Mental health articles

OF mental health care and mentally ill

Positive cognitive processing of negative experiences

It was almost 20 years before Alan was able to make sense of his carer’s roleand appreciate just what a wonderful impact he may have had on his father,his siblings and his mother. Putting that together with his (now openly acknowledged needs) to live through his sons has (if anything) improved his enjoyment of where his life has led him.

There remains one area to be mentioned—how to avoid the most feared outcome of developing some illness because of the increased risk. Alan was clever in his use of the army to provide surrogate parenting over the years in which he could have ‘let rip’ like his brother Barry. His subsequent marriageseems to have also been a major protection. But behind all of that Alan just seems to have the ability to accept what life throws at him and work atfinding a way round it. In contrast, Barry’s survival through his world travels and sometimes wild experiences seems to be more a matter of chance. Butthus far, neither he nor his sister Chrissy have developed frank illness, andboth have overcome past anti-social traits and activities.

So could we have re-written Alan’s teenage years, and where would his personal trajectory have taken him? Would intervention through the 7 or 8years of his adolescence have changed things much? Perhaps not. And this isthe central issue: we must approach each young person’s difficulties in a manner that is sensitive to their emerging personality, the family and cultural context. We must offer to enhance skills and traits where we can, but must accept that not every person will accept support or care from us. Education must be made freely available in a format that is easily accessible, and then the opportunity to discuss the issues must also be freely available—one-onone,or in a group as appropriate to the circumstances. We have to reach out actively, and not bury ourselves in our daily work tunnels, but we must respect the wishes of the young people we work with. We must think more often of the systemic context of young people’s lives and acknowledge the wide range of pressures they may be under from television, peer culture,marketing and where the world has got to, post ‘9–11’. We must at least attempt to think in terms of a personal trajectory over time, and look for the points at which some intervention may be protective. Adolescents with parents who have a mental illness are at increased risk for a primary illness which breeds true; they are also at risk for a range of other adverse outcomes.The information and programs for prevention of these must be available, we must be trained in their use, and we must give the young people every opportunity to find their own way.

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