ContentsChapter 1: Mental health overviewMental health problems – an introduction1What’s mental health? 3Do I have mental health problems and shoud I get some help?4Reporting on mental health - media guidelines6Mental health in the UK: The big picture7We need to rethink how we classify mental illness8Key findings from the 2017 Mental Health of Children and Young People report101.4 million people referred to NHS mental health therapy in the past year12Chapter 2: Mental health challengesSetting more exams to combat stress among school students is utterly absurd13Exam stress for school children14Teenagers who access mental health services see significant improvements, study shows15School mental health referrals rise by more than a third161 in 10 children have no one to talk to in school when they are worried or sad18Risk and protective factors20Funding for mental health services fails to reach the frontline22Mental health: there are fewer beds, nurses and psychiatry trainees than in 201023These black women felt excluded by mainstream mental health charities – so they started their own24An interest rate rise may put thousands at risk of mental health problems26Chapter 3: Managing mental healthFive lifestyle changes to enhance your mood and mental health28For the first time, print media reporting of mental health is significantly more balanced and responsible with more coverage than ever before – latest study shows30Gaming addiction can be treated on the NHS after it is declared a medical disorder31LSD and magic mushrooms could heal damaged brain cells in people suffering from depression32Why we invest in mental health33Report shows that therapy dogs may reduce risk of self-harm in prisoners34What treatments are available?35ASMR videos could be a new digital therapy for mental health36UK teenagers turn to mobile apps to help with mental ill health 38Key facts40Glossary41Assignments42Index43Acknowledgements 44ISSUES: Mental HealthChapter 1: Mental health overview1Chapter 1: Mental health overview ISSUES: Mental HealthMental health problems – an introductionThere are many different mental health problems. Some of them have similar symptoms, so you may experience the symptoms of more than one mental health problem, or be given several diagnoses at once. Or you might not have any particular diagnosis, but still be finding things very difficult. Everyone’s experience is different and can change at different times.What types are there?DepressionDepression is a feeling of low mood that lasts for a long time and affects your everyday life. It can make you feel hopeless, despairing, guilty, worthless, unmotivated and exhausted. It can affect your self-esteem, sleep, appetite, sex drive and your physical health. In its mildest form, depression doesn’t stop you leading a normal life, but it makes everything harder to do and seem less worthwhile. At its most severe, depression can make you feel suicidal, and be life-threatening.Some types occur during or after pregnancy (antenatal and postnatal depression), or may come back each year around the same time (seasonal affective disorder).Anxiety problemsAnxiety is what we feel when we are worried, tense or afraid – particularly about things that are about to happen, or which we think could happen in the future.Occasional anxiety is a normal human experience. But if your feelings of anxiety are very strong, or last for a long time, they can be overwhelming. You might also experience physical symptoms such as sleep problems and panic attacks.You might be diagnosed with a particular anxiety disorder, such as generalised anxiety disorder (GAD), social anxiety (social phobia), panic disorder or post-traumatic stress disorder (PTSD). But it’s also possible to experience problems with anxiety without having a specific diagnosis.PhobiasA phobia is an extreme form of fear or anxiety triggered by a particular situation (such as going outside) or object (such as spiders), even when it’s very unlikely to be dangerous.A fear becomes a phobia if the fear is out of proportion to the danger, it lasts for more than six months, and has a significant impact on how you live your day-to-day life.Eating problemsEating problems are not just about food. They can be about difficult things and painful feelings which you may be finding hard to face or resolve. Lots of people think that if you have an eating problem you will be over- or underweight, and that being a certain weight is always associated with a specific eating problem, but this is a myth. Anyone, regardless of age, gender or weight, can be affected by eating problems. The most common eating disorder diagnoses are anorexia, bulimia, binge eating disorder, and other specified feeding or eating disorder (OSFED). But it’s also possible to have a very difficult relationship with food and not fit the criteria for any specific diagnosis.Mental health overviewChapter1ISSUES: Mental HealthChapter 1: Mental health overview2Obsessive-compulsive disorder (OCD)Obsessive-compulsive disorder is a type of anxiety disorder. The term is often misused in daily conversation – for example, you might hear people talk about being ‘a bit OCD’, if they like things to be neat and tidy. But the reality of this disorder is a lot more complex and serious.OCD has two main parts: obsessions (unwelcome thoughts, images, urges, worries or doubts that repeatedly appear in your mind; and compulsions (repetitive activities that you feel you have to do to reduce the anxiety caused by the obsession).Bipolar disorderBipolar disorder (once called manic depression) mainly affects your mood. With this diagnosis you are likely to have times when you experience: manic or hypomanic episodes (feeling high); depressive episodes (feeling low); and potentially some psychotic symptoms.Everyone has variations in their mood, but in bipolar disorder these swings can feel very extreme and have a big impact on your life. In between, you might have stable times where you experience fewer symptoms.SchizophreniaViews on schizophrenia have changed over the years. Lots of people question whether it’s really a distinct condition, or actually a few different conditions that overlap. But you may still be given this diagnosis if you experience symptoms such as:• psychosis (such as hallucinations or delusions)• disorganised thinking and speech • feeling disconnected from your feelings • difficulty concentrating • wanting to avoid people • a lack of interest in things • not wanting to look after yourself.Because psychiatric experts disagree about what schizophrenia is, some people argue that this term shouldn’t be used at all. Others think the name of the condition doesn’t matter, and prefer to just focus on helping you manage your symptoms and meeting your individual needs.Personality disordersPersonality disorder is a type of mental health problem where your attitudes, beliefs and behaviours cause you longstanding problems in your life. If you have this diagnosis it doesn’t mean that you’re fundamentally different from other people – but you may regularly experience difficulties with how you think about yourself and others, and find it very difficult to change these unwanted patterns.There are several different categories and types of personality disorder, but most people who are diagnosed with a particular personality disorder don’t fit any single category very clearly or consistently. Also, the term ‘personality disorder’ can sound very judgemental.Because of this it is a particularly controversial diagnosis. Some psychiatrists disagree with using it. And many people who are given this label find it more helpful to explain their experiences in other way.This information was published in October 2017 – to be revised in 2020. The above information is reprinted with kind permission from Mind. © 2019 Mindwww.mind.org.ukISSUES: Mental HealthChapter 1: Mental health overview3Mental health spectrumThe World Health Organization defines mental health as a state of wellbeing in which every individual achieves their potential, copes with the normal stresses of life, works productively and fruitfully, and is able to make a contribution to their community. Mental health includes our emotional, psychological and social wellbeing. It affects how we think, feel and act. Like physical health, mental health is something we all have. It can range across a spectrum from healthy to unwell; it can fluctuate on a daily basis and change over time.What’s mental health?Adapted from Centre for Mental HealthGood mental health helps children:• learn and explore the world• feel, express and manage a range of positive and negative emotions• form and maintain good relationships with others• cope with, and manage change and uncertainty• develop and thrive.Building strong mental health early in life can help children build their self-esteem, learn to settle themselves and engage positively with their education. This, in turn, can lead to improved academic attainment, enhanced future employment opportunities and positive life choices.Promoting mental healthThere is good evidence that schools can help all children develop essential social and emotional skills through delivering bespoke sessions designed to cultivate these skills, through ensuring broader opportunities are capitalised on to reinforce skills across the curriculum and through whole-school modelling of these skills. Social and emotional skills prevent poor mental health from developing, help all children cope effectively with setbacks and remain healthy. These whole-school programmes are noted to benefit all children but particularly those who are at most risk.Schools can support these children by providing them with additional help to understand and manage their thoughts, feelings and behaviour and build skills that help them to thrive, such as working in a team, persistence and self-awareness. Coping skillsMental health doesn’t mean being happy all the time. Neither does it mean avoiding stress altogether. Coping and adjusting to setbacks are critical life skills for children, but it’s important that they develop positive, rather than negative, coping skills.Negative coping skills are attitudes and behaviours that have often been learned in the absence of positive support and in the face of stressful and often traumatic events and experiences which, over time, may put good mental health at risk.Example: children at risk of or experiencing maltreatment in the home may have learned to react quickly and in a certain way (flight or fight or freeze) to survive and keep themselves safe. But in a classroom, these reactions may not work well and could get them into trouble, disrupt learning and make them unpopular with teachers and peers. In the longer term, these learned behaviours may also impact on their mental health and wellbeing, sense of belonging, educational achievements, peer relationships and life chances. Positive coping skills are ways of thinking, attitudes and behaviours that allow children to deal with stress or adversity and which help them flourish. These positive coping skills form an important part of a child’s ability to be resilient in the face of setbacks and challenges. Children who have cultivated robust coping skills can still thrive with support, even when they are mentally unwell.What affects child mental health?A child’s mental health is influenced by many things over time. Children have different personalities and they will be exposed to a range of factors in their homes and communities that can trigger worsening mental health (risk factors), or alternatively protect them and help them feel able to cope (protective factors). Ideally, all children should have at least one adult in their life who is monitoring whether they are coping or not.Identifying children who are strugglingDeteriorating mental health is not always easy to spot and can be overlooked until things reach crisis point. At least two children in every primary school class (based on average class size of 27) are likely to have a diagnosable mental health condition. This rises to three to four students in every HealthyCopingStrugglingUnwellISSUES: Mental HealthChapter 1: Mental health overview4class by secondary school age (Green, 2005).1 Around a further six to eight children in each primary school class will be struggling just below this ‘unwell’ threshold (Wyn, J. et al., 2000).2Mental health: why it’s important to schoolsSchools are the ideal environment in which to promote and support the mental health of primary age children, ensuring they can reach their potential and take advantage of opportunities throughout their lives: • Most children spend a significant amount of time in school and school staff are in a good position to piece together the jigsaw of what may be undermining a child’s mental health.• Parents also tend to approach schools first for advice when children experience mental health challenges.• There is strong evidence that school programmes which promote social and emotional skills can improve mental health and academic attainment.• Children with good mental health are more positive, settled and can achieve better academically.• Early help can also prevent unnecessary crises, poor life chances and significant costs affecting the public purse.February 20181 Green, H., McGinnity, A., Meltzer, H., Ford, T. & Goodman, R. (2005). The mental health of children and young people in Great Britain 2004. Basingstoke, Hampshire: Palgrave.2 Wyn, J. et al., 2000. MindMatters, a whole school approach promoting mental health and wellbeing. Australian and New Zealand Journal of Psychiatry, 34(4), pp. 594–60.Do I have mental health problems and should I get some help?Chances are that within your lifetime you will experience some form of mental health problem, the most common of these being depression and anxiety. But because most people with a mental health condition will never access any formal types of support or treatment, many of these mental health problems will go undiagnosed. Longitudinal studies (i.e. research conducted with the same people over many years) support the notion that experiencing a diagnosable mental health condition or disorder at some stage during a person’s life is the norm, not the exception. A study recently published by Schaefer and colleagues (2017) established that over 80% of participants from their health and development study were found to have a diagnosable mental health condition, from the time of their birth to midlife. This was amongst a representative group of more than 1,000 people studied over a four-decade period. So if most of us will experience mental ill-health at some time in our lives, why is it so hard for people to recognise the signs and symptoms of this in themselves, and subsequently access treatment? Here are five reasons why people may be reluctant to seek professional help: 1: Mental health stigma and its impactRegrettably there is still a stigma associated with being diagnosed with a mental health condition. Understandably, given this stigma, people with mental health problems can worry that they will get judged and seen as weak, so many can end up keeping their experiences to themselves or denying that their problems exist. Fortunately, there is now greater protection against discrimination on the basis of mental ill-health, as a result of legislation like the 2010 Equality Act. This legal protection makes it easier for people to open up about their mental health problems, especially in the workplace. In addition to this legal advancement, large-scale public campaigns have sought to challenge mental health stigma, and increase awareness of its negative impact. For example ‘Time to Change’ in England, which has sought to reduce mental health-related stigma and discrimination since 2009. 2: Problems in the mild to moderate rangeEvery individual is different, and it can be hard for us to recognise if what we are experiencing is ‘normal’ or not. As the saying goes, ‘normal is nothing more than a cycle on a washing machine’ and the real norm is that most of us will experience a period of mental ill-health sometime in our lives. For the majority this will take the form of something The above information is reprinted with kind permission from Mentally Healthy Schools. © 2019 Mentally Healthy Schoolswww.mentallyhealthyschools.org.ukISSUES: Mental HealthChapter 1: Mental health overview5in the ‘mild to moderate range’ of difficulties. For example, temporary periods of feeling low are common, and are often a normal reaction to the stressors we can experience. For most people, seeking support from their friends and/or family members can help them get through these difficult times. Self-help resources and interventions like mindfulness can also be useful in assisting people in overcoming life’s challenges. If your low mood or other mental health problems persist, affecting your sleep, relationships, job and/or appetite, this can indicate that you may require some additional help, and a visit to your general practitioner (GP) would be recommended.“Normal is nothing more than a cycle on a washing machine.”– Whoopi Goldberg3: When is it really bad?It is important to be able to recognise when a mental health problem has progressed to becoming a major issue. Many people can struggle to notice in themselves when their mental health problems are more severe. This might seem surprising, but because a person can be suffering over a long period of time, their symptoms may not initially have a dramatic impact. In addition to this, even when mental health problems can be debilitating, a person may still feel that their problems aren’t bad enough to warrant professional treatment. If you are having persistent worries, distressing feelings or frightening experiences it can really help to get support and information. This may initially involve visiting your GP. Sometimes people may need specialised mental health services and a GP can help people access services. GPs assist many people with their mental health problems, and recently there have been some indications that they are supporting more and more people with mental health problems.4: Securing treatmentThere are a range of supports and interventions available for people with mental health problems. But it can be hard to know what to look for when attempting to get help. It can be overwhelming and exhausting just finding the right type of support for you. Do you want a psychotherapist? A practitioner psychologist? A counsellor? Is medication an option? Is a combination of medication and face-to-face therapy the best interventions for you? What is funded and what do you need to pay for yourself? There are also the challenges associated with getting a session or appointment that is at a time and place that is convenient to you. There is Improving Access to Psychological Therapies (IAPT), which began almost 10 years ago and has delivered treatment to over 900,000 adults with anxiety and depression, both in individual sessions and in group-based format. However, there can be waiting lists for IAPT and for other state-funded forms of therapy. For those with the funds available to pay for treatment, websites like welldoing.org can assist people to find a therapist.5: A lack of hopeHope is of fundamental importance to all humans, but when someone is struggling with mental health problems, this can be compromised. Sometimes people will not access help, even if they recognise that they have significant issues, in part because they feel so negatively about their future. A lack of hope in regard to one’s future is a sign that a person needs to seek help. It could be from a family member, your GP, the Samaritans, from the MIND infoline or a trusted friend.December 2017Schaefer, J. D. et al. (2017). Enduring mental health: Prevalence and prediction. Journal of Abnormal Psychology, 126(2), 212–224.The above information is reprinted with kind permission from Open Learn. ©1999-2018. All rights reservedwww.open.edu5ISSUES: Mental HealthChapter 1: Mental health overviewContentsChapter 1: Energy nowTypes and alternative sources of renewable energy 1Renewable energy information4Renewable energy set to be cheaper than fossil fuels by 2020, according to new report 6Eight awesome facts about renewable energy 7Scottish wind power smashes 100% production threshold8How we can use wind power when there’s no wind9About 15% of the UK’s electricity comes from wind 10Ocean energy: Time to unleash the current 11Renewable energy: Report claims large hydropower projects damaging to the environment 12Majority of UK public want to install solar panels, poll finds 13Is the UK sunny enough for solar panels to work? 14Homeowners trapped by 25-year solar panel contracts 15Why is it so hard to get people to switch to renewable energy? 16Do renewable energy technologies need government subsidies? 18EU countries by production of clean energy 20Has Spain learned its renewable energy lesson? 22Chapter 2: The future of energyEurope’s transition to a green energy future 23Meet the new ‘renewable superpowers’: nations that boss the materials used for wind and solar 25Running on renewables: how sure can we be about the future? 27Predictions – The future of energy 28Nearly 140 countries could be powered entirely by wind, solar and water by 2050 30Wind and solar power could provide more than a third of Europe’s energy by 2030 31Fairtrade renewable energy: shedding light on clean energy’s dirty secrets 32Fatbergs clogging up Britain’s sewers could soon be providing homes with green energy 34Poo power: is faecal matter the future? 35How we can turn plastic waste into green energy 36Promoting a sustainable energy future 37Energy saving quick wins 38Key facts40Glossary41Assignments42Index43Acknowledgements 4423ISSUES: Renewable EnergyChapter 2: The future of energyThe future of energyChapter2Europe’s transition to a green energy futureSweden is one of the leading lights when it comes to energy transition in Europe. The Nordic country gets more than half of all its energy needs from renewables. By 2045, it plans to be carbon free. The Scandinavian state’s success, however, is in stark contrast when compared to others. Despite the EU setting transition targets for 2020, some countries continue to lag behind. For instance, Poland still remains deeply reliant on coal to generate its energy. With so many jobs dependent on the fossil fuel, there is an obvious reluctance to change.Marek Wystyrk is a former Polish miner. He admits that transitioning to cleaner fuels is necessary but still believes coal has a future.‘I think we have to use our wealth of coal. I’m from a coal-mining family. But I know that we have to facilitate change because of pollution and our climate,’ he says.Marek steered his eldest son, Szymon, towards a high school specialising in green energy. For Szymon, the change can’t come soon enough.‘The environment is very important to me, because in the place where I live, I don’t need to smoke cigarettes. Just by breathing, it’s like smoking ten packets of cigarettes a day…but my generation will make a change. We are starting to do that.’While the majority of Poland’s energy still comes from coal, small steps are being made to generate greener energy in the country through solar farm initiatives.By 2020, 15 per cent of Poland’s energy needs should come from renewables.There is also a push to make coal cleaner. Krzysztof Kapusta is a researcher at the Clean Coal Technology Centre in Mikolow. The lab is funded by the EU.Share of energy from renewable sources(in % of gross nal energy consumption)01020304050607080NetherlandsMaltaLuxembourgBelgiumUnited KingdomCyprusIrelandPolandSlovakiaHungaryGermanyCzech RepublicGreeceFranceSpainItalyFYR MacedoniaBulgariaSloveniaRomaniaLithuaniaCroatiaPortugalEstoniaDenmarkAustriaAlbaniaLatviaFinlandMontenegroSwedenNorwayIcelandEU2004 vs. 20162004 201601020304050607080NetherlandsMaltaLuxembourgBelgiumUnited KingdomCyprusIrelandPolandSlovakiaHungaryGermanyCzech RepublicGreeceFranceSpainItalyFYR MacedoniaBulgariaSloveniaRomaniaLithuaniaCroatiaPortugalEstoniaDenmarkAustriaAlbaniaLatviaFinlandMontenegroSwedenNorwayIcelandEU2020 Target8.5 8.532.8 4.429.2 9.538.7 15.158.1 11.358.9 13.741.527.8 9.322.5 1114.9 17.318.4 10.419.2 9.323.5 4.817.2 8.416.3 8.716.1 5.29.4 9.415.7 2.56.3 11.18.4 8.99.5 6.56.9 8.36.8 8.15.8 94.4 9.86.4 5.66.9 4.42.4 7.13.1 6.21.1 8.21.9 6.80.9 5.40.1 5.92 4493838303123252820181814161511641467.53340342520241617231313151313201024ISSUES: Renewable EnergyChapter 2: The future of energy‘Gasification of coal is better than conventional burning because it makes it possible to reduce the environmental impact of the coal utilisation – by removing contaminants such as sulphur and mercury, for example, before coal utilisation.’At the University of Silesia, which is located in the heart of Poland’s coal mining region, Professor Piotr believes change can happen quickly if the government steps in.‘There are a lot of enthusiastic people, they start to use… different kinds of renewable energy. If our government will lead them to be active in this way, the situation will change very fast, I think.’Europe’s energy picture ÖEurope has doubled its renewable use in the past 12 years. ÖThe energy we waste in Europe could power all our buildings’ needs. ÖEnergy efficient products could save families up to 500 Euros a year. ÖMore than a quarter of the innovations for new tech in renewables are made by European companies. ÖThe ocean at Europe’s doorstep could eventually power 10% of all our demand.But, the drive towards cleaner energy has not been without its problems. Countries in Europe continue to disagree over the bloc’s 2030 transition targets.Sweden’s Energy Minister, Ibrahim Baylan, however, insists change is both inevitable and economically beneficial.Renewable energy in EuropeSource: EuroNews30 billionThe yearly reduction of our fossil fuel imports80%The prices that solar panels have fallen in just four years2012The year when renewables reduced CO2 emissions by 326 Mt (equivalent to the annual emissions of Spain)130 billion The amount earned by EU renewable companies 1 million The number of people that work in renewables2,400The number of renewable energycooperatives in Europe in 2015‘Coal is not anymore the cheapest way of producing electricity or energy... Solar is! This year, we are seeing off-shore wind being built without any subsidies. So, I think for those countries who are still arguing for fossil fuels... for coal... From economic point of view I cannot understand it anymore.‘Obviously when we made the transition it also created tens of thousands of local jobs… As a politician you have also to see not only the jobs you have today.’Nevertheless, the gap between EU countries when it comes to generating energy from renewables is significant.In 2016, Eurostat figures showed that Austria (72.6%) and Sweden (64.9%) produced at least three-fifths of all their electricity from renewable energy sources, while Portugal (54.1%), Denmark (53.7%) and Latvia (51.3%) produced more than half.At the opposite end of the scale, the lowest proportions of renewables were registered in Luxembourg (5.4%), Malta and the Netherlands (both 6.0%), Belgium (8.7%) and the United Kingdom and Cyprus (both at 9.3%).6 February 2018The above information is reprinted with kind permission from euronews. © euronews 2019www.euronews.comNext >