Time to Talk

It’s been a long time since I’ve written in this blog. While I could write a lot about the exciting developments and opportunities I’ve experienced during my time at the Rees Centre, that’s not why I’m writing this blog post today.

Today, as part of the Time to Change #TimeToTalk campaign, I am ‘coming out’ as a person with depression. One of that too-often stigmatised group referred to as ‘the mentally ill’.

I have had periods of depression throughout my teenage and adult life, though it’s taken some perspective to recognise that that’s what they were. I thought that was just the way people felt when they had got into a situation they could see no way out of. I thought that telling myself I was in a ‘bad situation’ meant that that was the problem. I knew that depression was an illness without one specific ‘cause’ (I don’t know who to credit but I love the “Why are you cancered?” analogy), but I didn’t know that it can be an underlying condition that raises its ugly head when triggered by something stressful. I know that now.

Depression is not something to be ashamed of. Just because it can’t be seen, that doesn’t mean it doesn’t matter. It’s debilitating, it sucks away your motivation and enthusiasm for life, and hacks away at the relationships that you so sorely need to get you through the bad days. It makes the tiniest decision seem like the biggest deal, and convinces you that things will and should go wrong for you. Depression can kill just like any of the physical health issues that steal people away from us. When you’re in the middle of a depressive episode, its link with death seems obvious. When you’re not, it’s hard to believe that you’re the same person who was looking at the world in such a terrifying way just a few days earlier.

I’m lucky. I have the support of my wonderful family and friends when I need it. I have a job with flexible hours and an understanding team (though those flexible hours aren’t always helpful when I need to motivate myself to get out of bed!). I have my physical health, so I can head out for a walk or a jog when I’m at that stage in between ‘immobile’ and ‘fine’. And my job pays well enough that for the first time in my life I don’t need to worry about being in debt. Yet with all those things going in my favour, it’s still bloody hard. On the bad days, I don’t want to see anyone, talk to anyone, think about the people I love who are hurting or getting older. I don’t even want to get up.

If it’s so hard for me with all those advantages, what must it be like for someone who’s living in poverty? For someone who doesn’t have a supportive family or friends? For someone who has to force themselves out of bed for a routine they never agreed to or wanted? For someone who’s been made to live in a strange place, with strange people and strange rules and who’s been told they can’t go home? For someone who has all this, and hasn’t even left school yet? Because as bad as it is for me, I cannot conceive how horrific it must be to be going through a depressive episode as a young person in care.

I am currently at a conference in Lausanne, where tomorrow I’ll be talking about a review I co-wrote for the NSPCC on preventing and treating poor mental health in looked-after children. I continue in my work to push for a focus on mental health for looked-after children and young people, who because of all these factors make them particularly vulnerable to mental health issues. I was asked recently if I was okay to continue my work on this topic, given my own mental state; but if anything, my experiences have made me more passionate about the need to address this crucial issue for young people in care. Those who hold the money and the power to intervene need to know the best way to do this, and that’s where research like our review can help. But there is so much more to be done.

Depression is not ‘my problem’: it is ‘our issue’. We owe it to our young people to protect their health, and an important first step is making the #TimeToTalk about it. Please take 5 minutes today to talk to someone about how they are feeling, and post your own messages on Twitter. Your support can make a world of difference.

Regression. Progression. Regression. (reblog)

Another great post here from the ‘adopt and keep calm’ blog, this time giving some insight into the links between changes in routine and regression to ‘age-inappropriate’ behaviour for children with traumatic histories.

Follow the link for the post: http://adoptandkeepcalm.wordpress.com/2013/04/27/regression-progression-regression/

You can also follow the author on Twitter: http://twitter.com/jayandaitch

Brothers and sisters

At the Rees Centre we’re about to start an evaluation of a new scheme being run by Siblings Together with Community Service Volunteers. The scheme will involve befrienders working with groups of siblings who have been placed separately in foster care, bringing them together for activities on a monthly basis.

Having talked a lot recently about this project means I am particularly aware at the moment of personal accounts where experiences in foster care have involved some fracturing of the relationship with brothers and sisters. When I was looking through the excellent Who Cares? Town site for young people I stumbled across this excellent blog post on this very topic. The writer’s insight into his own behaviour can help us to understand why some of these sibling difficulties can arise at the very time when the relationship might be most important. It remains to be seen whether the new project can help to repair any damage to sibling relationships, but this is clearly an area that deserves more focus than it currently achieves.

On the outside looking in

As I look out of my office window I can see a few snow flakes drifting, but here in Oxford we have been spared the severe weather that has hit many parts of the country. The sight of snow always takes me back to my teens, when I would sit with fingers crossed listening to radio announcements of school closures – to no avail.  My school was never closed, despite a decidedly dodgy heating system and being perched on a very treacherous hill.

I had a real love-hate relationship with secondary school. I’ve always loved studying, so I tended to enjoy the lessons – but I struggled socially. Most of my friends from junior school had gone to a different secondary; I was very shy and got picked on by some of the other kids. Despite this, I know that I was lucky. My social difficulties were nothing to do with my home life and I had a warm and loving family.

For thousands of children this is not the case. Experiences of abuse or neglect can leave some children struggling to cope with social situations. Psychological models can help us to understand why this might be the case. Crick and Dodge’s social information-processing model places the child’s experiences at the centre of their responses to social stimuli. Viewed in this way, repeated exposure to violence at home can predispose a child to interpret all social encounters in a negative light and react accordingly. Aggressive behaviour can be the most adaptive response if it’s a case of ‘hit, or be hit’ – the problem is that behaviour that is adaptive in the maltreating environment is unacceptable in more ‘normative’ social situations. Children whose ingrained response to social encounters is to lash out can therefore become known in the peer group for all the wrong reasons.

A Vygotskian approach would suggest that children learn how to relate to others in their earliest interactions with caregivers. Unlike physically abused children, whose experiences with caregivers might contribute to a negative-bias in the processing of social information, severely neglected children, who have experienced little interaction with parents or others, might therefore be expected to struggle to acquire the ‘tools’ needed for successful social interactions. As a result, they can become socially withdrawn and ‘invisible’ in the peer group.

I should point out that these difficulties are not inevitable; neither are they irreversible. If my interactions with looked after children and care-leavers have taught me anything, it is that this is a set of individuals displaying remarkable diversity and resilience. Indeed, for some young people, school provides a feeling of security and a set of stable and mutually satisfying relationships that is not available at home. Notwithstanding these individual success stories, the general picture from the research is that the risk of peer relationship difficulties is greater for children with maltreatment histories.

Educators and foster carers can work together to make improvements in this area. This means being aware that children who have been abused or neglected might find it difficult to concentrate on making academic progress if they are struggling to ‘fit in’ socially. By placing our focus on improving young people’s socio-emotional well-being, we can help them get into the right ‘headspace’ to learn.

I am currently preparing the results of my study into the socio-emotional well-being of maltreated children in primary schools for publication. Check my publications page or follow me on Twitter for updates. 

Lean on me

Judy and I have now published a review of the international literature on opportunities for peer contact between foster carers, and the potential that contact schemes can have for meeting carers’ support needs. 

The review – ‘Supporting each other: An international literature review on peer contact between foster carers’ – shows that fostering services provide a range of schemes to encourage peer contact amongst foster carers, and that these can fulfil carers’ needs for emotional (the provision of caring and empathy), instrumental (concrete assistance), informational (assisting with problem-solving) and appraisal (positive feedback) support (Hinson Langford, Bowsher, Maloney, & Lillis, 1997). In addition, peer contact can serve to counter the sense of isolation that foster carers can experience (Blythe, Jackson, Halcomb, & Wilkes, 2011).

The review also highlights a need for more evaluation in the use of peer contact schemes for foster carers. We are currently planning a follow-up study in which we will work with a number of foster care providers on the design of peer contact schemes, and evaluate outcomes for carers and their placements.

For a free download of the report, please click here.

 

References

Blythe, S. L., Jackson, D., Halcomb, E. J., & Wilkes, L. (2011). The stigma of being a long-term foster carer. Journal of Family Nursing, 18(2), 234-260.

Hinson Langford, C. P., Bowsher, J., Maloney, J. P., & Lillis, P. P. (1997). Social support: A conceptual analysis. Journal of Advanced Nursing, 25(1), 95-100.