Young people do not get help in time
'I became a shut-in'
Young people with psychological issues often wait too long to get help. Research done by sociologist Dennis Raven at the UMCG has shown this.
Anna had trouble focusing even in elementary school, but was only diagnosed as having ADHD when she was twenty-three.
Noud spent three years slowly sinking into depression before he got help. Depressed young people seek help relatively more often than other people, but even they often wait too long, says Raven.
Young people and their environment often (without knowing it) develop coping mechanisms to deal with their symptoms without asking for help. Noud’s coping mechanism was lying.
Raven thinks it is important that people with psychiatric issues seek help, lest their problems get bigger.
Young people with psychiatric problems often wait much too long getting professional help, says sociologist Dennis Raven. At the UMCG, he researched psychological problems among young people. ‘Many disorders develop early in life, but people often don’t contact social workers until later in life.’
The same went for Anna* (26). Even in elementary school she had trouble sitting still in class. She also had a hard time focusing. ‘I never really paid attention in class. I wanted to do my homework, but I just couldn’t find the discipline. I also really suffered from it in high school. I tried really hard, but I often just didn’t quite make it’, she says.
Since then, she has figured out what it is: she has ADHD. But it took a long time before she was diagnosed. ‘I functioned well socially, I had many friends and I was never bullied. At home people generally didn’t pay a lot of attention to me: most of the attention went to my brother, who is severely autistic. That meant I didn’t figure out what was going on in time’, Anna explains.
Relief
As she started studying, the problems remained. Eventually she typed her biggest issue, the trouble she had focusing, into Google. The results indicated ADHD. At this the student finally went to her doctor, at twenty-three years old. They referred her to a psychologist.
‘That intake was such a relief’, Anna remembers. ‘They asked all these questions that were instantly recognisable. It was quite emotional: only then did I realise it wasn’t my fault. My problems were completely normal.’
She is convinced her life would have been different if she had been diagnosed earlier. ‘Then I would’ve been able to get special help and I would have been able to graduate before I was twenty-three. I restarted my studies three times. My study financing runs out in two months and then I’ll have to start borrowing money.’
Prevent problems
According to Raven, recognising psychiatric disorders in a timely manner is essential to people getting help faster. But, says the researcher, common disorders and their symptoms need to be much more well-known in order for that to happen. ‘It’s more than just about recognition and treatment: some of these issues are actually preventable.’ He lists being bullied at school as an important predictor of psychiatric problems in young people.
‘Phobias, separation anxiety, ADHD/ADD and behavioural disorders such as oppositional defiant disorder are mainly expressed during childhood. Depressions and mood disorders occur halfway during adolescence and addictions pop up towards the end of adolescence’, says the sociologist. The European Psychiatric Society named his research the best publication in child and youth psychiatry of the past year.
TRAILS
Sociologist Dennis Raven focused on a wide range of psychiatric disorders in 1,584 young people between eighteen and twenty years old. In his research, he used data provided by TRAILS, a long-running study into the mental, physical, and social well-being of young people.
They were interviewed to determine whether they suffered from any disorders, when these developed, if they had got help, and how old they were when they first made contact with professional help. Out of all the participants, 43 percent had suffered from a psychiatric disorder.
Raven discovered that the time it takes young people to seek help depends on the disorder they have. ‘For anxiety disorders, it would take approximately twelve to thirteen years. And then only thirty percent of the respondents had contacted a social worker. For ADD it took round and about eleven years before fifty percent got help. In comparison, a third of young people with depression get help within a year after they experienced their first symptoms. That is a lot sooner than with other disorders, but even they wait too long.’
Severe depression
Informatics student Noud* (25) suffers from severe depression and post-traumatic stress disorder. Although he got help faster than Anna did, it took him quite a while, too. ‘In hindsight I should’ve known something was up much sooner’, he admits. He only truly realised something was wrong in April of last year. ‘By then it was much too late.’
For three years, Noud was slowly sinking into depression. He spent increasingly less time on his studies and kept skipping exams and classes. Eventually, he ended up doing absolutely nothing. ‘It just kept getting harder for me to do things. Not just in university, but in life. I withdrew from the world, I didn’t want to go out anymore, I kept cancelling plans. I became a virtual shut-in.’
Raven did not research why young people wait so long to get help, but he has his theories. ‘Young people and their environment are often able to, unbeknownst to them, develop coping mechanisms to deal with the symptoms. What these mechanisms are and how they work is something for further study.
Web of lies
Noud’s coping mechanism was lying. He told his friends and his environment nothing about his situation. He came up with excuses and tried to keep up appearances. ‘I created a web of lies’, he admits. ‘It wasn’t even a conscious choice. I just automatically lied to protect myself. I was in really bad shape. But I thought that if I just pretended that everything was fine, it would be.’
Eventually he realised that he might be depressed. After an online test he went to his GP, who referred him to the crisis centre at Lentis. Two months later he started specialist treatment. Noud still sees his psychologist every week. ‘I’m pretty much able to do things on my own, but I still can’t really undertake things. I’ve always loved studying. I’d really like to go back, but I just don’t have the strength for it right now.’
Resistance
As a child, Noud had also been to visit a psychologist, so he was not as resistant to getting psychiatric help as other people. Raven knows that many people with psychological issues have trouble getting help. ‘And yet it’s very important that these young people do get help, lest their problems become ever bigger. Psychiatric disorders are known to return later in life or cause other psychiatric problems.’
Noud’s issues also seem to stem from an earlier trauma. His parents divorced when he was very young. He moved in with his mother, but suffered physical abuse at the hands of his stepfather. ‘Eventually I moved in with my father’, says Noud. But they did not get along. ‘My father’s parenting techniques were problematic, but I had issues, too.’
For four years he visited a child psychologist. ‘It looked like the problem had been solved.’ But Noud’s doctors think it was not, in fact, solved: according to them, his trauma has resurfaced. ‘I just thought I was depressed, but it turned out to be more than that.’
* At the request of the interviewees, the names Anna and Noud are fictional. Their real names are known to the editorial staff.