18-25 Year Olds Aren't 'Adults' When It Comes To Mental Health

It is time to recognise that 18-25 year olds aren't "adults" when it comes to mental health. Young people face a difficult transition from childhood to adult life, are squeezed by our economic system and face a wide range of pressures affecting their mental health. If special consideration applies to the mental health needs of older adults, surely it is the case that young people aged 18 to 25 deserve some recognition too.
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Although mental health problems can affect anybody, regardless of age, over 75% of cases are established by the age of 25. Young people are subject to an incredible amount of pressure growing up; facing issues such as exams, relationships, bullying and peer pressure, body image, financial worries, responsibilities as parents or carers - the list goes on - it is no wonder that CAMHS (Children and Adolescent Mental Health Services) are struggling to meet demand across the country.

But because CAMHS services have focused upon under 18s, young people have traditionally faced a 'cliff edge' of care on their 18th birthday. The National Institute for Clinical Excellence (NICE) found that up to two-thirds of teenagers are 'lost' or received interruptions to care as they tried to access adult services for the first time. They warned that "the lack of information, support and services available to meet the complex needs of young people and their families can be confusing, creating additional hurdles". In 2015, a mental health strategy published by the Department of Health, Future in Mind, further acknowledged that "for many [young people], adult mental health services are either not available or not appropriate".

We tend to think of over 18s as adults - able to drink, vote and get married - but for most the pressures of being a teenager do not magically disappear at 18 years old. Young adults can be just as affected by issues around peer pressure, drugs and alcohol, and sex and relationships, while also facing additional pressures around housing, finances, exams and employment. The emotional age of 18 year olds can also vary hugely; whereas some will be moving out of home for the first time and others may not do so at all, some will already be living independently and be in full time work. Some may have large networks of friends and family to look to for support, while others may be on their own, completely reliant upon the NHS and social services for help and advice.

For those entering university, exams and finances are the main stress factors. The number of students leaving university due to mental health problems has risen by 210% since 2009. Under 25s in employment also face momentous financial pressure, due in part to blatant discrimination when it comes to the government's National Minimum Wage, and with the removal of housing benefit for 18-21 year olds, some will find themselves at risk of homelessness; in some cases having children of their own to care for. Others leaving the social care system at the age of 18 often find themselves struggling to look for work or failing to pay bills on time without adequate support.

In its mental health strategy Future in Mind, the Department of Health recognised that a better transition was needed between child and adult care, and that many organisations were already working on a 0-25 model to provide better care for young people transitioning into adulthood. But despite recognising the flaw with a 0-18 model of care, the NHS nationally has resisted changes to the way that it operates.

For example, in Improving Access to Psychological Therapies (IAPT) services, both NHS Digital and Public Health England continue to include 18-25 year olds within an "18-64" age category, despite giving extra consideration to "65-74", "75-89" and "90 and over" age categories. That seems both unfair and contrary to the commitments laid out by the government in Future in Mind. In Kensington and Chelsea, a Joint Strategic Needs Assessment aimed at young adults pointed out as a key problem that "available data and evidence (and consequently the conversation) is often merged into wider age groups".

It is time to recognise that 18-25 year olds aren't "adults" when it comes to mental health. Young people face a difficult transition from childhood to adult life, are squeezed by our economic system and face a wide range of pressures affecting their mental health. If special consideration applies to the mental health needs of older adults, surely it is the case that young people aged 18 to 25 deserve some recognition too.

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