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Chair of Child and Adolescent Psychiatry Professor Mina Fazel outlines her recent paper on building and promoting trust with adolescents to share information about their mental health. It was published in the British Journal of Psychiatry
Take a typical 14 year old who decides to share something personal with an adult outside the family home - maybe with an adult at school - perhaps about low mood, self-harm, or worries about home. What might happen next with the information they share?
The pathway is often uncertain. Because they are under 16, they step into a kind of grey area: they may not know who will be told about what they have said or where that information will go next.
Professionals, quite rightly, have safeguarding duties. They usually begin any conversation by explaining the limits of confidentiality – in other words, that what’s shared will be kept private unless there are concerns about the young person’s safety or the safety of others.
That caveat is essential for protection but its also the moment when trust can start to wobble. For some adolescents, the message is entirely appropriate and reassuring. For others, it is enough to close the conversation before it even begins.
This grey area - between the promise of confidentiality and the duty to protect - is where we focused our research.
In my early work with refugee children we set up school-based mental-health services because we knew that families were struggling but not presenting to clinics and formal services. We hoped that working in schools could democratise access to care - to make the step of walking into an unfamiliar clinic, to talk to strangers, a little less daunting by bringing services into the school environment where children and their families already felt some familiarity.
Read the full story on the Department of Psychiatry website.