GPs should give teenagers’ health needs a higher priority, the former children’s commissioner for England tells Channel 4 News.
Professor Sir Al Aynsley-Green, who addressed the Royal College of GPs (RCGP) in Glasgow on Friday, said a new approach was needed because behaviour that leads to “major adult diseases” was established in adolescence.
“Obesity, long-term consequences of alcohol, smoking and substance misuse, mental and emotional ill health, all carry grave consequences, yet are amenable to interventions that promote positive health,” he said.
Writing for Channel 4 News, Sir Al said young people should be praised, not stigmatised. “Despite the relentless negative media coverage of youngsters that influence how adults view them, we have stunningly impressive young people in society, who, given the chance, can show courage in overcoming personal difficulties, as in Paralympic athletes, and in making positive contributions to local communities.
“Overall, the UK performs poorly compared to other developed nations in many aspects of their health, especially in low self-assessed wellbeing and low expectations with high numbers not in employment, education or training.”
Sir Al highlighted the findings of a report by the World Health Organisation’s Europe office, Social determinants of health and well being among young people , as a key resource for policy makers in understanding international trends.
“Some outcomes, including teenage pregnancy, suicide in young men and tobacco and cannabis use, are showing welcome improvement in the UK, whilst sexually transmitted diseases, binge drinking, obesity and long-term conditions, including disability, are increasing.”
Despite the relentless negative media coverage of youngsters that influence how adults view them, we have stunningly impressive young people in society. Sir Al Aynsley-Green
Sir Al said one in 10 adolescents had a diagnosable mental health disorder, but many were unable to access the services they needed.
He drew attention to the pleas he had heard from many young people for “someone to turn to”, adding: “Especially vulnerable are young carers, children in care, those with disability, those who have been abused and those living in households within which alcohol, drugs and domestic violence are prevalent.”
Those who had lost someone they loved experienced “patchy” services, with many of these “under threat as a result of financial stringency”.
This was another reason GPs had to be particularly mindful of people who are “neither children, nor adults” and “need services designed to meet their specific requirements”.
Sir Al wrote that teenagers had the shortest consultation time of any age group, with many refusing to attend GP practices and expressing “dissatisfaction with access, attitude, location and ability of GPs to relate to them”.
He said GPs should take note of Department of Health guidance, “which sets out clear recommendations for the design of services including access, publicity, confidentiality and consent, staff training, skills, attitudes and values, and, above all, the participation of young people by being listened to and involved in policies and design and location of the services they are comfortable with”.
He called on the RCGP “to put young people’s health at the heart of the organisation, setting up meaningful reference groups of young people, improving the training of GPs in understanding their different needs and relating to them, and being effective political advocates for improving policy and practice”.
Sir Al added that while many GPs were aware of the needs of young people, family doctors had to ask themselves “how many young people are in my practice?; how many disabled and especially vulnerable ones are there that need special attention as they transit from paediatric care to adult specialist services?; how are young people involved in recruitment of staff, in developing policies, and considering alternative ways of providing services, such as drop-in clinics, that meet their needs?”
GPs should meet young people “at least once for a discussion of their health needs”, he said, adding that “they played a crucially important role as gate-keepers for adolescents, advocating for their needs, and giving support for healthy adulthood”.