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Violence can happen everywhere in the lives of young people with cognitive disability. Young people with cognitive disability, family members, and workers talk about what needs to change. Services need to work together to help young people with cognitive disability. Others need to know about and respect the culture of young people with cognitive disability. Others need to respect young people’s choices on whom they want to love. Young people with cognitive disability can be helped to understand what is violence. Services can change what they do so that they can keep young people with cognitive disability safe. Young people with cognitive disability say that there should be ‘nothing about us unless it is led by us’.
This chapter explains what this book is about. Becoming an adult is different for everybody. Young people with cognitive disability can find it hard to get the right supports to become an adult. Many young people can experience violence and abuse. This book tells the stories of young people with cognitive disability from different backgrounds. Family members and practitioners also talk about stories of young people with cognitive disability.
This chapter looks at the Department of Child Safety and the criminal justice system. Child Safety often didn’t understand that a young person had a cognitive disability. Sometimes young people with cognitive disability were abused while they were in Child Safety. Young people with cognitive disability often did not get much help when they left Child Safety. Parents with cognitive disability often had their children removed from them by Child Safety. Some young people were abused by police. Young people with cognitive disability who went to prison didn’t get much help. They also found it hard when they left prison.
Young people with cognitive disability found school to be both good and bad. Things were good when young people had friends and when teachers listened and tried to help. Things were bad when the school wanted young people with cognitive disability to be like everyone else. Young people could be punished or neglected if they didn’t fit in with everyone else. Leaving school could be hard. Young people with cognitive disability often didn’t have a job or university to go to. The United Nations Convention on the Rights of Persons with Disabilities says that all people with disability have a right to a good education, and that people should be supported to get a job or to learn more after school.
This chapter explains how the researchers talked to young people with cognitive disability, their families, and practitioners. The researchers included people with disability on the research team. The researchers wanted to know what was happening for young people with cognitive disability. They wanted to know about the world in which young people with cognitive disability lived. There was much to be learnt about working well with people with disability in research. It’s important that people with cognitive disability have a voice in the research that is about them.
This chapter explores what we know about violence against young people with cognitive disability. It looks at what can make it more likely that young people with cognitive disability are abused. It’s hard to really know how many young people with cognitive disability have experienced violence. Young people with cognitive disability can be harmed by workers, family, or friends who are meant to help them. Abuse can happen in many places. Services and society need to learn how to keep young people with cognitive disability safe. We need to make sure young people can make decisions for themselves.
Young people with cognitive disability deserve to live in a home of their choice. They also deserve to get help when they feel mentally unwell. This chapter looks at where young people with cognitive people live. Many young people felt unsafe where they lived. Some young people needed mental health services. It could be hard to trust mental health staff. Mental health services were good when staff really wanted to help and listened to the young person. Young people with cognitive disability should be helped to make their own decisions.
Family, friends, partners, and pets can help young people with cognitive disability as they become adults. Some young people with cognitive disability had families who spoke up for them and helped them when times were hard. Some young people with cognitive disability had partners who helped them feel good about themselves. Friends could help young people with cognitive disability leave abusive situations. Professionals can do more to help young people with cognitive disability make friends and be part of their community.
Young people with cognitive disability, families, and practitioners reported many acts of violence against young people. The violence included physical abuse, sexual assault/abuse, neglect, exploitation, emotional and psychological abuse, and domestic and family violence. Young people were abused by other young people with disability, family members, partners, practitioners, and services. Young people in this book found the strength to speak up and tell their stories of violence.
This chapter tells Amethyst’s story. Amethyst is an Aboriginal and South Sea Islander young woman with cognitive disability. Amethyst is not her real name. Amethyst was abused many times as a child and a young adult. Her story can tell us a lot about what needs to change for young people with cognitive disability. We need to understand that abuse affects a person’s whole life, their family, and their world.
Becoming an adult involved lots of changes and challenges for young people with cognitive disability. Many services, and sometimes families, judged young people badly because they had a cognitive disability. Young people needed help to be independent, but this wasn’t always given to them. Some young people were lonely and found so-called friends who abused them. Aboriginal and/or Torres Strait Islander young people and young people from culturally and linguistically diverse backgrounds needed others to understand and respect their culture. LQBTIQA+ young people wanted love and acceptance as they became adults.
This chapter looks at services and focuses on the National Disability Insurance Scheme (NDIS). Services don’t always recognise what young people with cognitive disability can do. They can neglect young people with cognitive disability. This can lead to violence and abuse of the young person. This chapter looks at how young people with cognitive disability found support from NDIS agencies. Young people with cognitive disability had trouble getting onto the NDIS. Professionals, families, and young people needed to fight to make sure supports were helpful. The NDIS must get better for all people with disability.
Young people with childhood adversity (CA) were at increased risk to experience mental health problems during the COVID-19 pandemic. Pre-pandemic research identified high-quality friendship support as a protective factor that can buffer against the emergence of mental health problems in young people with CA. This longitudinal study investigated friendship buffering effects on mental health symptoms before and at three timepoints during the pandemic in 102 young people (aged 16–26) with low to moderate CA. Multilevel analyses revealed a continuous increase in depression symptoms following the outbreak. Friendship quality was perceived as elevated during lockdowns and returned to pre-pandemic baseline levels during reopening. A stress-sensitizing effect of CA on social functioning was evident, as social thinning occurred following the outbreak. Bivariate latent change score modeling revealed that before and during the pandemic, young people with greater friendship quality self-reported lower depression symptoms and vice versa. Furthermore, sequential mediation analysis showed that high-quality friendships before the pandemic buffered depression symptoms during the pandemic through reducing perceived stress. These findings highlight the importance of fostering stable and supportive friendships in young people with CA and suggest that through reducing stress perceptions high-quality friendships can mitigate mental health problems during times of multidimensional stress.
This study evaluated the impact of 2015/2016 prescribing guidance on antidepressant prescribing choices in children.
Methods
A retrospective e-cohort study of whole population routine electronic healthcare records was conducted. Poisson regression was undertaken to explore trends over time for depression, antidepressant prescribing, indications and secondary care contacts. Time trend analysis was conducted to assess the impact of guidance.
Results
A total of 643 322 primary care patients in Wales UK, aged 6–17 years from 2010–2019 contributed 3 215 584 person-years of follow-up. Adjusted incidence of depression more than doubled (IRR for 2019 = 2.8 [2.5–3.2]) with similar trends seen for antidepressants. Fluoxetine was the most frequently prescribed first-line antidepressant. Citalopram comprised less than 5% of first prescriptions in younger children but 22.9% (95% CI 22.0–23.8; 95% CI 2533) in 16–17-year-olds. Approximately half of new antidepressant prescribing was associated with depression. Segmented regression analysis showed that prescriptions of ‘all’ antidepressants, Fluoxetine and Sertraline were increasing before the guidance. This upward trend flattened for both ‘all’ antidepressants and Fluoxetine and steepened for Sertraline. Citalopram prescribing was decreasing significantly pre guidance being issued with no significant change afterward.
Conclusions
Targeted intervention is needed to address rising rates of depression in children. Practitioners are partially adhering to local and national guidance. The decision-making process behind prescribing choices is likely to be multi-factorial. Activities to support implementation of guidance should be adopted in relation to safety in prescribing of antidepressants in children including timely availability of talking therapies and specialist mental health services.
Young people (YP) (between 10 and 24 years) are disproportionally vulnerable to developing and being affected by mental health conditions due to physical, social and emotional risk factors. YP in low-and middle-income countries (LMICs) have poorer access to, and quality of, mental health services compared to those in high-income countries. Digital mental health interventions (DMHIs) have been proposed as tools to address this burden of disease and reduce the global treatment gap in youth mental health outcomes. This study aimed to examine the evidence for DMHIs for treating mental disorders in YP based in LMICs. To do this, the author searched academic databases (MEDLINE, PsycINFO, Embase and Web of Science) for primary studies on DMHIs targeting YP in LMICs. Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria were followed. The quality of the studies was assessed using the Critical Appraisal Skills Programme) framework. A narrative synthesis methodology was used to summarise and explain the findings. The authors identified 287 studies of which 7 were eligible in the final review. The authors found evidence of the effectiveness of multiple forms of DMHI (especially internet-based cognitive behavioural therapy) on anxiety and depression outcomes. Studies reported a lack of long-term benefits of treatment, high dropout rates, and did not include key geographical settings or data on cost-effectiveness. No studies were judged to be of high quality. This review highlights the available evidence showing that DMHIs can improve mental health outcomes for YP in LMICs, but due to the limited number of studies and lack of high-quality data, increased adoption and scaling up of digital interventions require more rigorous studies showing clinical effectiveness and ability to provide return on investment.
Identifying children and/or adolescents who are at highest risk for developing chronic depression is of utmost importance, so that we can develop more effective and targeted interventions to attenuate the risk trajectory of depression. To address this, the objective of this study was to identify young people with persistent depressive symptoms across adolescence and young adulthood and examine the prospective associations between factors and persistent depressive symptoms in young people.
Methods
We used data from 6711 participants in the Avon Longitudinal Study of Parents and Children. Depressive symptoms were assessed at 12.5, 13.5, 16, 17.5, 21 and 22 years with the Short Mood and Feelings Questionnaire, and we further examined the influence of multiple biological, psychological and social factors in explaining chronic depressive symptoms.
Results
Using latent class growth analysis, we identified four trajectories of depressive symptoms: persistent high, persistent low, persistent moderate and increasing high. After applying several logistic regression models, we found that loneliness and feeling less connected at school were the most relevant factors for chronic course of depressive symptoms.
Conclusions
Our findings contribute with the identification of those children who are at highest risk for developing chronic depressive symptoms.
This chapter provides a research agenda for pediatric climate distress. It is structured into five domains. First, it reviews the importance of delineating among existing definitions of climate distress, including distinguishing between normal and pathological stress responses and integrating concepts from existing anxiety literature. Second, it discusses the importance of researching the epidemiology of climate distress, including developing and validating measurement tools, identifying young people most vulnerable and resilient, and considering the effects of parental mental health and social determinants of health on youths’ psychological responses. Third, it highlights the need to explore the psychological meaning and sequelae of climate change, including moral disengagement, dialectics of climate distress, and moral outrage. Fourth, it points to conventional and novel interventions to address climate distress that require further investigation. Fifth, it reviews the need to assess how climate change may impact young peoples’ psychological distress on a biological level. It concludes with recommendations for how to foster interdisciplinary collaborations and increase funding for this research.
It is well established that climate change poses significant threats to human health and well-being. Young people, who face a future burdened by climate change, will be among those most affected. It is understandable that increasing awareness of these threats brings increasing distress. Many young people will experience anxiety and other distressing emotions in relation to climate change, but some may experience a level of anxiety that threatens their mental health. In order to provide help needed by young people who are affected, there is a need to further understand the nature, predictors and consequences of climate distress. This chapter thus provides an overview of what we know and what we need to know about young people who experience climate-related distress.
Emerging research suggests that young people are more likely to experience climate distress than adults, yet there is little understanding of the factors that influence young people’s experience of climate distress. This chapter uses a social-ecological framework to identify individual, physical, and systemic influences from micro (e.g., family, peers), meso (school, community), techno (technology and media), exo (government), and macro (culture and society) systems on youth climate distress. Factors that may exacerbate climate distress or protect youth well-being are highlighted, as well as recommendations and key considerations for supporting the mental health of young people.
Parents and grandparents face unprecedented challenges in supporting their children to survive, cope with and adapt to the impacts of climate change while simultaneously preparing them for the greater negative impacts predicted in the future. This chapter draws on multidisciplinary research in parenting science, child and youth development, and disasters to guide parents in varying contexts. We first discuss how parents and carers can help young people cope with the direct exposure to both sudden and gradual climate disasters and flow-on effects that exacerbate social inequalities. We then discuss how parents can help children manage the emotions that knowledge of climate change can engender, explore parents’ vital role in fostering children’s sense of agency and hope, and highlight ways that parents can support young people’s active engagement. We end by stressing that parents and others with responsibility for raising the next generations should take action at local to national levels to drive the urgent changes needed to prevent climate catastrophe.