Children’s Mental Health Week – running from February 7 to 13 – has brought with it a wealth of research reports focused on the mental health and wellbeing of our young people – and the picture seems grim.
Increasing mental health challenges combined with inadequate funding for services, continuing difficulties with CAMHS referral thresholds, and a limited capacity for early intervention seems to be creating a perfect storm.
Let’s look at four of the reports published this week…
Anxiety (Place2Be)
The vast majority of school staff say they are seeing increased levels of anxiety among their pupils, but barely one fifth say they could access specialist support for children who need it.
The figures have been published by Place2Be (2022) – the organisers of Children’s Mental Health Week – in conjunction with the National Association of Head Teachers (NAHT).
They come from a poll of 1,130 school leaders, teachers and other staff working in primary and secondary schools. The survey was carried out in January.
The results show that that 95% of staff are seeing an increase in anxiety among pupils – particularly acute at secondary level – but only 23% say they can “regularly access specialist support for pupils who need it”.
Other mental health issues are also on the rise according to the respondents:
- Low self-esteem (86%).
- Depression (76%).
- Self-harm (72%).
- Suicidal thoughts (61%).
- Eating difficulties (56%).
The respondents said these issues are negatively affecting pupils’ ability to engage in learning (91%), pupils’ behaviour (87%), and pupils’ progress (86%). Attendance is also being affected (80%), especially at secondary level. There are also knock-on effects on staff workload and wellbeing.
Paul Whiteman, general secretary of the NAHT, said: “The findings of this survey are truly shocking – but unfortunately, to anyone working in schools, they are not surprising. Our members consistently raise pupil mental health and wellbeing as one of their top priorities – they really are on the front-line when it comes to identifying and supporting children and young people’s mental health needs.”
Mr Whiteman said the figures added “real urgency” to the call for additional resources to support the mental health and wellbeing of pupils.
Children in need mental health referrals (LGA)
The number of children assessed by councils as having a mental health need has rocketed by 25% compared to pre-pandemic levels.
As of March 2021, 77,390 children had been assessed as having a mental health need, compared to 61,830 two years earlier.
A Local Government Association Parliamentary briefing says that the figures amount to 1,500 children a week being referred for mental health support (LGA, 2022).
The referrals form part of the latest children in need figures (DfE, 2021), which show that in the year ending March 2021 there were 388,490 children in need. The year saw almost 600,000 referrals for assessment, of which 77,390 included concerns about mental health.
But the rise in cases is not just down to Covid. Even before the pandemic, children’s services had seen a massive increase in demand, with the number of referrals for mental health issues increasing by nearly 60 per cent between 2017/18 and 2019/20.
The LGA, which represents 350 councils in England and Wales, has warned that the number of children with mental health problems will likely continue to “sharply grow” and has called for children’s social care services to be adequately funded.
It says that spending on preventative children’s services has fallen from 41 per cent of children’s services budgets in 2010/11 to just 25 per cent in 2017/18. Meanwhile, spending on youth services reduced by 69 per cent, from £1.4bn to £429m.
But it warns that the cost of running children’s social care will increase by as much as £600m a year until 2024/25 due to the pressures of the pandemic. It adds that eight in 10 councils are already overspending budgets.
Cllr Anntoinette Bramble, chair of the LGA’s Children and Young People Board, said: “Hundreds of children every week are seen by social workers because they need help with their mental health and we expect these numbers to grow as the full impact of the pandemic is felt.
“This reinforces the importance of fully funding the whole system of children’s mental health support to make sure that children get the help they need, when they need it. That includes early help to prevent children reaching crisis point.
The LGA says that the wellbeing for education return and recovery funding the government provided to councils is “a small amount of money given the scale of need being presented to schools, councils and health services”. It wants to see “long-term sustainable investment in the whole system of children’s mental health support”.
Severe mental health needs (BBC)
There has been a sharp rise in the number of young people needing specialist treatment for the most severe mental health issues.
An analysis by the Royal College of Psychiatrists, carried out for the BBC, found that 409,347 under-18s were referred to the NHS in England for specialist care for issues such as suicidal thoughts and self-harm between April and October 2021 (Jeffreys, 2022).
This compares to 230,591 referrals in the same six-month period in 2019 – an increase of 77%. These referrals include children and young people who are considered to be at immediate risk.
There were also a record 349,449 under-18s in contact with NHS child and adolescent psychiatric teams as of October 2021.
Emma Thomas, chief executive of mental health charity YoungMinds, said that the figures “echo what we’re hearing from young people that the pandemic has put once-in-a-generation pressures on young people’s mental health – exacerbating existing pressures and creating new ones”.
She continued: “Even before the pandemic, many young people struggled to access support from mental health services, which are now facing unprecedented demand. The reality is that too many young people and families just can’t get the help they need and the variation in waiting times across the country is unacceptable.
“Getting support for your mental health early on can help prevent problems from escalating so there must be more spaces where young people can have these conversations.”
YoungMinds is calling for the government to introduce a network of early support hubs where young people can drop in and discuss their mental health without the need for an appointment.
CAMHS: Thresholds and referrals (Children’s Commissioner)
The number of referrals to NHS child and adolescent mental health services (CAMHS) has fallen for the first time in four years – sparking fears that the pandemic has preventing young people from coming forward.
A report from the Children’s Commissioner for England (2022) shows that in 2020/21, 497,502 children were referred, a decrease from 539,000 the previous year.
However, rather than being cause for celebration, the report warns: “It is likely that even though more children have mental health problems, fewer were being referred to services during lockdowns because of disruptions caused by the pandemic. Numbers referred into services are likely to increase again in the coming years.”
The report also finds that waiting times for those children who are accepted into mental health treatment services have decreased “substantially” from 43 days in 2019/20 to 32 days in 2020/21. However, 37% of children accepted onto waiting lists are still waiting for their treatment to begin.
Furthermore, only around a third of children (32%) with a probable mental health disorder are accessing treatment. This calculation is based on the latest NHS figures estimating that one in six children and young people now have a probable mental health condition.
Also, the proportion of children whose referrals were “closed” before starting treatment has decreased, but still stands at 24% – this figure includes referrals which didn’t meet thresholds as well as young people who chose not to pursue treatment or who were referred to other services.
Commenting on the report, Mark Russell, chief executive at The Children’s Society, echoed calls for the creation of early support hubs in every community, “where children can go and get help when their problems first emerge, before they escalate and reach crisis point”.
He said: “It’s clear many children need support following successive lockdowns, so it’s really concerning that referrals to CAMHS fell, with some children out of sight of professionals able to identify concerns. Since then, following the first year of the pandemic, NHS Digital data shows there has been a surge in referrals, including for really severe mental health crises.Even before the pandemic, our research had highlighted a deeply distressing decline in children’s wellbeing, with potentially disastrous consequences.
“While shorter waiting times to access treatment are welcome, the Children’s Commissioner’s analysis shows that far too many children are still being turned away. Our research with GPs last year found that it is common for young people to be referred and rejected a number of times, as they repeatedly fall below the threshold for CAMHS services. We also found that, shockingly, more than a quarter of young people struggling with their mental health don’t ask for help because they ‘don’t want to inconvenience anyone’.”
- Children’s Commissioner: Briefing on Children’s Mental Health Services – 2020/2021, February 2022: https://bit.ly/3rAEJAY
- DfE: Characteristics of children in need, October 2021: https://bit.ly/3gE4tpG
- Jeffreys: Children's mental health: Huge rise in severe cases, BBC analysis reveals, BBC, February 2022: https://bbc.in/3ov981N
- LGA: Debate on special educational needs and children’s mental health services, House of Commons, February 2022: https://bit.ly/3B6mB52
- Place2Be: School staff witness an increase in pupil anxiety, low self-esteem and depression, February 2022: https://bit.ly/3srSVLT