If we can understand this issue then parents and teachers can learn from us and apply the positive messages in their interactions with their children. About 10% of children under the age of 10 years in the UK have one or more diagnosable mental illnesses which impair their progress in education and the social world. About 10% of all children are subject to maltreatment in the UK.

THE HEALTH SYSTEM IS NOT STAFFED WITH ENOUGH PEOPLE TO MEET DEMANDS AND THE NEEDS OF THESE CHILDREN.

This basic issue places us in a situation of struggle against impossible odds to deliver the best comprehensive care to all children. Professionals within health have responsibilities to young people and so do parents, teachers, social workers and other professionals and the young people themselves.

If we all work together and work compassionately and collaboratively with young people, then we can effectively meet the needs of at least some young people.

Each of the different health professions have their own professional standards. In practice nurses and psychiatrists will deal with more crises and have a higher number of cases, whilst psychologists psychotherapists will need to manage crises and deliver therapy as Cognitive Behaviour Therapy, Dynamic Psychotherapy and Family/Systemic Psychotherapy. There are also other forms of therapy to consider.

All professionals spend time on administration which takes up too much time and reduces the number of young people who can be seen in a day. Ideally we should be able to see six cases a day and see complex cases for at least 20 sessions. In reality the health system wants young people to be seen for fewer sessions and moved through an under-resourced system, more quickly. Health professionals are asked to consider the delivery of their work in relation to the adminstrative and organisational processes around them in their day to day work.

Consequently the issue of moral injury arises when you have a compassionate, dedicated and able health professional placed in this system. The health professional is working in a system which limits their work and capability and takes control away from them, whilst holding them accountable for adverse outcomes. Patients and relatives probably do not want to think about this as they just want a good service for themselves, whilst the health professional is holding in mind the needs of many patients and many families. 

It is worth learning from colleagues how they cope with stress and of how they get through the day. For many there are basic healthy lifestyle choices to follow in relation to diet, exercise, sleep and being with family and loved ones. There is the issue of personal faith and motivation for the work. I really enjoy my work and feel very priveleged to help young people and their families and I try to focus on what I can influence each day to help young people, their families and my colleagues across all agencies.