Generation of children and young people risk not getting the mental health care they need
Many children and young people will be left without vital mental health support unless the Government goes further to invest fully in services where they are most needed, according to a new report out today.
Without this, there is a real risk that mental health problems will follow them into adulthood, with more serious and complex issues in years to come, pushing up both personal and financial costs.
The report, from the NHS Confederation’s Mental Health Network, says there is growing concern that the mental health system for children and young people in England is reaching a “tipping point”, as the COVID 19 crisis brought with it uncertainty and anxiety caused by the lockdowns, school closures, isolation from friends and peers, bereavement and loss, and extra stresses and pressures on families.
The pandemic has worsened existing challenges, including health inequalities, with potentially serious consequences, in particular for the mental health of children and young people from BME backgrounds, lower-income backgrounds, those who identify as LGBTQ+, and those with special educational needs or neurodevelopmental differences.
While confirmed cases of COVID-19 are stabilising currently in England, health leaders are concerned about increased transmission in the autumn as more offices reopen and as pupils return to school, and the additional toll this disruption and uncertainty could take on the mental health of children and teenagers.
The report, Reaching the tipping point: children and young people’s mental health, identifies how demand for mental health support for children and young people across all services has already grown significantly since the pandemic, with the number of children and young people contacting mental health services rising by nearly a third in the last year. In March 2020, there were 237,088 children and young people in contact with mental health services, compared to 305,802 in February 2021.
Also, at least 1.5 million children and young people may need new or additional mental health support as a result of the pandemic, according to modelling from the Centre for Mental Health.
In particular, demand for support for eating disorders has risen dramatically over the course of the of the pandemic. The number of young people receiving urgent treatment for eating disorders increased by 141 per cent between the last three months of 2019/20 and the first three months of 2021/22.
The NHS Confederation is calling for additional funding from the Government in the imminent Comprehensive Spending Review to tackle the growing demand among children and young people within the NHS and local authorities, as well as in schools and other educational settings. In the last spending review, £79 million was set aside for 2021/22 to support the NHS to care for children and young people with mental health problems, as well as an additional £40 million announced in June and £17 million for mental health initiatives in schools.
However, leaders are clear that these short-term emergency cash injections need to be replaced with sustainable funding for the longer term given the levels of demand for mental health support they are seeing.
In addition, the NHS Confederation is calling for a stronger focus on prevention and early intervention services, including addressing the social factors affecting children and young people’s mental health, such as economic background and issues such as unstable home environments.
Sean Duggan, chief executive of the NHS Confederation’s Mental Health Network, said: “A generation of children and young people requiring support for their mental health risk being failed because the NHS is not being adequately resourced to support them. While health leaders are grateful that investment from the Government has begun, as well as for the prioritisation children and young people’s mental health has been given, the continued toll of the pandemic has shown that it may not be enough to respond to the rising demand for their services. Funding must be both long-term and sustainable.
“We have seen outstanding examples from our members working together to support the mental wellbeing of their younger patients, through both preventative services and inpatient care, but nationally, it is clear we are now at a tipping point.
“Many young people are developing mental health problems as a direct result of the pandemic and with COVID-19 cases expected to rise in the autumn, this is a worrying position to be in.
“Additional and targeted investment is essential, as is a real commitment from the Government to continue expanding and improving services so that we can avoid failing children and young people when they may need help the most.”
Catherine Roche, Chief Executive of Place2Be, the children’s mental health charity said: “We know that the proportion of children experiencing mental health problems has grown in recent years. Even before the pandemic, school leaders were telling us it was increasingly challenging to get child and adolescent mental health support when pupils needed it.
“With services struggling to meet increasing demand, it’s vital that we intervene early to prevent the escalation of mental health problems. Half of adults with lifetime mental ill health first experience symptoms by the age of 14. Our recent study in partnership with University of Exeter and University of Cambridge evidences that providing mental health support in schools has long-term benefit, as improvements in mental health were maintained over a two-year follow-up period.
“To prevent extra strain on CAMHS as more and more young people reach crisis point, we need a joined-up approach to mental health, with health services, community support services and schools coming together to get children and young people the help they deserve at the earliest stage.”
The report from the NHS Confederation’s Mental Health Network adds that workforce shortages in key mental health roles need to be addressed, and that children and young people’s mental health must be made a priority for integrated care systems (ICSs).
Without full integration of mental health services, there is a serious risk of putting even more pressure on services that can ill-afford to take any more strain. It says ICSs can play a crucial role in addressing the fragmentation of services many people face and improve access to both early intervention and specialist mental health services to help prevent more serious problems from developing down the line.
The report calls for:
- Investment in workforce development
Investing in more children and young people’s mental health specialists, as well as training, support, and consultation for the wider workforce in the NHS and beyond, is vital.
- Continued investment in transforming the whole children and young people’s mental health system
System transformation is essential, including through working alongside people with lived experience to make services more accessible and flexible to meet the needs of children and young people.
- Investment in early intervention
Early intervention and addressing the wider determinants of mental health need to be prioritised and funded accordingly. Upstream interventions are much more cost-effective and can reduce the impact on specialist mental health services and other parts of the system.
- Boosting integrated working
Integrated working across systems is essential to put in place joint strategic approaches to responding to the needs of communities. ICSs are ideally placed to work with partners on this, prioritise it and make it a reality.
- Ensuring mental health representation on ICS boards
Children and young people's mental health is a complex subject, and ICSs will benefit from having expertise on integrated care boards and in integrated care partnerships.
