When I was 17 I was living at home and going to Sixth Form in Devon. My friend Soph had passed her driving test and a carload of us used to go round the country lanes at night in her mum’s car listening to Velvet Pants by Propellerheads. Then we’d all go and get a take-away pizza. Smells of that era that take me right back include Lynx, Archers, CK One and Paco Rabane. Top nostalgic tastes are Pernod & Black (thanks to Han who loved it), scampi fries and cheesy chips.
Is any of this taking you back too? What are your 17-year-old memories, smells and tastes? And how different were they when you were 18?
I was pretty much doing the same things a year later. I was a bit more stressed about A levels, I started growing out my hair, but I was basically facing the same dilemmas.
Yet if I’d been unlucky enough to experience a mental health problem at the two different ages, I’d have been offered different services.
Multiple charities recently called for better services for 16-17 year olds.
They highlight a long-standing problem. There’s a cliff edge at 18 where young people have to go to adult services. Fair enough you might think, there has to be a cut-off somewhere, but whether that cut off should be there is debatable, and the consequences of the cut-off are certainly problematic.
If you’re a professional referring a 17-year-old to a stretched service then you’ll know that there will be a waiting list (not the fault of the service – there is not enough resource to go round). If you know that the 17-year-old won’t get into the service til they’re nearly 18 then you know they won’t have enough time to make use of it before they have to be discharged. On top of that, the threshold to adult services is often even higher than for child and adolescent – so the reality is that 16-17-year-olds are disadvantaged in what services they can access.
This isn’t supposed to be the case, there’s been guidance for at least 5 years trying to address this, but it does happen.
Part of the problem is a lack of flexibility. Part of the problem is the age threshold itself, given what we know about young people’s developing brain and experiences.
Whilst 18 is the standard age for CAMHS services to end, what we know about the brain is that it’s still significantly developing until 25. Professor Sarah-Jayne Blakemore and colleagues have done fantastic work to describe the functional significance of this (TED talk here if you want a summary). The relative over-sensitivity of areas involved in social reward (how much we feel reinforced by our peer groups’ approval) and the later development of areas involved in problem-solving and planning, mean that under-25 we are more likely to be swayed by our friends’ approval and less likely to be able to problem-solve and plan longer-term.
This shouldn’t be a reason to be ageist, it should be a reason to help this age group more. Instead we put an arbitrary age threshold in the mix and we effectively deny this group access to services. We could frame this as age-based discrimination, sadly something that teenagers are all too familiar with.
At the upper end of this age range, 18-25 year olds, whether at university or trying to find their way in the world of work, have a lot to contend with. On top of brain changes there are all the transitions, new expectations, identity challenges… you’re supposed to be independent, you’re supposed to be having the time of your life, but actually it can be pretty lonely.
So 16-17 year olds do need better access to services, yes! And this is also true for 16-25 year-olds. We need to stretch our idea of young people. Early intervention services for psychosis often do this – straddling late childhood and early adulthood and meeting the needs of both groups. I wonder what would happen if we experimented with using this model in some other settings… More than this, if we allowed for some flex in the system, so people get a service they need instead of a service that matches their age. We need to enable access for this whole group, not make it any harder.