It is quite normal for young people to explore unusual or less mainstream beliefs as part of developing their own identity. This can take the form of an interest in more extreme or unusual political or religious movements or following a particular music cult through dress or lifestyle. Religious beliefs and acts of faith may not appear logical to everyone but such beliefs, along with cultural beliefs or superstitions, are shared by many others and therefore, do not indicate mental ill health.
Young children will also express beliefs in the magical or fantastic; for example believing in fairies at the bottom of the garden or monsters in the wardrobe. Again these are very normal and are often encouraged by parents and carers and will decrease as the child develops in their general maturity and understanding of the world. In certain cases, for example the Tooth Fairy or Santa Claus the child may choose to suspend disbelief because they enjoy the fantasy.
It is also possible for people to develop temporary false beliefs due to an illness such as a fever, drug intoxication or poisoning. Severe hormone imbalance or nervous system problems can also cause certain individuals to become irrational in the way they express their belief systems. These would all require investigation by specialist health services.
It is common for people to have false beliefs through misinformation or misunderstanding. Normally, however, these beliefs can be corrected when the person has access to new information or to evidence which makes it clear that they are mistaken. False beliefs that are associated with mental illness tend to be fixed and not amenable to logical argument. In other words, they remain fixed regardless of overwhelming evidence that the belief is wrong. This can lead to conflict and distress and can cause the individual to withdraw from social activities and refuse to communicate for fear of contradiction.
Examples of false beliefs associated with mental ill health:
- A belief that individuals or groups unknown to the sufferer (such as political figures or celebrities) are planning to harm them or to interfere in their lives, or are already doing so.
- A belief that they have been given important messages (very often with a strong religious content) that they have a duty to pass on to others.
- A belief (that they are prepared to act on) that they have become very powerful, important, influential or indestructible.
- A belief (that they are prepared to act on) that they have ideas that will immediately solve problems of major world significance such as world poverty, global warming, etc.
Often false beliefs associated with mental illness happen in combination with other symptoms and behaviours such as hearing voices. When mental illness is involved, there will usually be other signs that the young person is troubled, for example:
- The young person might talk or laugh aloud as if having a conversation with an invisible person.
- They may become withdrawn and less inclined to mix socially.
- They may have difficulty in concentrating on studies or TV programmes, etc.
- They may lose interest in normal activities.
- Their thoughts and ideas may appear to be all mixed up and sound like nonsense when they attempt to express them.
- Care in their appearance and self care may deteriorate.
- They may become lethargic and lose motivation or be agitated and overactive.
- It might be that the false beliefs are not disclosed by the young person but others notice that they appear to be distracted or are acting out of character.
Young people who are expressing false or bizarre beliefs and are suspected of having serious mental health problems should be considered as vulnerable and may be a risk to themselves. Psychiatric advice should be sought as soon as possible and they will always be treated as a high priority by the local mental health specialists.
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- Remember that it is normal for young people to develop interest in unusual subjects and alternative culture and lifestyles as part of exploring and deciding on their own life values.
- A fear of ridicule, stigma and of not being believed can often cause a young person to try to cope with their problems alone.
- Other young people will probably have noticed changes in them and may be concerned or frightened by their behaviour or their strange thoughts and ideas.
- Mental illness that involves bizarre false beliefs is often made worse by stress such as exam pressure and work deadlines.
- Situations of high emotion like family conflict, arguments and shouting often have a detrimental effect on the well being of people who have bizarre false beliefs.
- It may be that the young person experienced a bereavement, trauma or abuse that might be provoking their current state of mind.
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It can be difficult to accept this type of behaviour if you have not encountered it before. Most people are apprehensive when they discover a young person is expressing false beliefs because of fears of ‘madness’ and the stigma and prejudice surrounding mental illness. If you have not had much experience of people who have bizarre false beliefs, the uncertainty about how they will behave can lead to avoidance of them or the issue. Alternatively if you have had a difficult experience of someone with a mental illness in the past you may make unhelpful assumptions about how this situation will develop. It is important in responding helpfully that you are aware of your own feelings and thoughts so that your reaction is genuine to the needs of the young person.
For more information, see section on being aware of yourself and your own response.
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- Keep them safe and seek support and advice from colleagues and specialists.
- Be careful to assess the level of immediate risk for the young person and for others by allowing the person to talk to you openly about their beliefs and concerns.
- In the first instance, it is important to show the young person that you believe what they are telling you is real to them and that you would like to hear more about it.
- Talk and listen to the young person. You need to decide whether the false beliefs are causing distress or are likely to lead to self-harm or violence towards others as this requires urgent attention. The more information you can obtain, the clearer your understanding of the associated risks will be. However, you also need to be aware of the anxiety the young person may feel if forced to disclose information without feeling safe and secure.
- Sensitively discuss your concerns with other people who know them well because they may also be concerned and may be aware of useful information for example, about their level of risk to themselves/others or that they are already receiving support from specialists etc.
- Interventions which are used to help people who have false beliefs tend to be specialized and it is important to get them referred to the appropriate specialist, normally a psychiatrist or member of a specialist mental health team.
- It can be difficult to engage in conversation about something you consider to be bizarre. You should try to concern your self with the impact this belief is having on the young person and those around them rather than the reality (or otherwise) of the belief.
- Be prepared for sudden changes in behaviour, especially if the young person feels that they are not being listened to.
- Try to alleviate any conflicts with others and to reassure the individual that you are trying to understand their concerns.
- Ideally, the young person should feel that you are interested in what they have to say and that you are genuinely concerned about any difficulties they may be experiencing.
After they have been seen by a specialist:
- Be understanding and respectful and try and reduce the stigma that they may be feeling by being tolerant and inclusive and by educating others to do the same.
- Talk with others involved in supporting the young person because developing and coordinating their support network is very useful in aiding their recovery.
- Encourage them to follow the treatment and advice offered by the specialist such as attending appointments, therapy and taking medication as prescribed.
- Encourage the young person to be involved in social activities.
- Encourage them to be involved in activities such as education or hobbies.
- Encourage them to take an interest in their appearance and self care.
- Encourage them to look after their health by taking exercise, eating a healthy diet and getting enough rest and relaxation.
- Protect them from situations where there is high emotion being expressed for example when people are arguing or shouting.
- Try and reduce the amount of stress the young person might be under.
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- Don’t ignore your concerns or their behaviour in the hope that it will go away. They may be in a state of confusion and distress. Early support/treatment will be useful and can reduce distress, risk and improve recovery.
- It is important not to reinforce the false belief by superficially agreeing with the person.
- Don’t attempt to persuade the person that they are mistaken. This can lead to barriers developing and suspicion about your motives.
- Try not to minimise the young person’s concerns. Acknowledge that their belief may well be distressing for them and it is being taken seriously.
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- As soon as it becomes apparent that a young person has a fixed bizarre belief for which there is no obvious physical health cause.
- If the young person is already being treated by a specialist and you notice any significant change in them, for example, suicidal ideas/behaviour, an increase in their symptoms, deterioration in their self care or increase in their isolation.
Contact a mental health specialist urgently if, in extreme circumstances, an initial appraisal of risk suggests that someone could be harmed. An example of this would be if the young person is claiming that they need to self-harm or hurt someone else to satisfy their belief. This should be taken very seriously.
You should get in touch with your local health centre or hospital to obtain a contact number for the appropriate children and young people's mental health specialists.
Remember - you can contact your local mental health specialists for a number of reasons, for example:
- For advice on how to make a referral about a named child.
- For advice about whether or not to make a referral (it is normal practice to seek this advice without naming the child in the first instance).
- For advice about what to do (once again there should be no necessity to name the child).
By not naming the child you are protecting their right to confidentiality. This method of seeking advice also has the advantage that you do not need to get anyone’s consent in advance of your contact phone call.