lecture

The Issue of Suicide
Suicidal behaviour continues to be a subject that challenges society at all levels. There are no easy answers to this problem.  It is still the case that more people die by suicide in Ireland each year than in Road Traffic accidents, a fact that was acknowledged in Reach Out The National Strategy for Suicide Prevention  when it was published back in 2005.

In March of this year Catherine Shanahan a reporter in the Irish Examiner wrote about a study that had been carried out looking at 27 EU states plus Iceland and Norway finding that Ireland has the second-highest level of deaths in Europe by intentional injury.   Shanahan stated in her article that “While the suicide rate among girls in Ireland is almost 2.5 times the EU average (2.09 per 100,000 compared to 0.84), it is far lower than the male youth rate at 5.12 per 100,000, which is more than twice the EU average of 2.39.” (Shanahan, 2014).

Shanahan also reported in the same article that according to Prof Anthony Staines from Dublin City University that issues like self-harm continue to be a problem and can often be linked to alcohol abuse; according to Professor  Staines  a lot more needs to be done , we need to work towards a broad-based, multi-agency approach, building supports in schools, communities and the home. (Shanahan, 2014)
 
There are a lot of factors that we need to consider when we are trying to understand the root cause of suicidal behaviour; this would include social and environmental factors as well physical and mental wellbeing.

Mental Health Issues in Children & Adolescents
It is a fact that 75% of all adult mental health issues begin before the age of 24.  Left untreated, Mental Health Issues can have a severe impact on a person’s quality of life and plans for the future.  In 2006 The Irish Government launched its Mental Health policy “A Vision for Change” advocating for a comprehensive Mental health Service across the entire community.  (Buckley, Gavin, McNicholas, 2009).  The more we develop our understanding of mental health issues for children and adolescents the better position we are in to offer them the support they need. 

Mental Health Services for children and adolescents have certainly improved, and there are a lot of very committed, passionate professionals working and continuing to develop these services, despite cuts in funding and other challenges.

There is still a large gap in services for young adults who are discharged from child & adolescent services, with little support other than scarce adult services which may are may not be appropriate for them.

We know we can’t counsel children and adolescents in the same way we would adults, we have to adapt our therapies to suit the different age groups and we have many therapies on offer such as Play Therapy, Art Psychotherapy and Cognitive Behavioural Therapy.  There is one particular intervention that I have come across recently which is getting more recognition as an important approach and that is the area of Mentalisation Based Treatments.

Mentalisation:  What it is and why it is important
Mentalisation is both a new and an old concept.  Mentalisation Based Treatments were originally designed to treat people with Borderline Personality Disorder.  However current research findings would indicate that Mentalisation is seen as a development construct, and that there could be a benefit to adopting it to treatment no matter what the approach as it has the potential to improve wellbeing over a range of disorders.  Mentalising encourages the practitioner to see things from the client’s perspective.  I think this is of particular importance in the context of childhood development and the complex issues that children and adolescents are faced with in today’s world.  

“having a patient’s mind in mind will make any therapeutic effort more efficient” (Midgley, Vrouva , 2012: 28)

Mentalising is not something that is just associated with therapy; parents who have the capacity to mentalise will enable their children to mentalise.  Mentalising is there to promote mutual understanding, develop self-awareness enabling us to reflect on our actions, thoughts and being able to communicate our needs.  It is the understanding of our mental states and others’.  It is important for family members to have an understanding of how mental health issues and psychiatric disorders can interfere with mentalising e.g. Depression interferes with creative thinking and focuses on negativity – anxiety consumes one’s energy and focuses on threat.  We all need to be educated to mentalise the client’s/patient’s experience.  (Allen, 2013)

Mentalisation connects strongly with Bowlby’s attachment theory and thinking on developing self-regulation. 
“All psychotherapists, whatever their focus, share the potential to recreate an interactional matrix of attachment in which Mentalisation develops and sometimes flourishes.” (Midgley, Vrouva, 2012: 28).

I will be exploring and expanding on some of these theories and thoughts at the Lecture on Wednesday 10th September.

Anne Burke, MIACP

Article References:
Allen Jon G., PhD, Senior Staff  Psychologist (2013) Interview with Janice Poplack, LCSW, director of Social Work, What is Mentalising and Why do it?  The Menninger Clinic
https://www.youtube.com/watch?v=NLT7ieO3hTk

Buckley Sarah, Gavin Blanaid, Fiona McNicholas, (2006) Mental Health in Children & Adolescents, A Guide for Teachers,
 
Irish National Strategy for Prevention for Action on Suicide Prevention (2005) Reach Out,  HSE
http://www.nosp.ie/reach_out.pdf

Midgley Nick & Vrouva Ioanna, (2012) Minding The Child, Mentalization-Based Interventions with Children, Young People and their Families, Routledge

Shanahan Catherine (2014) Irish teen suicide rates among highest in EU, Irish Examiner
http://www.irishexaminer.com/ireland/irish-teen-suicide-rates-among-highest-in-eu-262690.html


About Anne Burke:

Anne Burke originally graduated from the Tivoli Institute with a Diploma in Psychotherapy/Counselling.  She went on to receive a BSc in Psychotherapy/Counselling from Middlesex University and has been awarded an MSc in Psychotherapy Studies by the University of Sheffield.  Anne also holds a Diploma in Gestalt Therapy has professional certificates in Cognitive Behavioural Therapy and Treatment of Sexual Addiction and is a fully accredited therapist with IACP, and IAHIP, a Practitioner of Therapeutic Play. Anne received her Diploma in Supervision from the Dublin Gestalt Centre and is an accredited IAHIP supervisor.
Anne has completed further training in the area of Relationship Counselling, Suicide Intervention, Loss & Bereavement, Sexual Abuse, Bullying & Harassment, Self-Development & Assertiveness, Anxiety & Panic Attacks, Critical Incident & Stress Management, PTSD, Group facilitation and Expressive Arts Therapy.  Anne is currently studying for a MSc in Child  & Adolescent Art Psychotherapy with the Mater CAMHS and UCD.Anne works with individuals, couples, adolescents & children and also runs Group Therapy and workshops from the Centre.

Anne uses an existential-humanistic and integrative approach, which incorporates all the different therapies which she has studied; psychodynamic, gestalt, cognitive behavioural therapy, person-centred, Expressive Arts Therapy and Play Therapy.  Anne is a Lecturer/Tutor at PCI College Dublin, teaching courses on the issues of Working with Suicide and Child & Adolescent Counselling & Psychotherapy.
Anne firmly believes that once people are given the right environment to address issues, they can explore and understand their difficulties in a new light, discovering strengths within themselves to make any changes they may feel are appropriate, while developing supports and resources that are open to them and also becoming more aware of their own potential and ability to cope and empower themselves.

Relevant Links / Online Resources:

http://www.yspi.eu/

http://www.apa.org/about/governance/president/suicidal-behavior-adolescents.pdf

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2589203/pdf/yjbm00064-0055.pdf

https://www.youtube.com/watch?v=NLT7ieO3hTk

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