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Gillian O'Brien is Director of Clinical Governance with Headstrong, an organisation that supports the mental health of young people in Ireland.

JOE recently sat down with Gillian O'Brien to talk about Jigsaw, a network of services run by Headstrong around Ireland that young people between the ages of 12 and 25 can visit if they need someone to talk to. There are currently 10 Jigsaw services in Ireland, with centres in Clondalkin, Donegal, Dublin 15, Galway, Kerry, Meath, North Fingal, Offaly, Roscommon and Tallaght. O'Brien speaks about bullying, anxiety, self-harm and many of the pressures facing young people in Ireland in 2016. "Overwhelmingly, our number one top presenting issue is anxiety. Number two is low mood. And number three fluctuates between family problems or anger," she explains. "Whatever the distress is, our job is to peel back behind that distress and what's causing it because anxiety isn't a problem in and of itself. There are often reasons for why that's going on and the same for low mood.

"When society thinks about young people and mental health, we're very concerned about low mood, suicide and self harm - things we should be concerned about - but anxiety is a huge issue as well. It's always been more of an issue in Jigsaw, proportionally, than low mood.

"Sometimes there's not as much focus on that, or we're not as fearful of it, but that's a really big one because of certain kinds of bullying behaviour. "The pressures young people face and feel really feeds into their sense of anxiety. It could be in their peer group, it could be at home, it could be the pressure they put on themselves, but it's hugely related to the pressure they feel to look and act a certain way. To feed into a cultural view of masculinity or femininity." While she does not deny the rise of cyberbullying in particular, O'Brien believes that face-to-face abusive behaviour is still one of the leading reasons for young people to seek help. "Oftentimes young people will come in about a particular issue and, when we peel it back, we find that there's cyberbullying going on - there might be exchanging of photos online and comments are being made," she says. "Young people, oddly enough, are slightly accepting of that and they're coming in not with distress about that piece, but about other things. It's remarkable, it's like young people have got accustomed to the fact that your privacy can be completely taken advantage of and exploited by others. "That's one piece of it, but what we will say is that most bullying still occurs face-to-face.

"(In a My World survey conducted in 2012) we asked young people if they had ever been bullied in their lifetime and around 40% said 'yes.' Of those 40%, when we asked, 'Where are you most frequently bullied? Is it in school, online or at home?' we got the response that 77% said it was at school.

"It's important, when we speak to parents, to put the point across that most bullying has its kernel in a real relationship. Then it transfers online and becomes unmanageable, really overwhelming and really difficult. In some ways that's slightly more hopeful because it means we can trace back the origins to it." Our impression of bullying, she insists, is often different from the reality. "Sometimes, when we think of cyberbullying we think of people that we don't know in different countries just randomly abusing people. It does happen, but for young people a lot of it is located in the systems they live in. It's in school, in their family, in community, in college or in work or wherever it might be." Anxiety, O'Brien reveals, is by far the biggest issue among the young people who go to Jigsaw. "When society thinks about young people and mental health, we're very concerned about low mood, suicide and self harm - things we should be concerned about - but anxiety is a huge issue as well," she says. "It's always been more of an issue in Jigsaw, proportionally, than low mood.

"Overwhelmingly, our number one top presenting issue is anxiety. Number two is low mood. And number three fluctuates between family problems or anger. Whatever the distress is, our job is to peel back behind that distress and what's causing it because anxiety isn't a problem in and of itself. There are often reasons for why that's going on and the same for low mood."

Crucially, O'Brien points out that a young person does not need to be in the depths of a crisis to seek help. She is keen to stress that, "there's no problem too small for Jigsaw." "Oftentimes, and it's a positive message, young people come in and they're not ill. There's nothing strange or unusual about them, they're just young people who have gone through an accumulation of experiences and it's just that notion of the straw that breaks the camel's back. "Maybe they're transitioning from secondary school to college, or they're moving out of home, and that can be the catalyst that throws apart these things. Sometimes, when you talk about mental health, people think it's something strange or unusual that's causing the distress and we want to blow that perception apart - it's actually just difficulty coping with an accumulation of everyday things." While it may be a cliché, she believes that there is a lot of truth in saying that 'a problem shared is a problem halved.' https://www.youtube.com/watch?v=sub0VSMraEk "Some of the young people who come into us, their levels of distress are really acute, they might be hyperventilating or crying but that dissipates very quickly - it's the relief they feel with being able to share that. "There's an anxiety where people think, 'I can't tell anyone what's going on with me because they'll think I'm mad or strange.' But we help them pick through the jumble of things that are going on and you make it a bit more manageable. When you talk to someone, it's not as overwhelming. "The language we use is important; it's not about treatment or intervention. We just say, 'if you need a chat, if you need a bit of support, if you're feeling stressed or worried or fed up, come and see us.' "We try to normalise it a lot and tell people that it's no big deal, that's what we're here for."