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Children as young as 10 and 11 are finding their way into the corridors of A&E departments because of deliberate self-harm, a suicide attempt or emotional crisis.
At the start of Children's Mental Health Week, senior reporter Lauren Abbott spoke to the people waiting at hospitals to offer a compassionate ear to those in distress.
Spending hours every night in the stark, sterile hallways and waiting rooms of Kent’s accident and emergency departments, under glaring lights and surrounded by sickness is undoubtedly not an experience for the faint-hearted.
But six nights a week men and women from charity Emerge Advocacy enter the big double doors of some of the county’s biggest hospitals and wait.
Determined to provide a voice of hope - and driven by their Christian faith - they are awaiting the arrival of any young patient aged 10 to 25 who comes in having self-harmed or because they’re suicidal.
These adults don’t ask questions - or make decisions about what should happen next - they’re simply there to strike up conversation with those open to a chat and to try and help anxious teens move away from the ‘flight, fright or freeze’ state they arrive in.
They’re dab hands at card games like Uno or Dobble, they’re big fans of colouring and other mindfulness activities and they’re down with the kids when it comes to discussing the latest viral videos and online trends.
But their presence also introduces an impartial voice, a mediator, and critically, three months of follow-up contact for any young person they’ve met in hospital should they want it. Quite the offer at a time when child and adolescent mental health services find themselves overwhelmed with referrals.
In 2016 the charity’s founder Joy Wright found herself supporting a girl in hospital while working as a church youth worker in Surrey.
As medics and mental health teams reached an impasse with their young patient, Joy unexpectedly discovered a role for herself that helped break the stalemate by giving the frustrated youngster someone else to speak to.
Borne out of a realisation that terrified - sometimes stubborn - young people entering A&E because of self-harm or suicide needed something more, Joy’s vision was to see volunteers step into a supporting role.
Her original Guildford-based project took off. By 2020 word had spread and shortly after Joy’s teams moved into Medway Hospital and Kent for the first time.
Since then demand for the charity’s work has ballooned - propelled not least by a global pandemic that has seen levels of distress and anxiety among youngsters explode.
Joy admits - as has been well documented - that many mental health-related issues have become more apparent post-Covid. In particular, big increases in eating disorders are being seen.
Joy said: “It was like a pressure cooker through lockdown - with so much focus on physical health.
“It really exploded after lockdown had finished.”
Night time volunteers are now stationed at hospitals including Darent Valley and Tunbridge Wells while there is a satellite service at Queen Mary’s in Sidcup.
There is also work running out of Maidstone Hospital and a new evening service at William Harvey in Ashford.
Karen Costelloe, managing director for children’s services at the William Harvey Hospital, said: “It is lovely to be able to welcome Emerge’s team to our emergency department to provide additional support to young people while they are in the department.
“No one enjoys being in hospital but it can be particularly overwhelming for young people when they are experiencing mental health difficulties and the team will be able to provide emotional support while our dedicated clinical teams care for them.”
A mix of employees and volunteers man each hospital, with projects inside A&E departments usually staffed six evenings a week from around 7pm to almost midnight.
While the charity’s paid staff usually have a background in youth work, volunteers with a ‘natural way’ of connecting with young people are sought from local churches - with everyone put through a thorough recruitment and training process to ensure they are physically and mentally up to the job they’re about to take on.
The work has already earned them a Queen’s Award for Voluntary Service and in September were named the Outstanding Charity of the Year at the Kent Children’s Awards.
Help in numbers
In the last year at least 300 young people in Kent have come into contact with the charity - the youngest are of primary school age, the oldest in their early 20s.
However, the peak is among children aged between 14 and 16, where Joy suspects puberty, school, exam and relationship pressures tend to collide.
Bullying, identity and gender issues, undiagnosed conditions like ADHD and other spectrum disorders and the breakdown of family relationships also can all play a part.
Unsurprisingly social media usually finds itself caught up in the mix too.
When things escalate however, it’s usually a breakdown in a ‘key relationship’ that has become the main trigger.
“It’s so confusing and there’s so much information on these platforms they cannot make sense of” Joy explained.
“It’s really challenging.
“So many are emotionally struggling.”
In Medway, an overdose has been the main reason behind referrals to Emerge Advocacy with 21 youngsters having been scooped-up by the charity in the past year.
This is followed by those experiencing an ‘emotional crisis’ alongside 15 with suicidal feelings while nine young people from Medway accepted support after coming to A&E having self-harmed according to some of the charity’s 2024 statistics.
Suicide is also the main trigger behind those who come to the service in Tunbridge Wells where more than 20 children and young people who talked about taking their own life met with volunteers last year.
An overdose and an eating disorder are also among the prime reasons why young Pembury patients find themselves seeking support.
It’s the same at Darent Valley, where 15 young people over the last 12 months have chatted to the charity because they were brought to hospital feeling suicidal. More than 10 opted for contact after self-harming.
Within just a week of the new team at William Harvey moving in last autumn - four young patients had been seen. Two for issues associated with an eating disorder, one for self-harm and one young patient that came to the charity having been brought to A&E suicidal.
It is down to each young patient as to whether they accept involvement from Joy’s teams - so these figures are far from the complete picture in Kent - and changing all the time.
However, more than 70% of all those seen by Emerge Advocacy in the last 12 months across the entire county were female.
Joy - a mother herself - believes young people today are living under such considerable pressure that it has come to have a profound affect on their emotional wellbeing.
For example, the amount of pornographic material impressionable teenagers now encounter online - she explains- can be just one of many reasons why young people’s ‘self worth’ can take such a hammering - where they’re experiencing pressures to look and act a certain way rarely connected to reality.
“Young people see things they should not be seeing” she explains.
“They hold themselves to standards that are not a reality.
“They can have such a warped view.”
Statistics by the charity Young Minds say one in six children aged five to 16 were identified as having a probable mental health problem in July 2021 - a huge increase from one in nine in 2017.
It’s estimated now to be the equivalent of around five children in every classroom.
But despite the heartbreaking statistics - Joy is determined to provide a voice of hope - something she says families can also do if they can find the strength and patience to remain understanding.
“Traditionally being a teenager was hard because of exams and puberty but now it’s completely different and that’s hard for parents to understand - to maintain that supportive relationship” Joy acknowledges.
“Children with supportive parents do tend to do better.
“The post-war generation had it really difficult but children today are finding it tough too.”