Mental health network

A Healthy State of Mind: improving young people's mental fitness

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Localis, an independent cross-party think tank, has launched a new report on young people’s mental health. The report aims to identify what the system requires to be able to work better to both offer immediate help to those with serious conditions and a wide and flexible variety of support for all those who feel they need it.

This was carried out with data obtained from Freedom of Information requests to CCGs and Foundation Trusts in England; interviews with experts in the field; roundtables of NHS and local government leaders; and focus groups with young people themselves. The Children’s Society and NSPCC also contributed as members of an advisory panel.

The report focuses on:

  • Overcoming barriers around first point of contact and access to services
  • The role of non-mental health professionals in helping young people with their mental fitness
  • The benefit for services of encouraging young people to have resilience, agency and independence
  • Settings where non-mental health professionals interact with young people – primarily primary care and education but also social services where there are high levels of state interaction

These themes respond to the perceived need to improve support for young people’s mental health and tackle the strain on the system which exists despite the commitment of £1.4 billion in funding over five years to provide for an additional 110,000 young people in CAMHS. The report estimates that 555,623 young people with a diagnosed mental illness will not receive treatment from an NHS-funded community mental health service by 2020/21. 

Key themes from the report

First point of contact

  • A young person’s initial experience sets an expectation about their condition and the level of treatment the will receive
  • The impact of a negative experience can be very damaging to a young person, leading to further deterioration in their condition and delays in receiving support
  • Improving the first point of contact means that those who urgently need help will receive it and a greater variety of support and flexibility of access could be available to all

Supporting mental fitness

  • We must encourage greater independence and agency in young people when it comes to mental wellbeing by moving away from framing mental health problems as ailments in need of a specialist cure to the view that mental health is a continuum which can go up or down.
  • Professionals, regardless of what services they are formally part of, must consider themselves collectively responsible for the mental wellbeing of every young people with whom they engage.
  • Services must be offered to young people before their issues become serious enough to demand specialist treatment.
  • Support services must be based in settings which encourage and enable access at an earlier stage and in different ways to reflect changing modes of communication with young people.

Relieving the pressure on specialist CAMHS

  • The act of referring a young person who does not meet thresholds sets level of expectation about the severity of their needs which can prove damaging.
  • Specialist services must be delivered in ways that fit the individual needs of each young person – there should be no ‘one size fits all’ approach.
  • The point that a young person reaches adulthood is not necessarily the point at which they reach maturity, and services should reflect this.

Recommendations for policy

The report recommends the following:

  • The Department of Education should ensure that a mandatory module on mental health is included in initial teacher training.
  • Government should provide guidance to school leaders on how free mental health training will be rolled out in schools.
  • School forums in every local area should be empowered to select a lead mental health co-ordinator for their area who will: 1) sit on Health and Wellbeing Boards to ensure that school-based services are considered in the production of Joint Strategic Needs Assessments and 2) work with CCGs to ensure that any revised local transformation plans include provision of services in schools
  • Government should ensure that mental health is incorporated into the professional training standards of Social Work England.
  • Government should support the provision of school-based support services by: 1) providing local authorities with the statutory duty to provide schools-based support services for young people aged 11-18 with Councils allowed to use 6.5% of pupil premium allocations to fund these services plus additional money to be drawn from local CCGs and 2) revising current funding agreements to make it compulsory for academies to provide school-based support services, sourced either from the local authority or independently.
  • NHS England should accelerate its investment into 3,000 practice-based mental health therapists to support and build confidence of GPs in meeting young people’s mental health needs directly within the GP clinic.

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