Depression and low mood (young people)

Dealing with health professionals

Establishing and maintaining a good relationship with their health care providers – GP, counsellor, consultant psychiatrist, nursing staff and so on – was crucial to young people’s experience of care and the process of getting better. The key factors young people talked about influencing these relationships were good communication, trust and confidentiality, being treated as an equal partner and being involved in the decisions and, perhaps most importantly, being taken seriously.

Characteristics of a good health professional
Being treated as an individual, and for one’s life situation to be viewed as a whole were among the most important things young people wanted from their health care professionals. One woman said of her consultant:

“He’s the only one that’s properly seen me as a person with an illness as opposed to a walking illness.”
 
Young people described how the best health professionals they had come across were “encouraging”, “respectful” and "non-judgmental”, as well as “proactive” in finding out what would work best for which individual.

Loz says his consultant is great and like 'an Asian version' of his Nan.

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Loz says his consultant is great and like 'an Asian version' of his Nan.

Age at interview: 17
Sex: Male
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My consultant [consultant’s name], she’s really good, she’s like, I call her, my second Nan, she’s, she looks like my Nan but more of a sort of like an Asian version, if you know what I mean. She’s really good, she is, she’s a great woman. I’m glad I’ve met sort of like the people I’ve met, they’ve really helped me. Not get over sort of like the stuff that I’ve been through, but to deal with it, yeah deal with it more than I, than I have. So I think I’ve been quite fortunate in that sort of retrospect.

Sarah describes being 'a nervous wreck' before her first counselling session but says how happy she was that she made the hardest first step.

Sarah describes being 'a nervous wreck' before her first counselling session but says how happy she was that she made the hardest first step.

Age at interview: 17
Sex: Female
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I’m really happy that I made the step that I did because the first step really is the hardest part. Waiting to go in into the doctors to say, can I have a referral, or therapy or, or even going to your first therapy session, you’re stood outside you know, you know you stand and chain smoking you know, you might just stand there and like be a nervous wreck beforehand, but as soon as you get in you sit down, the first words that come out of your mouth are just tumbling, it’s so easy and after that it’s you’re not falling anymore, you’ve stopped yourself. And you can climb back up and stand up and say well, I’ve got through this and it’s a nice feeling once you’ve made the first step. ‘Cos you realise that you can change, that you’re not alone, that there are people out there who do genuinely wanna help you. It’s definitely the hardest step though, the first.
 
But you know it only gets, it gets harder but it gets easier again you know, you have your moments when like, you’ve talked about things in the past and they’ll hurt, and then afterwards you’ll feel so much, so much lighter you could like, you know you feel like you could float off into space, it’s nice. It’s good, it’s good to make that first step and everybody should do it, if you’ve got a problem definitely just not sit alone.

When he first saw the GP, Jack says everyone at the clinic was really helpful and he felt it was 'the start of a new life'.

When he first saw the GP, Jack says everyone at the clinic was really helpful and he felt it was 'the start of a new life'.

Age at interview: 17
Sex: Male
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And I was just very, very hopeful about it all, and I thought….
 
What if I, what if I have a panic attack there and then? You know I’ve got no medication or anything like that.”
 
And you know I spoke to this lady then and they were so helpful and a lot of people would just think, oh they’ll just say they’ll just, I hate this horrible, you know this teenage view that sometimes going to a GP isn’t helpful, they’ll just give you medication, turn you into a zombie, or… But there are non-medication ways of doing it, and it is so useful going to the GP and of course if you get in within their schedule and everything like that, but you know it’s, I just remember that just feeling of just feeling so good coming out of there and walking down the hall and just thinking, “This is the start of a new life really.”

Tina says it was fate that she had such an amazing GP. Tina believes that without her, 'I probably wouldn't be here'.

Tina says it was fate that she had such an amazing GP. Tina believes that without her, 'I probably wouldn't be here'.

Sex: Female
Age at diagnosis: 24
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She [GP] was great. She reassured me, she gave me a cuddle, she let me cry, she was just fantastic with me. I mean there aren’t many GPs out there that would hug you when you walk in to their office and hug you when you walk out. And she’s been like that with me for the past few years. And, you know, that’s fantastic. Most GPs want you in and out, you know, write out a prescription off you go. She’s not like that.
 
I am, I’m very, and I think you know again, it’s Karma, it’s fate. I was meant to have her as my GP and I’m fortunate enough to have her as my GP, and I could say, and I have said to her, if she wasn’t my GP I probably really wouldn’t be here now. And so for me she was my support. And still distant from it because I know she’s a GP and she’s there to do a job, but she was my support looking back.
Many people remembered back to that one special individual who had stood up for them by “going out that extra mile”, being “very special” or just “chatting through the night” by their bedside whilst on the ward. Finding that someone who people felt a special connection with, and who they felt was “on their side” could make all the difference in getting better.

Mandy and Sian say sometimes you get that 'special person' who will treat you not as a number or an illness, but 'as a person'.

Mandy and Sian say sometimes you get that 'special person' who will treat you not as a number or an illness, but 'as a person'.

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Sian' Some things do help. Some things don’t help. It’s about getting used to them really. It’s about getting, sometimes you do get that special person in the authorities that will make it happen for you.
 
Mandy' Or go that extra mile to make sure that you’re safe.
 
Sian' And when that’s there you do feel safer, and you feel a lot better for it.
 
Mandy' Yeah I know that someone is going to take the time to you know bend the rules and…
 
Sian' Yeah definitely.
 
Mandy' And break them occasionally just to make sure that you know, you’re safe. That they actually do care, rather than it’s not just a job, and…
 
Sian' Not just for a job.
 
Mandy' Not just a 9 to 5. You know that they’ll work with you and not talk at you, that you know, it’s respect I think, respecting that you’re a person and not an illness.
 
Sian' Yeah.
 
Mandy' ‘Cos what we find is a few people I think that they see past that, and that’s all that anybody ever wants is to be treated as a person and not a number or an illness.

Suzanna had an 'amazing' eating disorder therapist.

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Suzanna had an 'amazing' eating disorder therapist.

Age at interview: 26
Sex: Female
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My mother found an amazing eating disorder person, where I lived, actually through an article in a newspaper who was really exceptional and I saw her for quite a while, sometimes she would come to my house if I didn’t really, couldn’t go out. I realise it is very difficult for my family to cope with my illness and understand it but that they really try.
 
She was really amazing. And… yeah it was, it was sort of it was only you saw her by yourself obviously, and I much preferred that to being in a group. And she was just so, so understanding, she suffered herself as well. Yeah, and just a really nice person so. It was; I got on really well with her.

Cat's GP took her to the mental health unit in his own car because she was desperate for help.

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Cat's GP took her to the mental health unit in his own car because she was desperate for help.

Age at interview: 23
Sex: Female
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And it ended up in a very, very difficult situation, it ended up, I’d just taken my 18th suicide attempt, and three of those I had meant, the rest had been cries for help of where I had taken tablets and I have called up friends and gone, “I have taken them, what do I do? I just need help.” And it’s literally been cries for help. Three I have meant, and you know where I’ve told no-one and I have seriously meant it.
 
And the 18th one, was the last straw and I actually I turned up at my GP’s surgery. I sat on the door step and I wouldn’t move and I said, “I don’t care, I don’t care what you do, I don’t care anymore.” And I’ve never ever seen my GP run so quick. He called the police; got me in his car and he drove me to the in-patient mental health unit. And he put me up there and he said, “I’m not leaving until you see her.” And we stayed there for hours and hours and hours and it took him to do that for them to wake up and realise I needed help.

When B was on the psychiatric ward and couldn't sleep, a nurse made her a cup of tea and chatted with her through the night. (Read by an actor).

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When B was on the psychiatric ward and couldn't sleep, a nurse made her a cup of tea and chatted with her through the night. (Read by an actor).

Age at interview: 19
Sex: Female
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And I don’t really remember the first few days, but I remember bits and pieces like, I remember one night I was there like sleeping and I was crying, and one of the nurses came up and she made me a cup of tea and it was like right in the middle of the night and we chatted till the morning, and I went to sleep.
Making decisions together
One of the most important elements of care for young people was genuine involvement in their care and sharing decisions about treatments. People resented just being informed of the care plan and “being told what to do” without discussion or being told the reasoning behind those decisions.
 
Being involved in all their decisions about care helped people feel more in control and gain a sense of independence. A couple of people commented how it had really helped them rebuild trust in themselves, something which they’d struggled with as a consequence of depression. Some people even described being included in their care plan as the main turning point towards recovery.
 
Being offered all available help and support was important to many people as it made them feel better able to make most of the care. Some described the health professional’s role as “guiding us to find our own way” through the different options. People said it was important to be treated as an equal over decisions concerning their own life and some criticised these decisions as too “random” or lacking options when they only came from the doctor.

Being involved in your care helps you learn to trust yourself, gives you control and an 'opportunity to wanna live' again, say Mandy and Sian.

Being involved in your care helps you learn to trust yourself, gives you control and an 'opportunity to wanna live' again, say Mandy and Sian.

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Mandy' That they’ll [professionals] take the time to stop and go, “Well, this might help. But you know I want you to try it,” not, “This will help, go away and do this.” type thing. ‘Cos I found that even with the good ones to begin with. He gave me this thing of, he wrote it up, a sort of a care plan of what I’d do if I felt really, really bad, and I didn’t even, I didn’t do any of it really, I was you know, “I’m not doing what you tell me to. You know I’ve only just met you, I walk in and you give me this. You’re having a laugh.” But then you, he re-did it, and he re-did it with me, and he involved me in the process of it, and like I was a lot more open to actually using it then, which I found was helpful. So being involved I think helped. And you know since I’ve been a lot more involved in my care I’ve come a lot further.
 
Sian' Definitely. I think if they involve you in the meetings rather than talk behind your back, you feel. I mean, they haven’t been, they have like big case meetings and things about you and it’s all done behind your back and it’s all hush, hush. And you’re not allowed to know anything about it basically. That, that’s not good but when they do start thinking well, yeah, let her come in, let her sit down, have her opinion, and, but that’s what helps really, letting you, letting you have own opinion.
 
Mandy' And it helps you learn to trust yourself again. That you can make decisions, that you’ve got some control. Which is what a lot of people with the depression and sort of the similar illnesses feel they don’t have, they feel they’ve lost that.
 
Sian' Control, yeah.
 
Mandy' It makes you sort of, if you’re involved in trying to fix your life really, ‘cos that’s what it is, then you’ve got the opportunity to build a better one, you’ve got the opportunity to actually wanna live.

B says the best way doctors can help is to give her information about all the options available and discussing them together. (Read by an actor).

B says the best way doctors can help is to give her information about all the options available and discussing them together. (Read by an actor).

Age at interview: 19
Sex: Female
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I think the best form of help is telling you there’s help there, them telling me I can go to them, rather than them telling me, “Oh we want you to do this now,” or “We want you to take this medication. You’re going to be in hospital at this time.” Because now like I’ve got, before the care plan which has been made up for me, but now they include me in making like a care plan like they’ll say, “What do you want to do if you feel depressed? Do you want us to take you to the hospital? Do you want to talk to your, is there a specific person you want to talk to, not just a professional? Do you want to talk to a stranger? Do you want to talk to someone you know?” And sort of just including the person in the care that they’re receiving, is the best thing, rather than just telling them.
Trust & confidentiality
Being able to trust their doctor and the information, advice and care offered by them was key to how happy and satisfied people were with their care. Also, being able to trust their GP or therapist to honour confidentiality, with no information reaching their parents without young people’s consent, was just as important. Lack of trust in health care professionals had made some people “cynical” about talking to a doctor at all, or made them tell “an edited version” of what happened.

Erika-Maye feels "cynical" about talking to doctors.

Erika-Maye feels "cynical" about talking to doctors.

Age at interview: 17
Sex: Female
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I kind of have a a thing about doctors and hospitals and everything, ‘cos obviously lost my family members, died in a short space of time, in the same hospital as well, I developed a hospital phobia, so I wasn’t too keen on the idea of going to the doctors anyway. It was quite a hard thing to work myself up to do, because I have panic disorder as well, being around people, it’s very difficult. So sitting in a doctor’s waiting room full of people is difficult, and then to be told that it’s just my hormones, really helpful, it’s so good for your self esteem to be told that kind of thing [small laughter].
 
I refused to go a couple of times, ‘cos I just didn’t want to, I didn’t, I was kind of on a different point where I just didn’t care. And I just really did not care. I didn’t particularly want to go in and listen to what they had to say because as far as I’m concerned, counsellors, psychiatrists, doctors whatever, when I’m in a very, in one of my cynical moods, the only thought I have is that they’re paid to sit there and pretend to care. So I’m a bit cynical about speaking to doctors and speaking to the counsellors and that kind of thing.
 
Why do you think that is?
 
I think if I can be so bold that a lot of it has to do with the media because there’s such negative press about everyone, all the time, and about how evil and how conniving people are, it’s quite difficult to then see people in a positive light., from the ways that my friends were reacted to, and the way that I was reacted to, initially it’s then quite hard to try and work up the courage to give people a second chance.
 
And I usually tend to, I’m not one of these people whose like, “Okay, you’ve, you’ve hurt me once I’m never, I’m never gonna trust you again.” I’m too nice [laughs]. I try to trust people again but, I find that quite difficult with medical professionals. I’m not quite sure why.

Joanna was left in the waiting room while her parents and her consultant decided what would be best for her. (Read by an actor).

Joanna was left in the waiting room while her parents and her consultant decided what would be best for her. (Read by an actor).

Age at interview: 20
Sex: Female
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So I went to see that consultant person the same day, and she said, she went in without me, it was my parents and her again, and so I was left in the waiting room. And that felt really awful ‘cos I just didn’t know what was gonna happen. And they said you need to go to hospital and so I went to the general hospital and they said we just need to keep an eye on you, your parents don’t feel they can cope with you anymore. They can’t, they can’t manage your behaviour. And I thought, my behaviour? I’m not doing anything. I’m not doing anything at all, how can I be badly behaved? You know I’m just being quiet and just trying to deal with what’s going on in my head.
 
And they left me there, and I was just like really like scared, I was just like, well they don’t want me anymore or whatever. And I was next to a three-year-old that had some sort of terrible illness, it was, I think I heard it was cancer or something, and she was just screaming just the whole time. And she’d just scream and scream and scream. And then and it was really a clinical setting and stuff.
Trust involved having a good and open relationship with the health professional; to feel like they were genuinely interested in the young person’s situation, and trust in the professional’s skills, expertise and knowledge. A couple of people made the point that building trust was a long two-way process.

Tom describes the experience of going to his family GP in acute crisis as “horrific” but said he could trust him.

Tom describes the experience of going to his family GP in acute crisis as “horrific” but said he could trust him.

Age at interview: 21
Sex: Male
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It was horrific, my Dad just came with me to try and, ‘cos I was just a, a complete mess. My Dad came in you know, with me and he tried to assist me in describing what my symptoms were, and I was just hysterical in this in this doctor’s room, just, it gets to the stage where I was just was just going, you know mental in this, not mental, just really, really emotional in this room, ‘cos I’d reached the end, complete despair, that’s it, and so the doctor was just really great, he was very professional obviously, he’s the fact is I trusted this guy because he’s been my family doctor for 20 years and he’s in his sixties. Well late 50’s, 60’s, and he knew a lot, one of his passions was mental health, so it was very lucky and he was like, you know I trusted this guy and he said, “Look I understand a lot, this is very common, and it does, it does end, you know. There is a treatment, whether it’s counselling or prescription medication whatever, so.” I did trust him. But it took a few times to trust him.

Oliver says he won't expect a GP to be that familiar with mental health problems, among broken knees and common colds, but it's difficult when you don't get the help you need.

Oliver says he won't expect a GP to be that familiar with mental health problems, among broken knees and common colds, but it's difficult when you don't get the help you need.

Age at interview: 23
Sex: Male
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And when I came back from the GP saying, ‘cos that’s the way it works in this country and my understanding, if you want to see a psychiatrist you have to get a referral, there is a first line, a first hurdle that you have to get over in order to get help from somebody. And I understand you know you’ve got a national health service, it’s a very expensive thing, you need to make sure that the right people get the right care, but it’s difficult to expect a GP to know all of the things they need to know to be able to diagnose something.
 
And if the guy in the US says that very few people would give me the diagnosis he’s given me, and that’s of psychiatrists, I can’t really expect a GP to be able to… and I realise, you know that’s his training, he’s got all sorts, you know he has to deal with the other, you know, a broken knee and you know the common cold and you know, and you can’t expect that, but the, it makes it hard. And I think and everyone I’ve spoken to has said that the way he, the way he dealt with me wasn’t a very good way of doing it.
Communication and being listened to
Open communication with their doctor was essential for young people. They found it frustrating and irritating when health professionals wouldn’t speak directly to them but about them, with their parents, for example. They didn’t always feel listened to properly or said there wasn’t enough time in the clinic for them to be able to really tell the professional how they were feeling. Some had suffered from lack of communication or miscommunication between different health professionals within the health care system, for example between their GP and the consultant. Such experiences left these people needing to find things out for themselves and to keep proactive at a time when they were already struggling.

Oliver has learnt to trust his own instincts and to demand from the doctors all the information about his treatment choices.

Oliver has learnt to trust his own instincts and to demand from the doctors all the information about his treatment choices.

Age at interview: 23
Sex: Male
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And so it’s learning to trust my own instincts about who I am and how I’m gonna respond to things, that’s really important. And if a doctor tells me something and I disagree with it, trusting myself to disagree. And ideally if I do disagree to ask them about it, and to have a doctor that can say, “Well this is why I think you should do this.” And to treat me like an equal partner in, or an equal player in the endeavour of making my life better.
 
And that’s one thing that I sometimes haven’t gotten from doctors and usually when I do then I [laughs], I stop, or I don’t do any of the things that they’ve suggested, I might still see them but like, it’s just like, “Okay well, if you aren’t gonna give me the info I’m not gonna put whatever this chemical is in my body, ‘cos I don’t know what it’s going to do to me, and you haven’t proven to me that it’s going to actually make things any better.” And I know that some medication can make things worse.
Feeling patronised was the most common complaint. Many people felt they weren’t taken seriously or that the doctors questioned whether their experiences were “real”. Some felt they had to “keep proving” to the doctor how bad they felt, or how much they wanted help. Several young people had initially been turned away by their GPs and told they were “too young” to have depression or their experiences were just put down to “hormones”. One woman described this experience:
 
“I think the health professionals, along the parents, underestimate it because of the age, and they think it’s a phase, and that it’s not very serious. One of my doctors told me to go home and sort myself out, which isn’t exactly something that’s helpful.”

Ruby kept going back to her doctors 'trying to prove how bad I am to warrant' treatment. They wouldn't believe she could've had an eating disorder which had gone unnoticed for ten years.

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Ruby kept going back to her doctors 'trying to prove how bad I am to warrant' treatment. They wouldn't believe she could've had an eating disorder which had gone unnoticed for ten years.

Age at interview: 27
Sex: Female
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I’m going back and back and back to these doctors again, trying to prove how bad I am to warrant some better medication or some, ‘cos that was the way I’d been brought up to think about adults. Instead of talking to a doctor reasonably and explaining what was wrong, I was finding I was having to somehow prove that I was worthy of medication, or something like that you know? Like, not that I, like would dream when I was a kid wasn’t to grow up and be on meds, but once I did realise just how bad things were I couldn’t believe how difficult it was to be taken seriously.
 
What do you mean?
 
A lot of people, ‘cos by then I was 20, 21, and by then they were like, “Well you can’t have been bulimic since you were 12, someone would’ve noticed, someone would’ve said something.” They, they couldn’t believe, or if, or if they did they thought well it’s not as big a problem as she’s making out ‘cos otherwise something would’ve been done before this. You know? So it’s was like, I had, I found it a really hard time getting people to take me seriously.

Before being diagnosed with Chronic Fatigue Syndrome, Erika-Maye struggled to be taken seriously; she said it was 'humiliating'.

Before being diagnosed with Chronic Fatigue Syndrome, Erika-Maye struggled to be taken seriously; she said it was 'humiliating'.

Age at interview: 17
Sex: Female
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And they then decided to refer me up to the hospital. Went up there saw a doctor, who examined me; I had my stick at that point. Told me that she couldn’t find anything wrong with my reflexes, my muscle strength, anything like that, and when she found out I had depression, she decided it was all in my head. That was really difficult, that was the closest I had felt to suicide in years hearing that because I felt like she was actually telling me I was insane.
 
She took my stick away from me because she said I didn’t need it and told me I had to walk without it. That was humiliating. Because I walk awfully without my stick and I walk around inside without it because it’s just my family or my close friends that will see and that’s okay, but I was in a children’s hospital, and she made me walk around without my stick.
 
She then, and I was saying to her I have had the depression for ages, I have had this for such a long time I have had the headaches side of it, I have had the psychosomatic side of depression, I have had the headaches, I have had the nausea, I’ve also had the feeling of I don’t want to get out of bed and face the world today, but this isn’t, “I can’t, I don’t want to get up and face the world today,” this is, “I cannot get out of bed today.” It’s completely different, and she wouldn’t listen. So then I saw the psychiatrist, the psychologist and the social worker, got discharged.
 
I went for a meeting in [place name] with another psychiatrist who changed my medication, and then I ended up at [hospital name], the week after that and they doubled my dosage of antidepressants. And it was only there that one of the psychiatrists actually started to take me seriously. Because this was a bunch of mental health specialists that couldn’t understand why I was there really. ‘Cos I mean it was obvious that I’ve got depression and everything, but this was different. And, oh, it drove me mad, it was horrible and I sat there and I would cry myself to sleep each night thinking, “Shit what if I’m wrong, what if this is, is actually all in my head.”

Cat says she was 'spoken to like a child' and treated inflexibly. When she wasn't allowed to change her case worker she 'kicked off' to get her situation assessed properly.

Cat says she was 'spoken to like a child' and treated inflexibly. When she wasn't allowed to change her case worker she 'kicked off' to get her situation assessed properly.

Age at interview: 23
Sex: Female
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I was supposed to be on the, the government thing of the Care Programme Approach, CPA, which is supposed to be done when you’re, when you move over to that. I’ve actually never had one, I’ve got one, but it was never signed because it was never agreeable because they wouldn’t change it. The way that I was spoken to I was treated like a child. Appointment dates were arranged around them and not me. I had messages continually left on my home phone, “The dates I’m free are,” when again they were aware of my physical health and it leaves me back to you can’t have both, you just can’t have both because they do not take into consideration that because of my seizures are regular I can’t, each day’s different. I could be fine today; I could be really rubbish tomorrow. I was rubbish last night, I’m okay this morning. So, things are so unpredictable you just don’t know.
 
And that’s also the same how depression works. You know it’s a complete cycle, which they don’t, they didn’t understand that. And it was making me more and more stressed and more and more depressed and more and more anxiety, you know my anxiety was going through the roof.
 
And I asked to change case workers, ‘cos I checked with my social worker if I’m entitled to do that and she said, “Of course you are.” She said, “Any, any professional, you’re allowed to change GP, you’re allowed to change consultant, you’re allowed to change hospitals, you can change anything.” She said in her line of work, she said that you know, it all ranges, you know if you don’t get on with your social worker you can change. It doesn’t you know, it works like that, that’s how it is.
 
They refused it. They would not let me move. And they, we, I had it in writing, I asked in writing three times, I asked nicely twice, I even sweet talked to them on the phone, nope, it was refused. I then had it in letter, letter form refusal, in a really nasty kind of way, and that was the last straw. That was it. But I can’t deal with it anymore. If I can’t work with my case worker how am I gonna recover, I can’t, they had the cheek to turn round to me and say, “Well why don’t you talk to us?” Well how can I talk to you if I can’t talk to the person I’m supposed to be working with.
 
It doesn’t, it makes no sense to me at all. And the issue was a big care meeting was called, over my care because I kicked off, I literally kicked off.

Tasha felt 'completely brushed off' by her GP when she first saw him about depression. She went home and cried.

Tasha felt 'completely brushed off' by her GP when she first saw him about depression. She went home and cried.

Age at interview: 18
Sex: Female
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I think I was about 15 and I went and I said I’ve been feeling really low and I think it’s depression. And he sort of, I can’t say he laughed in my face but he sort of chuckled and said, “Oh you’re too young to be depressed.” Just like completely ignored what I said, brushed it off and then just said “Come back if you still feel like it.” So that’s all that happened, I was in there for two seconds and I was out.
 
And did you go on your own?
 
Yeah, I didn’t tell my parents that I was going.
 
Was that your own GP that you’d seen for other things?
 
Yeah.
 
Do you think it was a big step for you to take to go to the GP in the first place?
 
Yes. I think I was getting quite desperate and I was wanting help so I went.
 
So you didn’t get any advice even, or information?
 
No [laughs].
 
Or anywhere you could sort of come back to after a while or anything like that?
 
No.
 
So well how did you feel after that incident, about it?
 
I think I went home and cried. but I, I sort of left it and just sort of struggled on.

Being told by a health professional that “I understand how you feel” was one of the most patronising lines young people said they could hear. Several felt that a health professional could never really understand their situation and to claim to do so was seen as dismissive and unsympathetic. Some felt they got very little help from their doctors who had only given them limited options (usually only medication) or “given up” on them too quickly.

Sophie finds it hard to believe health professionals' advice as they can just go back to their 'happy lives' while she just has to go home 'thinking the same thing.'

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Sophie finds it hard to believe health professionals' advice as they can just go back to their 'happy lives' while she just has to go home 'thinking the same thing.'

Age at interview: 17
Sex: Female
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Like someone could sit there and blurt out well everything, but they [professionals] will not be able to understand what someone’s been through. It’s alright to sit there and say, “You’ll be alright,” and “Keep your chin up,” but it’s hard to go through that, but for someone to sit there and think I haven’t been through it, but yeah keep your chin up if you know what I mean.
 
Do you find it like difficult to believe them?
 
Yeah. ‘Cos it’s like they’ve got a job like, they can do what they’re doing and they’ve got a happy life, they can go home and chill out and, and I just don’t believe them because, it’s, I’ve still gotta go home thinking the same thing and being depressed.

For some young people, an unsympathetic approach or insensitive comments by health professionals could stay in their minds for a long time after.

Erika-Maye describes difficult experiences with a particular nurse on the ward who 'made anorexics finish their food and told depressives to laugh'.

Erika-Maye describes difficult experiences with a particular nurse on the ward who 'made anorexics finish their food and told depressives to laugh'.

Age at interview: 17
Sex: Female
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There was a nurse at the psychiatric unit and I, they were supposed to be going out on a walk and we’d gone out on one the week before, and they’d told me there wasn’t much walking, but I was actually stuck in bed for the next three days. So obviously when they said we’re going on another walk, I refused to go, which I thought was actually perfectly logical because I didn’t particularly want to be stuck in bed for the next few days. They tried to persuade me to go, and watch other people walking around. I was like, “Yes, because I love watching other people doing what I can’t do.” I got quite upset, understandably I think. I ended up staying. They sent me to sit in the lounge. I was crying by this point, and the nurse they sent in to see me was, is, rather cruel anyway.
 
No-one liked her. And it wasn’t just because she’d make the anorexics finish their food, or she told the depressives they had to laugh sometimes, it was because she was genuinely nasty. She told someone with an eating disorder they should just roll into the lounge. And she sat down opposite me flicking through paper work and said to me, “So what is actually physically wrong with you Erika?” I went, “Well they think it’s Chronic Fatigue.” She was like, “Well is it in tune with your mood?” She was like flicking through a magazine at this point while she was asking me these really personal questions. And I said, “No it’s not psychosomatic, if that’s what you mean?” She said “Did those words leave my mouth?” “Okay then.” When I’m in a mood where I feel quite low, but not completely down, I can usually cheer myself up, but I’d prefer to be left alone because then I can just think quietly and think about the stupid little things, and make myself feel okay. But she said to me, “You know if you don’t talk to me you’re not gonna get better.” “And not being funny but when I’m in this kind of mood I’d rather just be left along please.” She got up and slammed this magazine back down on the table, and said, “Well when you feel like actually doing something about your health, you can walk and come and find me can’t you?” just to give an example, and that’s not right. I don’t think that’s fair that someone who is being, ‘cos that’s just malicious, that someone who’s gonna react like that should actually be allowed to interact with teenagers who have got serious problems. Because we’re, we’re at a tier 4 status, so we’re like supposed to be the most crazy of the crazy lot. And yet she’s allowed to, I don’t think that’s right. She’s actually left now. We’ve put in a couple of official complaints. 

Kirstie's doctor's approach frustrated her because she didn't feel it dealt with her problems.

Kirstie's doctor's approach frustrated her because she didn't feel it dealt with her problems.

Age at interview: 16
Sex: Female
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But then he played this stupid game, he went right, me and your Mum are going to leave for a minute, he went, “I want you to move one thing in my office.” And obviously he’s got a bookshelf full of books. He went, “Move one thing, it can be a book or anything, just swap its place for something else.” He went, “Now come back here, and it’s my office and I’ll tell you if I know what you’ve moved.”
 
And he was trying to work it out for about twenty minutes. He went, “Right, now you leave the office, and me and your Mum are going to move something, and then you’re gonna come back in, and you can tell me whether, you know what I’ve moved.” I went back in, and I just had my eyes fixed on this little, like scruffy mouse, teddy thing, and I looked up and it had gone. And I could feel them looking at me ‘cos I was staring at where it should be, but I looked round, and I was like, “I don’t know what you’ve moved.” He went, “Why did you look up there?” And I was like, “‘Cos I was trying to read what that book there was called.” He was like, “Oh do you want to read it?” I was like, “No, I thought I did, but I don’t.” He was like, “So you don’t know what I’ve moved?” I was like, “No.” He went, “Do you want me to explain to you why I was doing it?” And I went, “Yeah.” He went, “I’m just trying to prove a point, that you’re not listening to what I’m saying.” I was like, “Yes I am.” He went, so how come in my own office, I didn’t know what you moved,” he went, “and to this point I still don’t know what you moved,”
 
He went, but you knew what I moved the minute you walked back in the room. I went, “What are you on about, I don’t know what you moved?”
 
He went, “You know I moved little Teddy Kirstie, ‘cos we noticed the minute you walked in and looked right at it. He went, “And I moved that ‘cos I just saw you staring at that all the way through, and it was the one thing you’d notice I’d moved.”
I was like, “Okay did we come here to play games or deal with the problem?”

Listening to your own body and accepting help
However, some people had had therapists or nurses who did have personal experiences of mental health problems and were genuinely able to draw on that knowledge – which many found helpful. Many people emphasised that they knew themselves best and for the health professionals to acknowledge and support this would be a better way forward. Many young people said they knew that health professionals were there to help them, and doing their best, but that sometimes they themselves weren’t in the right place to receive the help.

Stacey says all the professionals are there to help her and sometimes they understand her even when she doesn't herself.

Stacey says all the professionals are there to help her and sometimes they understand her even when she doesn't herself.

Age at interview: 17
Sex: Female
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They do help you. Everybody helps you out. And I just think sometimes, “Oh you’re stressing me out, you know what mean it, and you’re doing my head in,” but they’re not, they’re just trying to help me. And you just think, “Oh leave me alone.” But they’re just trying to help you. Every single one of them, the support workers, I have many arguments with the support workers, they’re just trying to help me out, and when you realise, do you know what I mean? They’re only doing their job.
 
Alright. They, they, I think they understand what I mean. ‘Cos sometimes I don’t even understand myself. But they do, do you know what I mean? When I’m on about something I don’t even know what I’m on about. I can’t explain it, but they do my bit, know what I mean, and the, they’re doing the right things to help me, do you know what I mean.
Health care system
Many made the point that once they had been diagnosed with a mental health problem, all their health complaints were always interpreted within that context, not giving them an opportunity for fair treatment:
 
“Also to be recognised that every health problem that I have it goes “no, it’s psychological”. It doesn’t matter what it is, I can, I could go down A&E with a suspected broken arm, and they’d say psychological, it wouldn’t, nothing would surprise me anymore.”
“I feel that as a mental health patient that we get treated unfairly, is that mud sticks and once you’re diagnosed with a mental health condition that’s it, mud sticks.”
There were also some structural aspects of the health care system that people found unhelpful; long waiting lists, having too little time in the clinic, not being able to see the same doctor at every clinic, or lacking in appropriate services in their particular area.

Cat says having to change doctors every three months was "detrimental" to her recovery.

Cat says having to change doctors every three months was "detrimental" to her recovery.

Age at interview: 23
Sex: Female
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Unfortunately the mental health system in this area, and maybe other areas as well, the place that I was under work on a-three-month-locum system, so you will see them for three months, they go, get another one for three months, they go. So by the time you’d built up a trust you’d built the bond they’ve gone. And I feel that that has been detrimental to my recovery, because I have seen, I have lost count in how many psychiatrists, psychologists I have seen, in, since I was 14.
 
And not also in the locum side of things, and whether it’s against ageism, sexism I don’t care, but it’s easier for a woman to talk to another woman than it is for a woman to talk to a man sometimes.

Last reviewed June 2017.
Last updated December 2013.

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