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eating disorders

bacplogoBy Stuart Crawford

The British Association for Counselling and Psychotherapy (BACP) has renewed calls that there should be a trained counsellor in every Scottish school. The BACP has over 1,500 members in Scotland (35,000 across the UK), who work across the private, public and voluntary sectors.

Counselling and psychotherapy cover a range of “talking” therapies, and offer an alternative route to tackle some problems that might otherwise be countered by prescription medicines, including antidepressants. These talking therapies can help people with problems as diverse as bereavement, relationships, educational problems as well as anxiety and depression.

Usually delivered in a safe, confidential environment by therapeutically trained practitioners, therapies allow people to talk through sometimes painful, confusing and uncomfortable issues with someone who can help improve things.

This, sadly, also includes young people. In 2004, over 55,000 Scottish children were identified as suffering with mental health problems – roughly 8 per cent of the age group population. One can only wonder at how many more might remain unidentified, or who do not seek or have access to the appropriate help. Current provision throughout the country is patchy at best.

Successive Scottish governments have been aware of this, and have attempted to tackle the problem of mental ill health in young people. In 2005, the then Labour–Lib Dem Scottish executive produced the report The Mental Health of Children and Young People: A Framework for Promotion, Prevention and Care, which called for the provision of confidential, accessible, and non-stigmatising counselling support for all young people by 2015.

Despite this commitment, there has been little movement towards this target during succeeding administrations and there is still no Scottish national strategy for its implementation.

Evidence does show that school-based counselling is associated with improvement in a range of problems that young people might face – for example family issues, eating disorders, bullying and anger management.

Recognising this, both Wales and Northern Ireland have their own national strategies in place for school-based counselling. Both provide ringfenced funding for the provision of these services in every secondary school in their countries. Indeed, such counselling services that have been implemented in Wales have helped thousands of children and young people and are associated with improved attendance and greater confidence in school.

But not yet in Scotland. It may be, of course, that the idea has fallen victim to politics north of the border. The pledge to place a counsellor in every school in Scotland was made in 2005 by the Labour–Lib Dem coalition. The SNP has formed the administration in Holyrood since 2007, and possibly it has slipped down the priority list as the party seeks to implement its own policies.

However, what can possibly be more important for the country, as it movees towards an independence referendum, than the wellbeing of its young people? They are the future of Scotland.

Accordingly, the BACP is once again voicing its recommendation that all Scots children and young people should have access to professional, qualified counselling services at school. There should also be alternative provision within community settings for those who prefer not to access the service at school.

The BACP fully understands the fact that such facilities would have to be authorised and implemented at local authority level, but is keen that the Scottish government should put a fair wind behind it.

That’s not really a lot to ask, is it?

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Now a health food??? <em>Picture: John</em>

Now a health food??? Picture: John

Can healthy eating be a disorder? That’s the question being asked in an article in the influential Time magazine.

It is highlighting a controversial condition called orthorexia, which takes “healthy” eating to extremes, with people obsessively avoiding foods perceived to be unhealthy.

This means steering clear of artificial flavourings, colours and preservatives, perhaps rigidly following a particular diet or refusing anything linked, however tenuously, to cancer or other diseases. Women are more prone to it than men, the article says.

Ironically this can be just as unhealthy as other diets because adherents risk missing out vital food groups and nutrition in their quest for so-called perfection.

The point of the article is that the Washington-based Eating Disorders Coalition wants orthorexia to have its own entry in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This being the American “bible” of psychiatric illness, if a condition isn’t in there it’s hard for US patients to get insurance companies to cover treatment. It’s also difficult for researchers to get grants to find out more about it.

Most doctors don’t currently think a separate diagnosis is warranted, so it’s unlikely to make it into the next edition of DSM, due to be published in 2013. The fact that the question has been raised, however, might well start a process whereby it makes it to the next one.