Working differently for improved primary care for young people in a difficult financial climate

Purpose: To think collectively and creatively about working in different ways in order to improve our response to multiple overlapping issues that lead directly and indirectly to poor health and wellbeing in young people.

Context: Difficult economic conditions for many people in Europe have been created by government measures to reduce public expenditure. Large cuts to social security, a lack of earnings growth, minimal or no job security, and high housing and living costs are leading to people becoming locked in a cycle of poverty and neglect in an era of rising inequality. In efforts to survive in a time of austerity, many local councils in the UK have made cuts to children and young people’s services that have taken away some of the ‘lifeline’ support for vulnerable children and families, as well as some of the educational and recreational opportunities for young people. Prevention services such as preventive substance misuse, teenage pregnancy services and youth offending teams have also been reduced in many areas. This summer, analysis of the Millennium Cohort Study – a multi-disciplinary research project following the lives of around 19,000 children born in the UK in 2000-01 – found that a quarter of girls and 9% of boys were depressed at age 14. A recent Children’s Society survey of 11,000 14 year olds found that 22% of girls and nearly one in 10 boys had self-harmed in a year.

GPs in the UK often talk about their feeling of helplessness when faced with increasing numbers of patients presenting with poor health and wellbeing caused by adverse life circumstances. Many of these issues are not medical, but they fill up the country’s surgeries nonetheless. Some GPs have coined a phrase to describe the condition of these patients: ‘shit-life syndrome’. It describes a situation where someone has so many things not working out for them that even an attempt to change one thing is often wiped out by the remaining factors causing them harm. Some areas with large numbers of patients in such situations have seen anti-depressant prescribing increase significantly.

State of the art: In this workshop, we will briefly introduce the problem, with the help of a short video focused on a seaside town in England, and encourage participants to think about the nature of the situation. We will then describe three very different projects that CHSS are currently working on, and identify relevant learning and key challenges emerging from them. The group will then have time to think collectively about working in different ways in order to contribute to a better future for young people. There will be opportunities for small and whole group discussion and feedback, and questions to the CHSS team.