This article by Dr. Lawrence Howells has been published in The Psychologist. It begins:
“Three years after qualifying as a clinical psychologist, I found myself facing a significant dilemma. I was asked to speak to college students about youth mental health and, despite a decade of training and being part of a newly established service, I realised I didn’t know anything about health. This dilemma has shaped my practice ever since…
In 2013, the NHS trust I worked for did away with the traditional transition at 18 years from Child and Adolescent to Adult Mental Health Services. A Child and Family service was created to work with those up to 14 years, and a new Youth Service working with those aged between 14 and 25 years (see Wilson et. al., 2018, for an account). The main drivers behind this change included the extending and increasingly fragmented phase of adolescence in today’s society, and research suggesting most mental health difficulties start before 25 years of age (Kessler et al., 2005).
Having started work in the new Youth Service, my colleagues and I had to ensure the service properly met the needs of young people. We began by considering two models. The first was the developmental model: we reasoned that the Youth Service must support a successful progression through the adolescent phase of life into adulthood; supporting the development of self-efficacy, self-identity, and positive, supportive relationships with peers and families. The second model we considered was the diagnostic model. We were aware that the diagnostic model did not apply in the same way to mental health as it did in other branches of healthcare, because there was no evidence to support the existence of any underlying cause for any mental disorder. This meant that the distinction between ‘ill’ and ‘well’ represented an arbitrary line bisecting the normal population along a continuum of wellness. Our experience of soaring referrals of young people to mental health services demonstrated the shift of this arbitrary line to include ever-increasing numbers in the ‘ill’ category …”
You can read more from here.