A Focus on Adolescent Mental Health

March 2018

I’ve been to CPD events run by ACAMH (Association of Child and Adolescent Mental Health) before so I expected that it would be well organised and offer a full day of quality speakers talking about their work and cutting edge research and I wasn’t disappointed. Educational Psychologists often have to deal with mental health issues as a factor in children’s and young persons’ learning, development and progress in education generally so I thought it would be a good use of my time and CPD budget but I didn’t expect to meet many fellow Ed Psychs.  From the few people I spoke to in the well provisioned coffee, lunch and tea breaks at the impressive Royal College of Physicians at Regent’s Park, I was right. I met several psychiatrists, a couple of GPs, mental health nurses, social workers and academics but no psychologists of any persuasion, i.e. clinical, educational or otherwise.

The day included five talks and a plenary. I listened with interest to the talks on cannabis use and psychosis, gender dysmorphia, whole school development work to support pupils’ mental health and wellbeing, evaluative research on treatment for depression in young people and the effects of peer relationship on young people’s mental health. The talk that interested me most was that of Professor Sir Robin Murray from Kings College and the Maudsley in London talking about the interface between adolescent and young adults’ cannabis use and psychosis. His headline point is:“Irrespective of whether use of cannabis is decriminalised or legalised, the evidence that it is a component cause of psychosis is now sufficient for public health messages outlining the risk, especially of regular use of high-potency cannabis and synthetic cannabinoids.”

Things that interested me were:

– Although trends in cannabis use are hard to measure in exact terms it appears that usage by the 15 to 34 year-old population is relatively moderate in Scandinavia, In France and Spain is increasing and in the UK is decreasing

– Until relatively recently funding for research into the relationship between cannabis use and its variants, such as Skunk and psychosis has been sparse

– Many studies, by necessity, use non-naturalistic settings, for example, Prof. Murray described an experiment in which participants smoked cannabis and then boarded a ‘virtual’ train carriage in which a variety of other passenger avatars stared at them and the degrees of ensuing paranoia were then noted

– The risk of long-term and heavy use of cannabis is associated with an increased risk of psychosis and is exacerbated by age of starting usage, i.e the stage of brain development, by socio-cultural factors and by predisposing vulnerability, E.g. neuroatypicism and/or family history of psychosis and the presence, type and proportion of synthetic cannabinoids

As a pragmatic practitioner psychologist I always hope the ‘so what’ question might be addressed. I wanted to know about any implications this research held for ways of helping young people? Why is the incidence of cannabis usage and psychosis so gendered? Why has government not prioritised this area for more research ? What are the individual stories of the young people involved? What protective factors can be identified amongst the 90+% of long-term and regular young people who do not develop psychosis?

All professionals involved in supporting young people’s mental health and wellbeing recognise and value the research that is underway and expect a day like this one to precedent this but how refreshing it would be to vary the didactic nature of the day to one that also includes the voice, experience and perspective of practitioners. Some would argue that the token question and answer space at the end of each lecture and the final plenary session allows for this. I don’t agree. These Q & A sessions are all too often a platform for the most vocal and confident, ‘tweeting’ is impersonal and limited and as for the plenary session, well I have to say that by the end of a day of listening to the academics it is no coincidence that most people have had sufficient and attendance is usually sparse. My ideal CPD day would always feature a blend of interactive small group discussion and co-presentations by academics and practitioners with expertise in common areas.

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