Transcript: Care experience and mental health

Podcast Episode: Care experience and mental health

What follows is a transcription of the audio recording. Due to differences between spoken and written English, the transcript may contain quirks of grammar and syntax.

MD - Michelle Drumm
TB - Thomas Bartlett
CA - Casey Armstrong

MD The following conversation was recorded by Thomas Bartlett and Casey Armstrong, two care experienced young people who talk openly about the subject of mental health as part of a project titled, ‘Mental health and care experienced children and young people: a partnership for change’.

The project seeks to improve understanding and practice in relation to care experienced young people’s mental health. A training workshop has been developed, aimed at students and professionals in residential child care, social care and social work which was piloted at the European Social Research Council’s Festival of Social Sciences in conjunction with the British Association of Social Work.

The episode forms part of the project and is co-produced with TRIUMPH (Transdisciplinary Research for the Improvement of Youth Mental Public Health) at the University of Glasgow; the Champion’s Board; Who Cares? Scotland; the University of Edinburgh; and Iriss.

Health warning: This episode describes scenes of traumatic events that listeners may find disturbing.

TB Hiya, I’m Thomas and I’m a care experienced young person. I have been working with Who Cares? Scotland and Edinburgh Uni. Today we’ll be speaking with care experienced advocate, Casey Armstrong. We’ll be having a conversation about our experiences and we hope you find it useful. Hiya, Casey. How are you doing?

CA Hi, I’m well thank you. So my name is Casey. I am 21 years old and I’m a care experienced advocate. I didn’t go into care until I was about 14, 15 years old, so I’ve got quite a bit of life experience before being in care, but then also I have the experience of being in care afterwards up until the age of 18. I’m also a student I guess. I’m studying Space Engineering at the moment, which is quite fun, but that’s the brief rundown on me. I mean, Thomas, are you happy to share anything about yourself?

TB Yes. I am care experienced and I went into care when I was 14, and I wasn’t in care long. I left care when I was 16. Casey, what is your best experience from being in care?

CA Okay, so my very best experience was definitely my 16th birthday. I’ve always had this sort of obsession with Paris. I just really love France. I really enjoyed learning French at school. Bit of a weirdo, I know! On my 16th birthday my carer surprised me. We’d just come back from a holiday in Turkey and the morning after I was woken up at about 9 o’clock in the morning. I was very upset because I was a bit jetlagged and I wanted my sleep, and my foster mum comes in and she went, “Casey, get packing. We’re going to Paris”, and I cried a lot of happy tears that day. We then went to Disneyland Paris. We stayed for a long weekend there, which was amazing. Don’t tell anyone this, but I had - well, I’m going to say it on this podcast - but I sat with the Eiffel Tower in view and had a glass of champagne on my 16th birthday, which was amazing. I really loved that day. So definitely my best experience.

TB Actually, it was not long after I went into care. I was in a residential unit and some of the staff there took us to a ceilidh. It was in Glasgow and it was brilliant. I got to meet so many new people, dance, have fun. All your problems are away. It was brilliant. It was probably one of my highlights of my life so far ‘cause it was memories you’ll never forget.

CA Thomas, sorry, what is a ceilidh?

TB I don’t know the exact definition but it’s a Scottish time where loads of people get together and dance and sing and have a meal, and it’s an unforgettable experience, as a lot of people would tell you.

CA I’m jealous. I want one in England! I want to go.

TB How about turning the other page, about your worst - if you don’t mind me asking - your worst experience while being in care?

CA So I think the one thing that stands out as the worst thing that ever happened when I was in care, I was 17 at the time, I was in college and things really weren’t going very well. My 18th birthday was ever approaching and as we all know that’s a very daunting day. As soon as you know that you’re starting to move out it’s not a very fun time, and I was living with a great foster family at the time but I thought that as soon as I left care it was going to mean that they were going to move onto the next foster kid and I was sort of old news, which didn’t happen. I’m really happy that it didn’t, but I had this one day where I was really, really struggling and I ended up attempting suicide, and it’s a day that now motivates me because I’d had a lot of suicide attempts in the past but this is the worst one I’d ever done. I was told by the paramedics that I was minutes away from being at an irreversible point. So it was a huge, huge reality check and it was very scary, but to turn it on a positive, I now see that as it gave me a reason to live because in that moment I realised that I didn’t actually want to die. It wasn’t my entire life flashed before my eyes, it was more like my entire future did and I realised everything that I was going to lose out on. So now, if anything I feel a lot more motivated to make sure that I reach that and I do that, if that makes sense. Thomas, if you don’t mind me asking, what was your sort of worst moment?

TB I would say it wasn’t a particular moment, it was a collective. It was every day you wake up and you had so much going on in your head - or I did personally - and you felt like there was no end to it. It was just going on every single day and you wanted to speak to someone but you felt like you were always intruding and you weren’t important enough. The turning point is when someone sits down and has that hard conversation that you don’t want, and you realise that maybe I’m not a problem, and that’s where it changed for me, but that did come down to believing it, which took a long time.

CA So when you said you had that conversation that really helped you, I mean can you remember - sort of thinking back to that moment - what that person said, or is there anything specific that really sort of helped you?

TB It’s not really word for word ‘cause it was a year and a half ago now, but it was along the lines of like how would I react to a child if I was in their shoes looking in, and I guess the way he talked to me was put yourself in other people’s shoes looking at you. If someone came to you would you see them as a problem or would you see them as oh just brush them on the side, ‘cause you wouldn’t, and that’s how other people looked at me, but obviously when you’re in that moment you don’t think about that, and that’s what changed my perspective, is looking in someone else’s sight, realising that you’re not a problem, and it was hard hitting. It really makes your heart go, which is my experience personally. When your carer spoke to you for example, how - if you don’t mind me asking - if you know what they said, do you remember if it affected your mental health positively or negatively?

CA If I look at my foster carer for instance, I’d say that one of the biggest things that actually had an impact on me - which might seem a bit surprising - is my foster mum telling me that I was her daughter and that I was a part of their family and that I was part of their girls, ‘cause they’ve got their own two biological children and when I first moved in it was “Casey and the girls”, and then after time it just became “the girls”, and I was part of that and I’m still part of that, and I think the time that I came into care all I needed was a family and it’s something that I’d never had. I’d always been the black sheep of mine, and having someone just sit me down and look me in the eyes and say, “Casey, no. You are part of this. You have a family”, honestly I think the first time I heard that I really felt like it changed my life. Thomas, was there anything that any members of staff - I think you said you were in a residential home - is there anything, any specific staff members or anyone in general that said anything that helped you, or any moments you felt like helped you?

TB Yeah. Once I was kind of settled in a home I used to go out with staff a lot. I think the thing that changed me and that really helped me was they didn’t look at me as another young person in care. They looked at me as their own child. We would go out and the council or whoever would give the care home money to go out and spend with the kids, but the thing that really hit me the most was we’d go out just for like a drink or something and they’d use their own money, and I think it’s not the money at all, it’s the principal. It’s that you’re getting treated as a normal child and you’re not relying on what if there’s not enough money in the pot or anything. You don’t feel different to someone who’s at school. You feel like you belong. I think that’s the thing that changed me the most.

CA Yeah, I feel like it’s something that’s actually quite understated. I feel like it’s not spoken about very much, but as a child in care, just having that feeling of belonging, like you said. I feel like belonging is a very, very important thing, especially if you get moved around from home to home, it’s something you’ve never experienced before and you know that you’re missing out on it, and then to be able to experience it when you’ve never seen it before, it makes you feel like you do have a home and you do have a place in the world.

TB Casey, if you don’t mind me asking, when you were struggling with your mental health, where did you go or who did you speak to?

CA So my battle with getting support was a bit winged. With not going into care until later on obviously I had the mental health problems emerging way before I went into care. It was those mental health problems that got me put into care, but I started to self-harm only sort of very minorly when I was about 10, and that’s when my depression and my PTSD at the time was starting to really become apparent. As I was getting older I could get a bit more emotional - I don’t really know how to explain it - and then I had a 2-year battle with my self-harm getting worse, then it making the relationship with my biological mum worse, and then I started getting into suicide attempts and suicide ideation, and it wasn’t until I’d been in hospital several times for being found at the train tracks and overdosing and things like that, that’s when I was then finally sent over to CAMHS, which is Child and Adolescent Mental Health Services, sort of like your NHS mental health services before you turn 18, and they were very unwilling to help me at first because of my age. So it was difficult at that point but they were the only people that I could really go to for help. Actually, I tell a lie. A lot of people don’t know this but you can go to your school for help as well. My school had a fantastic pastoral team. They knew what was going on at home before I’d gone into care and they accepted that and they made a lot of sort of adjustments for me. They were always there when I was having a bad day, without judgement. So I then got in contact with the school nurse as well as the pastoral team. So I did have that support there, I just didn’t get anything sort of therapy and counselling-wise until I got with CAMHS, and once I was in care it was much easier. I remember I decided to leave CAMHS after I went into care, thinking I was cured - I was not - and I asked to go back and it took a week from me being at the doctor’s saying, “I want to go back into CAMHS”, to getting the appointment and seeing a psychiatric nurse. So when you’re in care it’s very easy. At least on my end it was very easy to access mental health services, but on the run-up to that, when you do need the most help it can sometimes be really difficult.

TB Casey, it’s really good that you got the help and I’m pleased for that, and it might have been where you are or the people you’re connected to, but in doing this study we’ve found out that not a lot of people can get it that quick and it takes a few months minimum for a few people to get care. I’m wondering if you have any ideas why?

CA I think it’s really difficult ‘cause I was definitely very lucky to get seen so quick. I think obviously there is the shortage of staff issue and I remember there was a really good psychiatric nurse that I had but she left, and she was the best person that worked there but she left because the best people can’t get on with the system that is CAMHS and the NHS, because obviously it’s a very harsh environment. It’s very in demand. It’s very difficult. So where you do get the right people that are working, I think sometimes they can’t quite handle it. So they then leave. So I feel like there’s such a mental health crisis that’s going on at the minute and there’s that much demand that I think CAMHS and the NHS can’t quite really cope with it, which is difficult because it’s hard not to place the blame on CAMHS but at the same time they also do have a duty to make sure that children are healthy and happy and safe and not partaking in anything dangerous because of their mental health, which happens all the time in so many different ways.

TB Casey, while you were with your foster carers - you said it could have been when your worst bit was - what would you have liked your foster carers to do while you were waiting for help from a professional?

CA So I would say probably reassurance would be one of the main things, because when you’re on that waiting list you do feel very forgotten about and as if you’re not important, and then it coming back to that belonging and you lose that sense of belonging and that people actually want to help you. So I think it’s difficult because it’s hard to put it on the staff that are caring for you, because they’re not quite trained for it, but just for them to be there as much as they can to say, “Look, you’re on the way to getting help. You will get there. Every day that goes by you’re a day closer”, and yeah, it comes back to the reassurance and making sure that you will get there. So, Thomas, I mean in terms of the staff that you were living with, what do you think could have been helpful whilst you were on the waiting list, or was there anything helpful in specifics that they did do whilst you were sitting through them?

TB I think reassurance is really helpful. I also think being consistent. As they say, consistency is key. Just every day asking how you are, maybe doing something that would put a smile on their face, or something which isn’t that hard if you know what you’re doing. I think the problem is what this workshop’s about, it’s trying to get them to know what they’re doing.

CA Yeah. I think that consistency point is a really, really good point because I think just knowing that you do have someone there that is making it clear that they are available, and especially with the idea of keeping you happy, just doing little things to keep that person distracted, and I think before you know it they will be finally getting that appointment and they will be getting the help and they will be like, “Oh, that wasn’t so bad. We’re here. We’ve made it.”

TB Yeah, I agree. It’s just knowing that there’s someone there and someone you can turn to. It does change. It’s night and day with someone caring and someone not, and I think another thing is they need to care. I know it goes without saying but they need to show it, ‘cause young people are very good at picking up if you’re real or not, if you’re not faking it but just not being genuine. I think staff need to be treating them as maybe not their own but maybe just a small part of them.

CA It’s interesting that you bring that up as well ‘cause I was discussing this the other day on a call with some professionals and they actually asked me, “Well how do you show that you care? How do you bring love into the care system?”, and I think it’s a good point to raise that you don’t have to start telling every sort of person you look after in care that you love them and all of this sort of stuff. I think real compassion and real love towards someone is shown more by actions rather than words. I think it’s really important, like you said, that the genuineness is there ‘cause we can tell, and I think if you aren’t able to show that then maybe you’re not quite in the right profession, because you’re looking after these wonderful children and like you said, we don’t have anybody. So these staff members are quite often the only thing that we have, which makes our experience with them just the most important thing in the world to us, and especially to our future as well. So I think it’s showing that compassion and giving the person-centred and individualistic care is above all. It’s incredibly important.

TB Casey, is there anything that you would like to say personally to adults who work with care experienced young people about mental health?

CA I think patience is really important. After the sort of crazy things that we’ve been through in our lives, it has a huge impact when it’s your closest family members that aren’t how they’re supposed to be, whether it’s their fault or not. I think you just have to understand that quite often we’ll be pushing and pulling. One day we’ll be all over you and be having a great relationship, and then the next day we may be screaming and shouting and really frustrated, and that’s not because we are trying to be mean. It’s because we’re confused in our emotions and we’re scared that this new staff member could hurt us how our biological family may have hurt us, and it gets really complicated trying to build that relationship, but the more that you are patient and understanding and persistent, over time you’ll notice that we will push much less often and we’ll actually be keeping you closer more often, and it’s through that that you will see us become more healthy sort of normal individuals, able to function in a normal day to day life. Is there any final thought that you’d like to add, Thomas, sort of about adults that help young care experienced people?

TB I don’t think so. I think, as you say, the first time we meet a staff member or a carer or whoever, we act out because it’s the only way we know how to show our emotions, and as you said, patience and being consistent. After one or two kick offs, you could say, or acting out, don’t leave us ‘cause we’re trying to build a relationship with yourself. For example, treating us differently. Yes, I can understand we’ve acted out, but we’re only doing it because maybe we didn’t get the attention at home, or this is the only way to show that we like you in a way and we want to build a relationship with you, and that’s the thing that I think most care experienced young people struggle with, is the fact that they struggle to build relationships with people even though they really want to. I’d like to thank you, Casey, for coming on and really helping this project, and I guess thinking of other young people, that you were in the position but not now, will help other young people know that they’re not alone.

CA Yeah. I mean thank you for having me, and it’s really great that people are taking steps to have our voice heard now, because growing up in care, you don’t really hear from other care experienced people and it makes you feel much more alone, and I think it just makes stuff like this even so much more important. So it’s great that these opportunities are sort of coming around for care experienced people now.

TB This podcast has been created as part of “Feeling well, feeling cared for”, a mental health training session for social care and social work students and professionals. The training was co-produced with care experienced young people, Who Cares? Scotland, and the University of Edinburgh. The podcast was created in partnership with TRIUMPH, a network for Transdisciplinary Research for the Improvement of Youth Public Mental Health, which is based at the MRC/CSO social and public health sciences unit at the University of Glasgow. TRIUMPH brings young people, practitioners, policy makers, and academics together to find a new way to improve the mental health and wellbeing, especially among us where the need is greatest. You can find more about TRIUMPH at http://triumph.sphsu.gla.ac.uk/

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