Why community based solutions are the only way forward

We’ve all seen the headlines: “Buckling NHS fails to treat 250,000 children with mental health problems”. One in five young people now has a mental health problem, but the NHS is struggling to manage surging caseloads. Open referrals to Children and Young People's Mental Health Services (CAMHS) are at a record high of over 466,0001 and the threshold for treatment is now so high that one-third of all referrals are rejected. Between 2011 and 2022 rates of hospital admissions as a result of self-harm increased by 37% for young people aged 15 - 19 and 50% for children aged 10 - 14. When six children in every classroom are struggling, we desperately need community based scalable solutions.

How Tellmi is building mental health self-management skills in young people

Tellmi is a multi-award winning digital mental health support service that is evidenced to improve mental health, increase confidence and connectedness and build mental health self-management skills in young people (Ravaccia, 2022). Since launching in 2017 Tellmi has supported over 100,000 young people who are dealing with issues such as anxiety, depression or self-harm and 3,300 who were suicidal. Thomas was one of them. 

Thomas made this post on the Tellmi app in May 2022

I fucking hate my life. I've self-harmed, I haven't slept for days at a time, I've suffered through eating disorders, Anxiety to the point where I am afraid to talk to people, and the moment I seem to get better the cycle starts again. The scars are back on my arm. My mind is filled with negative thoughts. I become suicidal.

This is Thomas’s story

“I’m 16 and I've had a very messy background, always with financial difficulties. My parents split up when I was born, and I currently live with my mother, seeing my father every few weekends. Both my parents now have another child, both boys (although I'm the oldest). My dad is now married, and my mum is a different story. Let's just say she was in a toxic relationship, and waking up in the middle of the night to see your mother being hit down a flight of stairs wasn't uncommon. Finance-wise, my family has never been rich. I was born into a fairly poor lifestyle, and I've had my fair share of being "between homes". I've been to a food bank a couple of times in the past, and I've never lived a particularly extravagant life. I've only been on a few holidays (to the beach, to York, once to Paris, places like that). I think one of the most hurtful things was when other people at school (friends, etc) would boast. I know that sounds really childish, but coming back after the summer holidays and seeing that your friends got all these amazing presents for their birthdays and went to these crazy holiday destinations is just sad when you can't do it yourself. Other kids would talk about videogames and the hundreds of games and consoles they owned, and I would always have none. I currently own a laptop and am looking into buying myself an actual PC over Christmas, but back then I only had my phone.

I was anxious about my GCSEs, everyone is, but I think covid (i.e. working from home) amplified it all. I found my year 10 mocks (which were also done at home) incredibly stressful. At this point one of my brothers had just been born, so I got little-to-no sleep, on top of my mum and her partner (now ex) arguing constantly. Then, in year 11, we had to wear masks all the time. We were flitting between working from home and in school all year. For our GCSEs, we didn't have them across one week like normal. No. We had hundreds of "assessments'' (which were basically exam papers in exam conditions) across 7 weeks. 7 weeks of exams, all day every day. You can imagine that after a few days I was already burnt out. I just had no time. I'd go to school, have exams all day, then come home and have to revise for the next 3 I had tomorrow. I think what also affected me was the fact that I couldn't do any normal teenager things, like going out with friends or doing any of my hobbies. Whether it was because of Covid, or the fact I just didn't have any time, I couldn't do anything I wanted. I was stuck doing exams.

I don't know why I was feeling so low. It comes in waves. Like you're drowning. Every single time you break the surface and try to grab a breath another wave just washes over you and pulls you back under. You try to scream but you can't breathe, but the thing is you are watching everyone around you breathe fine. Nobody wants to help you and they just watch you struggle underwater. You just about manage to make it to the surface and then it starts again. I guess the post was just a desperate cry for help - a way of letting people know what my life was like.

My mental health issues definitely peaked around the time that Covid hit. It was just the constant pain over years and years that slowly led me to where I was. Stuff has happened - big things - such as my great aunt dying while I was in the same house, or my uncle getting cancer, or my neighbour passing away from an infection in his throat. However, there were also many small things. For example, whenever I performed at a concert (I play the piano) in secondary school, my parents would never turn up. After the school play, or after some big show, I'd see other kids running to greet their parents, who would welcome them with open arms. The parents would pick their kids up, ruffle their hair, tell them how much they loved them and how proud of them they were. After the concert, I'd get on my bike and ride home to an empty house. If this had happened once, it would have been understandable. But I did about 20 of them. Every time after I finished, I'd try to scan the audience, searching for one of my parents. I knew they wouldn't be there, but I always hoped.

I think the self-harm was a mixture of tension, irritation (as in when you're upset or angry, not irritation of the skin), and trying to punish myself for some of the bad things I've done. Now I realize that those things weren't actually bad enough to hurt myself for - just childish mistakes made by a teen. I did then, however, feel lots of guilt over it. I'd always try to hide the cuts, or make an excuse such as "it was the cat" or "I scratched my hand on a sharp corner of my desk", something generic like that. I'm quite independent, so most people believed what I said.

I’ve always been independent, I mostly cook my own food. I buy myself lunch, usually skip breakfast then make myself something for dinner (or my mother cooks something, in which case I would say I wasn't hungry and have as little as possible). I would either not buy lunch, or buy it, eat a tiny bit/bring it home to have another day. I'd commonly buy a £1 ham sandwich (as it was one of the cheapest options). As I'm sure you can imagine, I had a lot of sandwiches by the end of the week.

I tried to tell people how I was feeling, but nobody believed or understood me. My parents just told me to deal with it, and that it's something that everyone has to go through, and my friends just didn't care. This was evidenced by the fact that they all met up without me multiple times, and I later found out that when somebody asked if they should invite me, the rest said no. I was always the weird kid or the poor kid throughout my school years. Because I'm legally living in poverty (annual income-wise), I was made fun of. Whether it was my broken shoes, or unbranded, knockoff clothes, or even what I ate, I was made fun of for being born into a broken family.

I tried to gain help. Oh, believe me, I tried. I got a counselling appointment, which was then cancelled. A few days before my new one was due, the entire service shut down and the counselling company went bust. I was referred to a new company, who then delayed and cancelled my appointments 4 times in a row. This whole process lasted about a year, and as always, I just had to deal with things myself. By the time I managed to get an appointment (over the phone, not even physically), my GCSEs were done and I was improving (helped of course by Tellmi). To summarize, the experience I had was complete and utter crap. The phone call I finally managed to get wasn't even a therapy session like I was told, it was simply someone asking me if I felt okay, and lasted about 15 minutes. It was extremely unhelpful - like help was JUST out my reach, all the time.

My family flitted between being helpful and supportive, and simply telling me I was overreacting and being too sensitive. My mother said it happens to everyone, and that I should just learn how to deal with it, saying it was my fault I was like this, but then the next day she'd be really kind and caring. My father was probably the most considerate. They both tried to help my mental issues, but weren't very supportive about my state of wellbeing altogether.

My school did not know until the very end when I told them I was feeling anxious. They referred me to a counsellor (as mentioned before) but then did not follow up or even check if everything went according to plan. It didn't. My friends did know, and were not helpful in the slightest. They might have actually made it worse. The very first time I fully opened up to someone, and I told them everything, they didn't care. Their exact words were "nobody cares about your life story". Zero people in my friend group were supportive.”

Thankfully Thomas found Tellmi

“I think Tellmi came up as a recommendation on the play store, because I've tried similar apps before. I've been thinking about this quite a bit, and I've come to the conclusion that the anonymity was the best part. It didn't matter what you did, who you are, what you look like, there was always support. The community was one of the best; everyone there was so nice. I loved it. It's so rare for a company to create an audience that is that kind and generous, so I have MAJOR respect for you and all the people that use Tellmi.”

Thomas made this post in September 2022

I don't want to jinx it, but I think we've done it. I haven't cut in ages, I'm 2 months clean. I'm eating 2 or 3 meals a day, and after countless relapses, I'm now stable. I'm balancing college and a part-time job, and I don't feel like ending it any more. Thank you to everyone that's helped me, seriously, you are the reason I'm still here today :)

Thomas remains connected to Tellmi

Thomas was determined to not forget the people that helped him at such a critical time in his life.  He said

“I'm still here today because of them just as much as Tellmi itself. I've recommended it to lots of people! A couple of friends struggle with anxiety, and I've always made sure that they know how much Tellmi has helped me when I show it to them.”

In 2023 Thomas became a member of the Tellmi Youth Advisory Board. Since then, he has been involved in a number of co-creation projects, webinars and most recently, an exploration of the difference between emotional support delivered by AI and peer to peer support delivered by Tellmi.  

Tellmi may be slower, less polished and less perfect than Chat GPT, but for Thomas, that is exactly what makes it special.

“Knowing there's someone real on the other side of the screen, someone scared and hurt and in pain the same way you are, makes you feel less alone - and isn't that the whole point? The imperfections in the responses are what make it feel genuine - something that a perfect AI could never replicate. The responses you get and the words you type on Tellmi are raw and messy, not polished and clean and that’s what makes it so authentic.”

Thomas is now finishing his second year of media studies at Coventry University and he is absolutely thriving. You can listen to Thomas tell his story on the Tellmi podcast.