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Barriers and discrimination
In the following two films, we outline the challenges we face when trying to access help.
Stuart: Hi my name is Stuart, my pronouns are he/him.
Atlanta: And I’m Atlanta, my pronouns are she/her.
Stuart: We’re both Young Advisors at Healthy Teen Minds, and together, we’ve worked to build these guides for you.
Atlanta: We’re going to be guiding you through ‘What we need you to know’, which has been created based on feedback from young people across England who have experience accessing support in a mental health crisis.
Stuart: In this guide we will work to build your understanding of the challenges young people face when trying to access care, techniques to set up positive interactions, and advice directly from young people on what they look for in someone supporting them.#
Atlanta: The first thing we’re going to work towards is building your understanding of some of the challenges young people face when accessing care.
Stuart: Some of these things may be painful or uncomfortable to talk about, or even hard to hear. We aren’t here to judge or blame, we know that many of you are trying your best, and working really hard to support us. We believe that, by talking about our experiences, we can improve things for everyone.
Addressing Pain Points
Atlanta: We want to help give you a better understanding of where young people are coming from when reaching out for support, and how much it takes to ask for help.
Stuart: When young people access care, we’re in a vulnerable position, and for many of us, we’ve already tried everything to alleviate the pain, but are still in need of support.
Atlanta: Many young people reported that they felt dismissed, or belittled, receiving responses from crisis workers like, “You just want attention.” It’s so difficult to reach out for help, and when we are in a crisis, receiving responses like this makes us feel like we’ve done the wrong thing… and they hurt.
Stuart: Young people face many barriers when trying to access care; from long waiting times, to lack of funding or resources, to not having somewhere where they can safely be themselves, express their needs, or find support. So, when a young person does see you, it may have been a long and difficult process for them to even get there.
Atlanta: Many young people face additional barriers depending on their culture, race, religion, gender, sexuality, socioeconomic class and disability. These groups of people face discrimination within our society and our healthcare systems. Throughout this learning we will refer to the groups who face this discrimination as, ‘marginalised groups’.
Stuart: To give you some idea of the discrimination faced by marginalised people, we’ve provided some figures which help highlight these barriers – but remember, this in no way represents the full extent of the discrimination faced by people.
Atlanta: Black people are 4 times more likely to be sectioned under the Mental Health Act than white people.
Stuart: 14% of LGBTQ people avoid seeking healthcare because of fear of discrimination from staff, but 52% of LGBTQ people reported experiencing depression in the past year.
Atlanta: 69% of autistic people who were not offered adjustments by mental health services suggested that adjustments would have been required or helpful.
Stuart: These figures will hopefully provide insight into disparities many groups face when accessing care. We encourage you to do further research to gain more understanding of marginalised groups and the unique struggles they face.
As you have just heard, accessing care in a mental health crisis is really difficult and leaves us feeling extremely vulnerable. A lot of us will feel nervous or even afraid when speaking to you. Sometimes the person we speak to isn’t as compassionate as we need them to be, which makes us feel like we have done the wrong thing by reaching out. We know that everyone is working hard to be the best they can be for us – that’s why you’re here, right? So we want to share our experiences and perspectives to help you help us.
For those of us in marginalised communities, it can be even harder to access appropriate support. A lot of the time the support we receive isn’t suitable for our needs, leaving us unlikely to seek help again. We’ve provided some further information below to help you understand some of the issues we face. Click on the headings to reveal more data and resources.
According to the LGBT in Britain (2018) report, 14% LGBTQ people avoid seeking healthcare due to fear of discrimination from staff, but 52% of LGBTQ respondents said they had experienced depression in the last year. This means that a lot of LGBTQ people are left without necessary care or support.
Black people are four times more likely to be sectioned under the mental health act than white people (NHS Digital, 2019), and are far more likely to have police involvement in our first contact with a mental health service (Bignal et al., 2019). Fear of what might happen to us when we seek help can stop us reaching out altogether.
69% of autistic people who were not offered adjustments by mental health services suggested that adjustments would have been required or helpful (Brice S, Rodgers J, Ingham B, et al, 2021). Adjustments are really important because they allow the person accessing services to feel respected, safe and communicate their needs. This promotes positive patient-healthcare professional interactions.
Young carers face significant barriers that prevent them accessing the support they need, while frequently reporting that their caring role can impact on their mental health. Barriers include fears of being seen as ‘not good enough’ to support their family member after disclosing, that a family member will be taken away, or that they will cause additional worry for a family member that they care for (Carers Trust, 2016).
We encourage you to do further research, using the resources provided and additional studies, to gain more understanding of the struggles faced by those of us in marginalised groups.
Centre for Mental Health
You can read about the specific barriers faced by marginalised groups on the Inequalities in mental health fact sheet
The Centre for Mental Health’s Commission for Equality in Mental Health have a range of briefings and reports exploring this topic
Ambitious About Autism’s Know Your Normal gives an insight into young autistic people’s experience of mental health
LGBT in Britain report from Stonewall
Carers Trust produced a report looking at young carers experience of mental health services Invisible and in distress
NHS Digital’s Mental Health Act Statistics, Annual Figures 2019-20
In this next film, you will hear about some further pain points, including the impact of having- or not having- a diagnosis.
Atlanta: Young people with a mental health diagnosis on their record have told us that they often are not listened to or have their experiences dismissed due to assumptions being made about their diagnosis. People with one are often seen solely through the lense of their diagnosis, and people without one often don’t get treated at all.
Stuart: Remember as well that the process of receiving a diagnosis is often long, complex, and inaccessible to many people. A diagnosis, especially when you are young, is a privilege. And just because someone doesn’t have an official diagnosis doesn’t mean they are not experiencing the symptoms.
Atlanta: If the people we speak to are dismissive or don’t seem to understand, it feels like we have nowhere to go for help. If there are any conditions or diagnoses you are unfamiliar with, take some time to learn more about them. If you are speaking to someone with a diagnosis, let them be the expert. Ask them for guidance on how you can best support them. And even if they don’t have a diagnosis, take them seriously and acknowledge the symptoms they are experiencing.
Stuart: Many neurodiverse people believe that they should behave and present as if they were neurotypical, in order to get some support and understanding, but this pressure adds unrealistic expectations. Build your understanding of both physical and cognitive disabilities and divergences.
Atlanta: When we experience discrimination, especially when reaching out for help, it can be really detrimental to our mental health and our trust in services. Navigating all of this, alongside trying to access support, can have further negative impacts on our health, and the effects are long lasting.
Stuart: Everyone is worthy of help, but many young people feel nervous or even afraid when accessing care. Understand that this is where many of them are coming from when they see you.
Atlanta: When we access crisis services, we need a safe, non-judgmental space where we can talk, vent and receive care and support. In the next section we will give you some tips on how to create that space.
Stuart: We really do recognise that many people are trying their best, and working hard every day, to support us. Even by watching this module, and participating in furthering your knowledge, it shows that you care and want to do your best. We appreciate that!
Atlanta: We hope that, by sharing this information, you feel more informed and prepared to meet any young person, and treat them with care, respect and understanding.
Having one or more diagnoses can both be a privilege and a barrier when we are accessing care. Allow us to be the experts in our experience and be willing to take our lead on what can help. Not everyone with the same diagnosis will exhibit the same symptoms, and those of us without a diagnosis still need to be taken seriously.
We know these things are hard to talk about, and maybe uncomfortable or challenging to hear. We really do recognise that you are working hard everyday to try and support us. We believe that by listening to our experiences we can improve things for everyone!
We can work together to make our conversation feel meaningful and safe, and in the next film, we will look at setting up the interaction for success.
Take some time to reflect on the content you have just watched and read. Are there any interactions you’ve had with young people which stood out to you when you read through this guide?