We’re getting it wrong when it comes to children’s mental health
5-minute read
Bearing the brunt of the mental health crisis
A report by The Children’s Society has found that 7% of 10- to 15-year-olds in the UK are unhappy with their lives. The most recent NHS data shows that more than 66,000 children aged 19 and under were referred to Child and Adolescent Mental Health Services (CAMHS) in April: a 109% rise compared to the same month pre-pandemic.
The report identified several factors including appearance, school, and friends as the main drivers of their unhappiness. This adds to the existing body of evidence citing problems at home, bullying, sexual assault, and social media as drivers for increasing numbers of school aged children being unhappy with their lives.
These factors caused nearly 12,000 children aged 10 - 14 to be given antidepressants in 2021/22, as did over 180,000 children aged 15 - 19. This is an 8% increase since 2020/21.
Unfortunately, this information is not surprising. Concerns about children’s declining mental health had been growing long before Covid struck, it has made an already bad situation increasingly worse.
The Royal College of Psychiatrists declared that children and young people are bearing the brunt of the mental health crisis caused by the pandemic. Eating disorder services in particular are at crisis point.
The Centre for Mental Health think tank reports that approximately 1.5 million children under the age of 18, in England alone, will need new or additional support with their mental health as a direct result of Covid. The Commons Health Select Committee noted last December that “the number of young people receiving treatment has risen from 25% to around 40% of those with a diagnosable condition pre-pandemic”. Despite this large increase, more than half of children and young people are not receiving the mental health support they need.
This lack of support is resulting in thousands of young people to ‘attempt suicide while waiting for NHS treatment’. A YoungMinds research study on almost 14,000 young people uncovered that a quarter (26%) had tried to take their own life because of having to wait for help. Also finding that more than half (58%) said their mental health had gotten worse while they were waiting for help.
“There have been times where I have literally been forgotten about because of the poor system - it feels hopeless; as if no-one is doing anything to make it better”
In its current form, capacity has not, and will not, keep up with the level of demand.
With all of this stark information, we have barely made a dent in addressing the crisis. Despite greater funding going into children’s mental health services, and the creation of new support teams in schools and colleges specifically targeting anxiety and depression, the numbers of children reaching out for support continue to increase. Currently, the Royal College of Psychiatrists is demanding almost £80 million of additional funding to help address this urgent situation.
Child and adolescent mental health services (CAMHS) was already unable to help all children seeking care pre-Covid and continues to be overwhelmed. As services try to reduce the huge pressure on the system, many children continue to be rejected for not being ill enough despite their distress, vulnerability and worrying behaviour. those who are fortunate enough to meet the eligibility criteria still see delays as long as 3 months.
“I have been on the CAMHS waiting list for a year... Only now that I am suffering worse than before am I getting referred to another service, where I have been put on another waiting list”
The NHS is increasingly characterised by care gaps – a mismatch between needs and its ability to meet them quickly. This is illustrated by the long waits for GP appointments, surgeries, A&E treatment, and ambulances to arrive. CAMHS is yet another example of this.
It’s impeded in its ability to offer quick, appropriate, and high-quality care to all who need it. This is due to longstanding issues of lacking what it needs to effectively run a responsive service: staff, community-based teams, options to keep children out of hospital, and beds for those requiring inpatient treatment.
Given Covid’s devastating impact on everyone’s collective mental health, it would be naïve to expect that the NHS can treat the pandemic’s many young casualties any better and any more quickly than it can now. While more serious or urgent mental health cases must always be referred to an expert clinician, we can create better pathways in and out of hospital and clinical services.
What should we be doing?
With so many children and young people being turned away from CAMHS services, providing alternative spaces and programmes is crucial. This includes pre- and post-intervention supports. Listening to the how and where young people have said they want their support delivered is key. This includes investing in and leveraging the strengths of community-based models. These must be co-designed with children, young people, and their families, in youth-friendly spaces that are trauma-informed and include access to lived-experience and clinical supports when needed.
Integrated youth hub models as described and advocated by YoungMinds’ #FundTheHubs campaign are one such example of investing in evidence-based existing working models of collaboration.
“It’s a common pattern that when you reach out, you will be given helpline numbers to call. They’re an amazing resource - but if you’re struggling with your mental health, it isn’t going to be resolved in a 30-minute conversation with a stranger. You need to genuinely feel like there is help for you, a solid, regular support network”
1. Start here
We need formal CYP mental health support to work with voluntary, community groups, and third-sector partners to develop and deliver collaborative community-based models. Those that support prevention, early intervention, or crisis diversion services such as Recovery Cafes for young people. Community isn’t a second-best option; it’s what young people and their families have told us they want as part of their journey.
2. Invest here
Investigate and test the feasibility of local, national, and/or international models that can be scaled to meet the demands and pressures on the children’s mental health sector. Identify the fidelity criteria of what makes it successful and implement widely.
3. Collaborate here
Think beyond the usual suspects when it comes to community-based mental health for young people. Tap into existing communities of support, such as working with leisure and recreation, arts and culture, or anti-racism programmes to help improve children’s mental health. Steer clear of creating siloed mental health services in clinical settings, which we know children and young people rate as having poorer experiences. If we are more creative in using these spaces, networks, and communities to connect young people while they wait for more formalised provision, we might start to finally break the thinking that you must be ‘well-enough or stable-enough’ to be part of a community.
Remember some support is better than none. Our fear of doing harm, is likely resulting in harm though our inaction. With a young person referred to the NHS for mental health support every 30 seconds, we must build ways in which they can get immediate support no matter if they are just beginning to struggle with their mental health, or if they are at crisis point.
Getting connected
Young people report feeling more alone than many of the generations before them. We know loneliness is a big driver of poor mental health. By connecting young people with more peer services, we can normalise their experience and continue to reduce stigma of seeking support. Additionally, we can build safe natural communities of support they can connect with.
The message is getting through. This UK government report lists the importance of peer support for schools to include ‘’(self-reported) improvements in skills, self-confidence, and relationships as well as wider 'whole school' benefits, bringing positive benefits to the school environment’’.
Policy and implementation are different beasts. Many of us know what works. The difficulty is in the doing, but the community is certainly up to the challenge.
Habitus designs, delivers, and evaluates integrated youth mental health services, peer support programmes and training, and co-designing trauma informed youth friendly spaces within both community and clinical-based settings.
We have co-led feasibility and fidelity studies alongside families and youth. We offer one-to-one support and guidance to you and your team.
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