The Learning Needs of Young Adults with Mental Health Difficulties

1. Background

Studies have shown that young adults are one of the groups most at risk of having a mental health difficulty which will contribute to severe disadvantage and exclusion from society. Only 13 per cent of people with significant mental health problems have paid work, lower than any other group with a disability. The national report of the Tomlinson Committee in 1996 recognised the benefits of effective learning provision and the impact that mental health difficulties can have upon quality of life:

"education provision enables individuals to retain and improve their independence and capacity to learn" (4.24) "research for the TEC chief executives identified 11 indicators of disaffection, including, 'those subject to mental health or emotional problems.'" (4.25)

This briefing sheet outlines the learning needs of young adults (aged 16-25) with mental health difficulties and the role that the learning and skills sector can play in enabling these young adults to progress. The information given is based upon the findings of our initial research and is reinforced by research undertaken by other organisations and by quantitative and anecdotal evidence from the various development projects and funds that both NIACE and NYA have managed. A full briefing paper 'The Learning Needs of Young Adults with Mental Health Difficulties' covering this work is available from Nicola Aylward at the National Youth Agency.

The labelling of people as 'mentally ill' often results in the association of negative concepts and images that tend to stigmatise the people to whom they are applied. Many organisations and initiatives now prefer to use the term 'mental health' as a means of expressing that everybody has mental health (in the same way that everybody has physical health), but that needs vary and some individuals experience difficulties that prevent their mental health from being as good as it could be.

The Mental Health Foundation has reported that one person in every four experiences some form of mental health difficulty at some stage in their life.

For many young adults, the transition from childhood to becoming an adult, and the process of accepting and coping with all of the associated expectations and responsibilities, can be particularly traumatic and unsettling, sometimes resulting in mental health difficulties.

During this transition it is common to experience a mixture of emotions which can include anticipation, excitement, fear, anxiety, depression, stress or feelings of loneliness and isolation. It is sometimes difficult to differentiate between normal adolescent emotions and serious mental health difficulties. How can we measure where one ends and the other begins? Frequently such problems are overcome with the support and understanding of friends and family. However, for some young adults, such support is not available and the mental health difficulties they experience are more severe and have serious and long-term consequences.

During adolescence most people begin to make decisions about their future. For many young adults perceived pressure from family and peers, and self-imposed expectations about life plans, such as education, careers and personal relationships, may trigger emotional and mental health difficulties. The onset of mental health difficulties during adolescence can have a major impact upon a young person's future and upon their desire and ability to access learning.

Young adults with mental health difficulties often lack the basic level of self-esteem and emotional stability that is required in order to develop full and happy lives. Feelings of low self-worth and isolation can cause them to develop a negative self-image, which can reinforce and perpetuate their mental health difficulties.

The challenge to the learning and skills sector is to provide a sensitive, responsive and effective way of enabling young adults with mental health difficulties to develop a level of self-esteem which will be the foundation to their future learning and development. There is evidence of some effective practice in the provision of learning for young adults with mental health difficulties, but much of the evidence reinforces the findings of the Tomlinson Committee:

"colleges, schools and voluntary organisations told the committee about the lack of good-quality opportunities which specifically aim to support young people with emotional and behavioural difficulties, and that, when provision is made, it is often unsuitable." (4.25).

Many young adults with mental health difficulties are trapped in a vicious circle. In order to become engaged in learning, a basic level of self-esteem is required. However, because of the mental health difficulties they experience these young adults often have low self-esteem, which prevents them from becoming engaged in learning, especially if their previous experience has been one of underachievement. Nobody wants to reacquaint themselves with shame.

2. What mental health difficulties do young adults experience?

It is often assumed that young adults do not experience genuine mental health difficulties, or that the difficulties they experience are simply a phase. For children and young people in full time education the term 'mental health difficulties' are commonly redefined and labelled as 'emotional or behavioural difficulties.' It can be very intimidating for a young person to approach a professional adult for help. Moreover, dismissive comments such as 'you're too young to be depressed' or 'don't worry, you'll grow out of it' or 'it's just a phase you're passing through' can make the young person feel isolated and reinforce the problem, sometimes with tragic consequences.

The range of mental health difficulties that young adults experience are generally similar to those of the older population, and include depression, stress and anxiety. The manifestations can be suicide and attempted suicide; self-harm; eating disorders and behavioural difficulties.

A study by the Mental Health Foundation found that 6% of young men and 16% of young women experience mental health problems. Such statistics explain why the mental health of young adults is a Department of Health national priority:

In summary:

3. Current provision for young adults with mental health difficulties

In June 2001 the NIACE/NYA Young Adult Learners Partnership undertook a survey of learning providers in order to identify current practice in work with young adults with mental health difficulties. The responses revealed some good practice which is successful in addressing the very specialised needs of this group, but it also indicated that there are a number of areas that need to be addressed, these include:

4. Good practice

In the questionnaire respondents were asked to provide information about existing learning provision that they perceive to be effective/good practice in meeting the learning needs of young adults with mental health difficulties. Just over 10% of respondents cited specific examples of provision that they consider to be good practice.

This information, and a small number of follow-up visits, indicated that in order to be effective, learning provision for young adults with mental health difficulties should:

Policy makers and learning providers must be aware that the development of a tutor-learner relationship based upon trust and understanding is crucial if young adults with mental health difficulties are to remain engaged in learning. For many young adults, learning has negative associations: exam stress, bullying and pressure to achieve at school may have contributed to or triggered their mental health difficulties, and are all barriers which must be overcome. Achieving this is a lengthy process and one which requires a high level of skill on the part of the tutor.

Our initial research, which has included discussions with professionals in both the mental health and learning sectors, suggests that the following issues should be considered when establishing education provision for young adults with mental health difficulties:

5. Benefits of Learning for young adults

a) Structure and stability - effective learning programmes create a secure and stable environment that provides focus and structure to the lives of young adults.

b) Confidence and self-esteem - as young adults become more comfortable in the learning environment and begin to achieve small steps of progress, their level of personal confidence increases, improving their self-esteem. This can lead to greater motivation in all areas of their lives and can play an important part in helping them to cope with their mental health difficulties.

Increased confidence and self-esteem were cited in almost all of the questionnaires (a total of 210) that were completed and returned by practitioners.
The testimonies of learners who have experienced mental health difficulties also reinforce this point:

"Initially, the idea of starting education again seemed awful, but this seemed 'safe', and the atmosphere at the college soon confirmed this. As I progressed with both courses my mood lifted considerably, and my confidence improved. I am still very ill, and unable to work, but compared to how I was at the start of the course I have improved immensely. I have just started a mainstream art course at the college, along with several people I met through New Directions, which I still attend."

c) Support networks - young adults are able to develop trusting and mutual relationships with professionals and with other young adults with mental health difficulties. Professionals can offer them much needed immediate support, advice and guidance in an appropriate and sensitive manner. The opportunity to interact with peers who share similar fears, difficulties and experiences can ease the sense of isolation, help them develop empathy and help them to understand and cope with their difficulties. Questionnaire respondents indicated the importance of this learning outcome:

"An important benefit of learning for young adults who experience mental health difficulties is a sense of belonging to the community and being among their peer group."

d) Empowerment - many young adults may feel they have no sense of control over their lives. Effective learning programmes can empower young adults to make informed choices and decisions about their own needs and wishes. Initially this level of empowerment may be very small scale, but as they become more independent they will be able to take control over other areas of their lives. Effective learning provision, in a sensitive and appropriate environment, can work against the stigma and the negative attitudes often associated with mental health difficulties.

This importance of this benefit is supported by a comment made by an FE practitioner in Mansfield, and a youth service provider in Stockton:

"College empowers young people to make their own choices. It gives them opportunity, variety, and flexibility in courses and routes to learning."

e) Progression - effective learning programmes provide young adults with the opportunity to achieve their full potential in terms of both social and learning skills. Socially a young adult's ability to communicate, cope with situations and speak and act for themselves will improve, allowing them to develop the confidence to lead more full and independent lives.

Progression should be defined in terms of the 'distance travelled' by a young adult in relation to their initial starting point as a result of the learning undertaken. For some young adults with mental health difficulties formal qualifications are not the key factor that motivates them to initially engage in learning. Instead personal development outcomes, such as improved self-confidence or the ability to live more independently, are considered to be more important and relevant. However, for some young adults, the opposite is also true; the structure of formal qualifications and the desire to follow a traditional route is considered to be very important. If friends and peers are achieving GCSEs and A-Levels, are moving away to university, or are embarking upon a career, it can be very hurtful and isolating for those left behind as a result of their mental health difficulties. Learning providers must be able to respond to individual need by offering appropriate programmes and support for those who wish to follow conventional routes.

Staff involved with an Adult and Community Learning Fund project illustrate this point:

"Many of our DIY students experience mental health difficulties, they gain hidden curricula benefits and they also gain a valuable work related qualification."

An FE tutor from Coventry emphasized the importance of progression opportunities:

"We have a responsibility to ensure that young adults with mental health problems can work towards their intellectual and functional potential. They benefit from and respond well to the opportunity to progress through learning, which can assist the transition into adulthood."

f) Personal satisfaction - engagement in learning may serve the important purpose of allowing young adults to develop new areas of interest, which stimulate their minds and enrich their lives. Coupled with the new friendships and relationships they develop, this can lift many young adults out of the traps they feel themselves caught in. People who were interviewed about their experiences gained through the NIACE 'Prescriptions for Learning' project emphasise the importance of personal satisfaction for the learners themselves:

"It's fulfilling two things I needed to do - get out of the house and meet people. I used to be outgoing and I need to get back into things like that."

When an Adult and Community Learning Fund project worker was asked about the personal benefits of being involved in provision for people with mental health difficulties, she replied:

"Seeing the students enjoying themselves, I find it greatly rewarding to see marked improvements in the behaviour and mental condition of my clients. The presentation evening is very rewarding."

6. Benefits of Learning for society

Effective learning programmes for young adults with mental health difficulties serve the needs of society by:

All of these potential benefits can enable young adults to regain and develop their self-esteem and confidence. Learning will rarely result in the 'curing' of mental health difficulties, but it can be effective in equipping young adults with the skills and coping mechanisms to be able to manage their lives more effectively.
The social benefits of learning have also been cited by questionnaire respondents:

"Inclusion in learning can lead to access to work; integration in society; less marginalisation; greater understanding by the general public. It highlights ways in which young people with mental health difficulties can benefit from and be of value to the economy and society."

7. Future work

The findings of this initial research clearly indicate that there are a number of individual and social benefits derived from learning by young adults who experience mental health difficulties.

If you are involved in work with young adults who have mental health difficulties and you would like to tell your story, or if you would like to suggest development work that YALP could undertake, please contact Nicola Aylward on 0116 2853738, e-mail nicola@niace.org.uk. 

Useful resources

The fundamental facts: all the latest facts and figures on mental illness. Lisa Bird. Mental Health Foundation, 1999. ISBN 0 901944 637. £15.00

Images of possibility : creating learning opportunities for adults with mental health difficulties. Alison Wertheimer. NIACE, 1997. ISBN 1 86201 032 3. £14.95

Inclusive learning: report of the learning difficulties and/or disabilities committee. Further Education Funding Council. HMSO Publications, 1996. ISBN 0113613415.

Prescribing learning : a guide to good practice in learning and health. Kathryn James. NIACE, 2001. ISBN 1862011354. £8.95

The learning needs of young adults with mental health difficulties. Nicola Aylward. NYA, 2002. YALPubs briefing papers 2002. ISBN 0861552644. £3.50

Saving lives: our healthier nation. Department of Health, The Stationery Office, 1999. ISBN 0101438621. £15.00
Web Site: www.doh.gov.uk/ohn.htm 

Useful contacts

Careline - Confidential telephone helpline people experiencing mental health difficulties. It offers support in a number of languages, including Hebrew, Gujarati, Punjabi, Urdu and Hindi. Telephone: 020 8514 1177.

Samaritans - provide confidential emotional support to any person who is suicidal or despairing.
Helpline: 08457 90 90 90 (in the UK) or 1850 60 90 90 (in the Republic of Ireland)

Saneline - national charity concerned with improving the lives of everyone affected by mental illness. Website includes information about their medical research and a web discussion page. If you would like to speak to someone about mental illness, call Saneline. Telephone: 0845 767 8000
Website: www.sane.org.uk 

Young Minds - aims to create a greater awareness of the mental and emotional needs of children and young people. Provides a parent's information service, books and leaflets, seminars and training, and a consultancy service. Telephone: 020 7336 8445. Website: www.youngminds.org.uk 

@ease - web-based resource for young people under stress or worried about their thoughts and feelings. It provides information and advice about hope to cope with mental health difficulties, and it allows users to follow an interactive journey through the life of a young person under stress.
Website: www.nsf.org.uk/at-ease/ 

Mind - leading mental health charity working for a better life for people diagnosed, labelled or treated as mentally ill. It undertakes a range of work, including the organisation of events and training, producing information and the facilitation of networks. Telephone: 020 8519 2122
Website: www.mind.org.uk 

The Mental Health Foundation - leading UK charity in mental health and learning disabilities. Provides information and advice about children's and young people's mental health. Telephone: 020 7535 7400. Website: www.mentalhealth.org.uk 

Mentality - leading national charity dedicated to the promotion of mental health. Undertakes a range of work and produces resources for work with people with mental health difficulties. Visit their website for information about the Headstuff project for 14-17 year olds. Telephone: 020 7716 6777
Website: www.mentality.org.uk 

NIACE - the national organisation for adult learning committed to promoting increased participation in learning by adults. Through research, development and project work NIACE promotes good teaching and learning practice, and disseminates ideas through conferences, seminars, journals, books and through its website.
Telephone: 0116 2044200.
Website: www.niace.org.uk 

NYA - The National Youth Agency aims to advance youth work to promote young people's personal and social development, and their voice, influence and place in society. Provides resources to improve work with young people and how it is managed; creates and demonstrates innovation in service and methods, supports the leadership of organisations to deliver 'best value' and manage change; influences public perception and policy; and secures standards of education and training for youth work. Telephone: 0116 2853700
Website: www.nya.org.uk 

YALP - The Young Adult Learners Partnership is a joint initiative between NIACE and the NYA. YALP researches and develops effective approaches to learning and personal development among young adults on the margins of education, training and employment, with the purpose of fostering their capability and their integration as young workers, parents and citizens.

For further information about YALP please contact Nicola Aylward on 0116 2853738, e-mail nicola@niace.org.uk

____________________________________

< Back to Briefing Sheets Contents Page

Top of page