AYPH conference Young peoples experiences of skin conditions Tess McPherson Consultant dermatologist Oxford

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Roger Underwood
5 years ago
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1 Skin, Stigma, Services & Support AYPH conference Young peoples experiences of skin conditions Tess McPherson Consultant dermatologist Oxford

2 Skin Skin problems major problem in young people Skin condition in adolescence causes Specific problems for this age group Dermatological and Psychological Long term impact on many life outcomes Inadequate dedicated services addressing needs

Stigma Psychological Impact Increased risk of developing psychiatric disorders Especially depression and anxiety Increased suicide ideation and suicide risk Early onset skin disease (eg psoriasis <

3 Stigma Psychological Impact Increased risk of developing psychiatric disorders Especially depression and anxiety Increased suicide ideation and suicide risk Early onset skin disease (eg psoriasis < age 20) Significantly more anxious and depressed than patients with late onset Younger age at onset of psoriasis significant determinant of personality trait Embitterment, irritability, mistrust and aggression Long-term implications for life choices and outcomes Cumulative effects on life Mattel PL et al. Curr Probl Dermatol 2013;44:82 90.

4 Stigma Other lads my age dream of winning the lottery or playing for Man Utd. All I ever wish for is that my skin will be normal again, that I ll be able to look in the mirror without cringing, that I ll be able to walk down the street and look people in the eye. I know it sounds stupid, but sometimes I see people in wheelchairs and think well they re luckier than me, at least they have good skin. You see, my skin is the last thing I think about when I go to bed at night and the first thing I think about when I wake up in the morning. It s always on my mind Ben (Acne) age 16

5 Solutions Ensure Developmentally appropriate services Understand Adolescents needs Listen to Young People Provide Appropriate Support Medical independence, use of suitable products Psychological, emotional, social Early/ pre-emptive Peer support vital address Stigma

6 Services Vital time to learn how to manage health and illness especially chronic conditions Importance of engaging with this age group DoH Priority Develop Independence and self motivation Support & Education improve adherence which improves outcome Positive effects on life outcomes Oxford 2013 Teenage Young Adult (TYA) clinic developmentally appropriate service Open access to Psychologist in clinic Good control of inflammatory skin conditions improves symptoms and quality of life

7 Support Clinic Staff Psychologist Others eg mindful yoga Family Friends and Peers Resources

Impact of Clinic - Patient feedback 2 x audits patient experiences Patients report high satisfaction with the clinic All patients expressed confidence in sharing personal details with healthcare

8 Impact of Clinic - Patient feedback 2 x audits patient experiences Patients report high satisfaction with the clinic All patients expressed confidence in sharing personal details with healthcare professionals good doctor Thanks, staff friendliness very efficient clinic nurse is excellent staff very helpful and kind doctor excellent thanks, patients 3 consecutive clinics patients 3 consecutive clinics

to do independentlygreat as I am off to uni Very helpful Psychologist made huge

9 Impact of Clinic- Comments on Psychological support All Patients Satisfied or Very Satisfied Clear she understood itch scratch cycle and me- gave me really useful exercises to do independentlygreat as I am off to uni Very helpful Psychologist made huge difference Really helpful app Helpful Mindfulness new and helpful Psychologist reassuring and good advice

10 SKINs sections healthtalk.org healthtalk.org Rigorous and systematic research methods for patient interviews Award winning sites launched Shown to make patients feel less alone with condition and find solutions to problems ACNE, ALOPECIA, ECZEMA & PSORIASIS NIHR grant Patient experience resource age Separate sites for each condition Linked themes Launched April 2017 Patients, healthworkers, carers etc Data available for analyses

11 Solutions and Peer support I think in a weird way it s actually made me like more confident. Because, since it s got better, I ve now been like two fingers to you, eczema and like taking back my life Obviously like if I hadn t had it in the first place I'd be, I actually think I d be such a different person today if I hadn t had it in the first place, I actually potentially might not have been as confident as I am now like pick myself up from and kind of fight against. I think my confidence is probably actually up on the fact that I ve suffered eczema in a weird way

I m almost proud of my psoriasis to be like: What s wrong with it, like if you ve got a problem with it I don t really want to hang out with you Summary Skin disease specific challenges in

12 I m almost proud of my psoriasis to be like: What s wrong with it, like if you ve got a problem with it I don t really want to hang out with you Summary Skin disease specific challenges in adolescents Support Involve and listen to young people Offer appropriate clinical support Help find solutions to allow them to grow into confident adults who are comfortable in their skin Thanks.. tess.mcpherson@ouh.nhs.uk

We believe that young people are all one step away from making a life changing difference for themselves, and each other.

We believe that young people are all one step away from making a life changing difference for themselves, and each other. Mental Health Background about the Youth Action Group We are a group of emerging young leaders (ages 18 25) who are passionate about raising the profile of young people in Melbourne. Our group, the YAG