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Digital counselling to CAMHS – children's commissioner focused on mental health

An urgent expansion of mental health support and digital counselling, help for children struggling with school attendance and anxiety after the pandemic, and stronger safeguarding to protect young people on social media.

These are among the calls to action to emerge from the largest ever survey of children and young people in England.

The Big Ask initiative, run by England’s children’s commissioner Dame Rachel de Souza, garnered responses from 557,077 children aged four to 17 and representing every area of the country.

The subsequent report – The Big Answer (2021) – sets out areas of concern for our young people but also encapsulates their hopes, post-pandemic, for the future. Key findings included:

  • Seventy-one per cent of nine to 17-year-olds and 94 per cent of six to eight-year-olds are happy with their life overall.
  • However, of those who are unhappy, 70 per cent were unhappy with their mental health; 52 per cent of nine to 17-year-olds say having good mental health is one of their main aspirations; girls are twice as likely to be unhappy with their mental health than boys.
  • Fifty-seven per cent of children from deprived areas said leaving school with a good education was one of their biggest priorities.
  • Fifty-six per cent of nine to 17-year-olds were happy with life at school, while 16 per cent were unhappy; 68 per cent were happy with their progress in education, while 10 per cent were unhappy.
  • Children living in more deprived areas or attending schools rated “Inadequate” were more likely to be unhappy with life at school.
  • The participants’ biggest priorities for the future were education, protecting the environment, and having a good job; 39 per cent of children said that the environment was one of their main worries, while 31 per cent said they were worried about fairness in society.


Schools and education

The report calls for a “comprehensive catch-up package for schools”, but does not weigh into the row over the inadequacy of the government’s catch-up funding package for education.

However, Dame Rachel does state that the “first priority is to bolster catch‐up funding for school”. In her conclusion, she adds: “We are back in schools. Good things are happening. We anticipate proper ‘catch‐up’ funding.”

Elsewhere, the report asks for “an urgent focus on improved services to children struggling with attendance and consequences of the pandemic” including emotional problems and anxiety”. This comes after the survey revealed “unsurprising anxieties about attendance, routine, and acclimatising again to the demands of school – vulnerable pupils spoke of how much they needed high quality support”.

The report suggests creating “voluntary time, after school but in school” for “catch-up support and a richer set of extra-curricular activities”.

Dame Rachel also calls for tutoring support to be prioritised and where this is not possible for schools to receive direct grant funding in lieu.


Mental health and wellbeing

The biggest concerns to emerge from the survey focus on wellbeing and mental health, especially as we come out of the pandemic.

The report backs the policy of mental health support teams working in schools and communities, but says the roll-out is too slow – they will be operating in just 30 per cent of areas by 2023.

The report recommends: “A rapid expansion of mental health support teams using the voluntary and charitable sectors.”

It also calls for a “consistent digital counselling” for children, who say they prefer accessing this kind of support online. It adds that the government should develop community mental health hubs “to provide children with open access to NHS services for advice and treatment”.

The report warns us not to underestimate the impact of the pandemic on young people: “Children’s descriptions of strain over the past year were common: isolation, uncertainty around schooling, exams or assessment‐related stress, constant frightening stories on news, absorption of parental anxiety, estrangement from wider family, social media addiction, anorexia, self‐harm, thoughts of suicide, early bereavement and grief.

“For those children already suffering from severe illness such as cancer when the pandemic started, it is important to remember how much more challenging their already perilous lives have become.”

The report echoes long-held concerns about the capacity of CAMHS. The NHS’s Long-Term Plan has pledged that by 2028 all children who need specialist mental health support will be able to access it. Again, the report implies this is not good enough: “Experience of in‐school support is variable, and access to CAMHS too often a battle. Even when child have not sought help for themselves, they are conscious of the struggles of others, and this gives a pervasive sense that the NHS will not be there for them when they need it.”

Another key recommendation is for a package of measures to improve children’s online experiences including “stronger safeguarding from social media platforms and preventing children’s access to online pornography”.

One 14-year-old girl told the survey: “I don’t feel I was informed of my online safety from a young age and that it was considered a priority. Technology and social media are constantly developing so why aren’t our laws and protections for children on these platforms updating with it?”

Commenting on her report as a whole, Dame Rachel said: “The voice of half a million children gives me, and those in my team, a road map for how we continue to build a brighter future for childhood in England, not just in the aftermath of the pandemic but for the long term. I hope the Big Answer will be the foundation for a truly transformative period for a generation who are far from ‘lost’ and need all of us to help build them the future they most certainly deserve.”