Kitty Nabarro Founder of Nip in the Bud

Transcript

Alis Rocca

Hello and welcome to the Nip in the Bud podcast, the podcast that discusses and supports good mental health for children and their families. I’m Alis Rocca, life coach, education and wellbeing consultant and former head teacher. And in today’s episode, we will discuss how the charity Nip in the Bud came to be with founder Kitty Nabarro. We’ll discuss the charity from its initial conception to the thriving community it is today, helping and supporting hundreds of children and their families by sharing free information, experiences and resources, mainly through the medium of film. The goal of Nip in the Bud is to increase the prospects of early intervention and to avoid mental health conditions becoming more serious in later years. Now, Nip in the Bud offers their listeners links and information on a range of topics that affect children’s mental health. So be sure to listen all the way to the end of this podcast for more details. So Kitty is co-founder of Nip in the Bud together with her husband Daniel, and they co-founded the charity in 2015. She is also chair and administrator of the charity.

Previously, Kitty worked as a teacher of modern languages in secondary schools and adult education. After retiring from the classroom, she became an active volunteer for OCD action with particular focus on the OCD at school program, giving awareness talks prepared by the Maudsley Hospital. So welcome, Kitty, and thank you for your time today.

Kitty Nabarro

Thank you, Alis. It’s nice to be here. It was Daniel’s idea to start the mental health awareness charity, Nip in the Bod, learning about children’s mental health through film. As Alis said, we had both been involved with OCD action for a few years. We decided that we must not only focus on OCD, but on all sorts of other mental health conditions to look after children.

With the assistance of our friend Michael Caro, who had also been a trustee of OCD Action, we formulated the aims and directions of the charity. Michael dealt with all the legal aspects of setting up a charity. The aim of Nip in the Bud is to increase early intervention, so these conditions can be nipped in the bud and reduce the risk of them becoming entrenched.

Alis Rocca

Who would you say the charity is for? Who are you aiming at lately? Kitty.

Kitty Nabarro

The charity is primarily aimed at two audiences who care for or work with or are responsible for children. They are parents or carers on the one hand and teachers and professionals on the other. By professionals I would mean, by teachers I would mean teacher trainees as well at universities and any teaching staff. And by professionals I also mean social workers, GPs in particular, anyone working with children. Scouts,  could be people in the community working with children.

Alis Rocca

Thank you. I love the way you’ve called it nip in the bud and you’re hoping to nip things in the bud. Could you tell us a little bit about that, you know, that side of it? What were you hoping to achieve overall?

Kitty Nabarro

It started in 2015 with a book that we were particularly inspired by called Thrive written by the economist Lord Layard. He stated that the government should put funds and resources into mental health awareness in children and early intervention. Not addressing mental health problems early can have wide ranging and long lasting effects. So it can help, it can affect a child’s relationships, their educational attainment and job opportunities. And if left untreated, they could also develop into serious mental and physical health problems, which could be costly and have a significant economic and social impact, not just to the individuals and their families, but later in life also to the health and criminal justice system.

So we’ve thought that early intervention is key to be able to address these issues.

Alis Rocca

Yeah, I think it’s such a great beginning, such a great place to start from. Where would you say you have got? What have you achieved so far? How far on your journey are you?

Kitty Nabarro

We’ve come a long way. We launched at the end of November 2017 with six films. And we launched those at a cinema. And we now have about 65 short films, fact sheets and blogs. It’s quite an incredible amount of resource and it’s all free, freely accessible online.

Alis Rocca

And how do you know the impact you’re having on your audience? What sort of stories have you heard about people that are coming to your website and watching your films and reading your fact sheets?

Kitty Nabarro

We get comments on YouTube and some of those are sad, some of those are pleased to have found us, some of those are critical, which is fine because people need to have opinions as well. And we know that our numbers are growing steadily on our analytics. So we think in general the feedback that we’re getting is very positive, especially since we upgraded the website. Because we only have six films initially and have got so much more content now, we really needed to make a lot of changes and the website is absolutely beautiful as it is and easy to navigate.

Alis Rocca

It is, there’s so much on there, it’s packed full of information. What have been your main challenges, Kitty, and obstacles that you’ve come across on your journey so far?

Kitty Nabarro

Our challenge is to spread the word and to get that information out there. One of the problems that we face here in this country is GDPR, in other words, General Data Protection Regulations. So we’re not able to easily contact people. For instance, we would love GPs to know a lot more about what we do and the NHS. We have got a connection, a very good connection at the Maudsley with the mental health support teams, (MHSTs). And they love what we do, and they exist across the country. So when it came to asking if they could give us the details to contact all the other MHSTs across the country, they couldn’t do it because of GDPR. So that’s a stumbling block.

Alis Rocca

Why is it important to you to get this information to GPs?

Kitty Nabarro

Because GPs are generalists. I know they need to know a little bit about everything, but so much about what is happening today in life and the issues that people go to GPs with really do boil down to mental health problems. Even with COVID, it could just be that if the mental health problems were addressed, then the physical problems that come with it might be fixed at the same time.

Alis Rocca

So you’re really talking about the support and advice and information.

Kitty Nabarro

Yes, in order to do that, GPs need to have more knowledge about mental health and we feel that the resources are actually quite easy to look into, to get a quick idea of what each condition might be like. So a GP could get an enormous amount of information within a very short space of time if they simply have this website as a go-to place.

Alis Rocca

Can you give us an idea of what you’ve got on there at the moment? You said you’ve got up to 65 films. What are the types of themes or conditions that are covered?

Kitty Nabarro

So we cover at the moment 11 conditions and they are divided into Information Films. So those are films where we use top experts from the Maudsley, Great Ormond Street, Imperial College, King’s College, Anna Freud. We’re lucky to have amazing contacts with these organisations.

They explain the condition and they create a fact sheet that goes with that. To back all this up, we also need to hear from people with lived experience. So we have what’s called Real Life Experience Films where parents or young people will share their experiences and will make it a little bit more understandable to the general public perhaps.

Alis Rocca

So a real mix of real life experiences, but also specialists in their fields being able to share facts and research.

Kitty Nabarro

That’s right. We do have other kinds of information, but that’s more along the line of Emotional Wellbeing. We do believe that the Department for Education should be spending more time on emotional wellbeing. And I believe that a child will be able to eventually get to read and write and do maths and learn facts. But they will learn it quicker if they are happy, and if they’re emotional wellbeing is stable. So it seems that it would be worthwhile to put that as quite a priority in the education of this country.

Alis Rocca

Thank you. So just you touched on your own family’s experience. Could you tell us a little bit more about that? What is your family’s personal experience that has led you to this and what is the story?

Kitty Nabarro

So our daughter started with these thoughts when she was about eight years old. We have no idea how this came about, but it would be things like she’d left the tap running at school and maybe the school will be flooded. It was always about worries about fear that she had harmed or will be harming somebody in some way or that she hit her best friend by mistake with a pole or something on the head and that harm that will come to this child. But we would always say, don’t worry about it, it’s fine, because we didn’t understand that really this was a lot more than that in her brain, that the brain just wouldn’t switch off, especially at night time. But she didn’t understand that either, really. As she became a little older, we tried to see what could be done about this, but there was no information, nobody to go to, nobody that knew. I think she probably stopped telling us what was happening in her brain because she just decided that this is all very weird, and just carried on with life. But I suspect she must have been suffering more than we knew about. This made us, with hindsight, feel quite terrible about that because we were good parents. We were quite switched on. My husband was very capable, I was a teacher at secondary school, but there was no information and no internet in those days. Once we realised there’s a facility of getting this information out, we decided we got involved with OCD Action. We made a film for OCD Action initially, but that’s for adults to understand OCD. And we took it on further from that. We also had the unfortunate situation of a young friend who took her own life and it turned out that she had much more depression than we knew about. These are very important factors that have made us do something about it.

Alis Rocca

So Kitty, could you just tell us what conditions and themes could be found on your website?

Kitty Nabarro

So at the moment, the conditions are ADHD, anxiety, oppositional defiant disorder (ODD) and conduct disorder, depression, eating disorders, OCD, PTSD, self-harm, trauma, and certain aspects of autism spectrum condition, which is a very large topics, so we only do certain aspects. About autism, I will explain the main reason we talk about it is that it’s not a mental health condition in itself, but 70 % of people with autism have one mental health condition, and 40% of the 70% have more than one mental health condition.

Alis Rocca

That’s really high. You’re going to be getting a lot of the right information out to the right people. So just thinking back to you and your husband as being parents of a child with OCD, what do you wish you had known back then? You say there was no internet, there wasn’t the information that you’re now offering. If you could look back, transform yourself back to that time, what do you wish you had known?

Kitty Nabarro

If only we had known about the condition of OCD that nobody even knew about or if we had known the terms Obsessions and Compulsions or if we had known about Intrusive Thoughts and what were those things that were constantly in our daughter’s brain and if only we there had been internet and there had been information and the GPs had known and had been able to help us, we would have been in a very different place.

We had gone to an educational psychologist and she just said that she has a very high IQ, but couldn’t help us otherwise. But the point is she was struggling to concentrate on her work, even though she was working hard because of these intrusive thoughts. Of course, none of us understood that. The other factor that hindered us was our horrible word stigma. No one talked about mental health. Our daughter kept, as I said, her intrusive thoughts to herself and she hid her compulsions so that family and friends and the school didn’t know how much she was suffering.

Alis Rocca

Did she hide those compulsions from you as well?

Kitty Nabarro

She did. We knew that she did, for example, some hand washing and she was having some showers, but we didn’t know that by the time she got to university and we weren’t with her, she was having six showers a day.

Alis Rocca

And this word stigma, why was that such an issue, do you think?

Kitty Nabarro

Because you felt that if you talked to the teacher or the teachers they just wouldn’t understand and then they would put a different connotation on it, people just were scared to let people know that there was a problem, especially a mental health problem. This may sound a little strange but in those days there was a thought that if you suffered with something with mental health you might be crazy.

Alis Rocca

This is only the 90s that we’re talking about.

Kitty Nabarro

Yeah, so maybe people wouldn’t have thought that, but as a parent or even as a child, a young person, you don’t want to share these things because you don’t want to feel that you’re different from what you’re supposed to be.

Alis Rocca

Yeah, absolutely. Now, what would you say to your younger self? If you were able to give your younger self who found themselves in this difficult situation, not knowing what to do, what message would you send to yourself?

Kitty Nabarro

I would say that it’s crucial that from a very early age you should have an open communication with your children. The ideal would be that as a parent, even during your busy life, you should make time every day to chat to your child or to the young person.

I believe we did have a very open family structure at home and we did talk about things, but it was because we didn’t have the information that we didn’t know how to approach that subject. This time that I’m talking about with children, it should be without interruptions from mobiles, chores or other distractions. And this can then become a special time to share news and experiences and thoughts and it might be only 10 minutes but if it’s done regularly and it becomes a normal part of the day everybody feels comfortable and happy to share. So for instance if some bullying or verbal abuse or other fears and worries crop up it can be openly and informally discussed as part of a normal situation.

Alis Rocca

I completely agree and I think parents today have so many more distractions to be fighting against with their children and young people, don’t they? As you said, mobile phones and devices and games, etc. So, you know, it isn’t necessarily easy, but it is so important to just carve out like 10 minutes, as you say, to just have that informal chat, touch base. And if you do notice anything that you’re unsure about, of course, the Nip in the Bud website is the perfect website to go to to start doing a bit of exploring and saying, these are the things that I’m starting to see or my child is starting to tell me, and then finding that information.

Kitty Nabarro

That’s right.

Alis Rocca

How do you think the schools could have supported your daughter and your family, better on your journey? I know things are different now, but what did you experience from the schools that she went to?

Kitty Nabarro

Again, because there was no information, I don’t think we talked to the school much about it. The one thing we had was a counselor, or my daughter had a counselor which was arranged through the school. And we wrote to the counselor to say, we think it might be OCD. Can we discuss this? And the counselor never responded.

Now I think this is because by that point our daughter was at secondary school. So maybe it was because the relationship was between the counselor and our daughter. But that was incredibly disappointing. So we had zero support there because we suddenly got an inkling through another avenue that it might be OCD and she would not engage. There is another thing I will say about the counselor and this may happen in schools in general, it can be a problem for children to go to a counsellor or young people to go to a counsellor because unless they are in a place where other people can’t see where they are, if that door, if you’re standing by that door as a young person, that immediately tells the world that you’re needing to see a counsellor.

Alis Rocca

And obviously that young person is probably feeling very vulnerable at that time. So that’s a really good tip to be thinking about. And hopefully schools today do think about where they’ve got those rooms and those spaces where children, young people can go and talk openly. So hopefully things are a lot different in schools today to support children like your daughter today.

Kitty Nabarro

I would like all schools, if they could possibly be exposed to a site like Nip in the Bud, to know about it, to know that they can just get any information they want if they need it. If I was a teacher of primary school, I would probably take all the fact sheets of the conditions that we do, print them off, have them in the back folder as a quick check to see if I notice something in a child think, it could be that because by the time I go online and check it out, the moment has gone. That’s the first thing. The second thing, as I say, is I would like to see an awful lot more being done for emotional well-being and PSHE. Nip in the Bud has recently released a film, it’s called Let’s Connect Breaking Down Barriers to Learning. It’s a three-minute film made with children from Chicken Shed, which is an inclusive theater company. And the idea is for teachers to watch that with children in the classroom and discuss it openly and make children aware that different people learn in different ways and that children might have different issues that they might be worried about expressing. But if at least it’s discussed in the classroom and people start to have that conversation, then children with these needs might be freer to talk about them. It also just makes children aware of diversity in general.

Alis Rocca

Okay, that sounds like a good one to watch. Thank you for that. And I’m just thinking now, again, going back to your own personal story and your own journey that you, your husband and your daughter had, if you’d had all this information, if it had been available, how do you think things might have turned out differently? What changes would have happened along the way that might have been better for you all?

Kitty Nabarro

So the first thing that also comes to mind is, I had a friend who worked in psychiatry with children and she said to us earlier on when our daughter was maybe nine, why don’t you go and see this psychiatrist at the Royal Free Hospital? But if you’re going to go, you need to make sure that you will agree to medication.

This is at the point where we thought, no, we do not want our child at that age to start medication. That was a mistake. With hindsight, I think I wish we had listened to that and we might have been in a better place because medication eventually was needed. And after that point, our daughter was only diagnosed when she was about 16. So that was a very long time. And I regret that.

Kitty Nabarro

Thank you. And so you’re not saying that everybody should be seeking medication, but what you are saying is that you seek information. So you’ve got that opportunity as parents to know as much as you can so you’re in the right place to make the right decision.

Kitty Nabarro

Yes.

Alis Rocca

So Kitty, it sounds like information for carers, for parents, and for professionals is really important to you.

Kitty Nabarro

Yes, absolutely. This is why we became passionate to create as much free, easy to absorb online information. Because this leads to open discussions about concerns and symptoms and ways to get a diagnosis and treatment as soon as possible. I would also like to point out that we are not a service provider.  But we do have an excellent resource at the back of the website, the last section of the website, which is where to go for help, where to get help and support. So there are many charities that would be able to help for all the different conditions that people can find, because in many cases, even if you do get a diagnosis, there’ll be a waiting list and time before people can get treatment. But many of these charities have helplines and information on their websites on a particular condition that might be able to help their child while they wait.

Alis Rocca

So that’s really helpful. So even though you’re not a service provider, you signpost your audience, your parents, your carers, professionals to other charities and other organisations that can provide a service. Thank you. So Kitty, what’s next for Nip in the Bud?

Kitty Nabarro

The next topic which we’re tackling is stigma. In the past, as I said, this was a real problem of stumbling blocks. The themes like mental health weren’t talked about. But fortunately, these days there is more information. People are speaking openly about mental health and there is more help available. But stigma still remains an issue, especially within diverse, ethnically diverse communities where the topics of mental health could be taboo. So hopefully, Nip in the Bud can find ways of sharing the stigma film widely and make communities across the country more aware of what the topic entails and where help can be found.

The other topic we will be exploring is neurodiversity. This is a relatively new term that recognises that some people have neurological differences, including if they have dyslexia, dyspraxia, dyscalculia, ADHD, autism spectrum, and perhaps even the conduct disorder comes under that. The human diversity we really feel is to be celebrated. They must be respected for who they are and be helped in the areas where they struggle. So this is a whole area that needs a lot of work on. We are looking to produce some material on dyspraxia, which affects reading and writing. Sorry. I mean dyslexia, which affects reading and writing, dyspraxia, which affects fine and gross motor coordination, and dyscalculia, which affects the understanding of numbers.

Alis Rocca

Thank you. It sounds like you’ve got some really important themes to cover. How do you know which things to report on and find information about?

Kitty Nabarro

We are constantly networking with others and other people working with children in different conditions. For instance, I had a meeting with an epilepsy charity and they told me that the children that are epileptic actually are four times more likely to have a mental health condition.

I suspect that happens with many other conditions as well. So obviously we can’t now hone in just on epilepsy, but the idea is that it gives us another idea of which direction potentially to take. So it’s a question of talking to people, we are very aware, for instance, that children who are adopted or fostered might also have all sorts of problems that need to be addressed and that can result in mental health conditions, which if it can be nipped in the bud and discussed might resolve before it becomes entrenched.

Alis Rocca

And that’s your vision, isn’t it, to nip in the bud and get those early interventions in place. So what would you say, if I were to ask you in five years time, where do you hope Nip  the Bud will be and maybe even in 10 years time, what’s your vision going forward?

Kitty Nabarro

Nip in the Bud wants to be the go-to center to get evidence-based, user-friendly and up-to-date information about mental health in children and young people. We would want teaching staff to use the Nip in the Bud resources as a continual educational platform which could be part of their PSHE lessons. However, that’s still very difficult to disseminate widely across the country and we are having to see how we can find ways to get the Department for Education involved and that’s tricky. We are a very small charity, we have limited resources and getting to the Department for Education can be tricky but that would be one of our aims there.

Alis Rocca

Okay Kitty, and what about 10 years?

Kitty Nabarro

In 10 years we will have the same aim, but we will put more effort to encourag the government, the NHS, schools and other institutions to be much better at providing the help and therapies which are needed. We would also want to reach wider audiences. It would be good to have a more international presence and see if our resources can be translated into different languages so that other societies in the world can have access to this valuable information too.

Alis Rocca

A much wider reach in the future is what you’re hoping for to reach more children, more families. That sounds amazing. What are your own personal hopes and dreams for supporting good mental health for children everywhere?

Kitty Nabarro

If Nip in the Bud can continue to produce engaging educational mental health resources, my hope and dream is that we can find a way for every university to teach their primary school teacher trainees about mental health using Nip in the Bud resources and for every primary school to know about Nip in the Bud as a reference they can use widely and freely when needed. And hopefully that will then continue their education going forward and thinking in a different way about mental health.

Alis Rocca

I think that’s so important. And as a former head teacher, that would have been my dream to have newly qualified, or as they’re called now, ECTs coming into school with that understanding, that knowledge, and already being able to recognise and respond to the children’s needs in their classrooms really, really efficiently, effectively. Because I know as heads we had to do a lot of that work ourselves to get them to that point.

Kitty, thank you so much again for your time today. It’s been fantastic hearing about your personal story as well as the growth of Nip in the Bud. What one key thing would you want a listener to take away from your conversation with you today.

Kitty Nabarro

Early intervention is key!

Alis Rocca

Fantastic, as simple as that. Early intervention is key. That’s been amazing. Is there anyone you’d like to thank for helping you to create this project, this charity?

Kitty Nabarro

I would actually, before setting up Nip in the Bud, we had a meeting with Dr. Bruce Clark, the clinical director of CAMHS at the South London and Maudsley NHS Foundation Trust. We described our plan to him. He thought it was an excellent idea and he was very encouraging. He thought that Dr. Gordana Milavic might be interested in joining Nip in the Bud as medical trustees

Dr. Milavic had previously been clinical director at the Maudsley and we were delighted that she accepted the role. She’s been instrumental in connecting us with many experts in the field of psychiatry and psychology. So I would like to thank Dr. Bruce Clark, Dr. Gordana Milovic, and of course, Michael Carro, who I mentioned before, who was instrumental in helping us with the aim and the founding of the charity and setting it up as a charity.

Alis Rocca

Thank you. And we look forward to all of the things that you’ve talked about, the different areas that you’re going to be making films on, making podcasts on, creating resource sheets. So as Nip in the Bud continues to grow, continues to further the reach, we’d just like to say thank you, Kitty, for everything that you’re doing.