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Death penalty for being abused? The price is too high for society and disadvantaged young people

 

Young people who had been in the care system are far more likely to die in early adulthood than their peers, a report showed last week; indeed they are at least 7 times more likely to die prematurely, before the age of 21. The BBC story about this highlighted poor access to mental health services, the lack of general support available, and the consequent over-use of drugs, alcohol and other forms of unhealthy self-medication and attempts to manage stressors.

I have worked with children in the care system for over 30 years and at least the research is showing what we have always known clinically. Bad early experiences lead young people to use drugs, alcohol, take risks in sexual and other behaviours, but also to struggle academically, socially and in their emotional wellbeing generally. Most of my most worrying cases in the NHS have been in the care system, and major crises often occur at the age when they are supposed to become ‘independent’ at the age when most well-adjusted children from loving families in fact rely on their families more than ever.

 

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Touch, physical and emotional. Abuse or neglect?

 

What is the place of touch, physical closeness, and indeed emotional closeness, in professional relationships these days?  In these post Saville days there seems to be a lot of confusion. Quite rightly people and organisations are wary of the risk of inappropriate touching and of child abuse, awareness of which is thankfully much higher.  Much of my clinical work is at the Portman clinic where we see many sex offenders, and we are all too aware of the serious dangers of ignoring these issues, the vital importance of Safeguarding and the need to ensure children are protected. However the counterpoint is an increasingly frightened and rule-bound culture which looks after professionals and institutions and puts their interests above the children in their care.

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Psychological damage and physical abuse linked to poverty

In the last couple of weeks we have seen new studies which have put more flesh on the bones of what we already know about the link between economic circumstances and mental health issues. One study  [1] by Judith Baer and colleagues from Rutgers University looked at 5,000 parents. Mothers who received free food or had a difficult time paying their bills were nearly 2.5 times more likely to have symptoms that would warrant a diagnosis of generalized anxiety disorder, compared with those who were in better financial situations. Interestingly what the researchers seem to have found, using a structural equation model, is that it is the economic circumstances that were the main trigger for psychological symptoms which are quite serious. Poverty and not knowing where the next meal is coming from, not surprisingly in itself is a major contributor to anxiety levels.

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