Latest NHS figures show that one in eight children aged 5-19 in England have a mental health difficulty. But The Children’s Society’s latest research shows that too many do not get the help they need, as policy manager Richard Crellin explains.
Mental ill-health can affect every aspect of a child’s life – their safety, relationships, education and physical health.
We see all these things through our frontline services supporting vulnerable children, and we know there can be a longer-term impact, with three quarters of adult mental health problems originating in childhood.
The Children’s Society’s previous Good Childhood research has shown that, on average, children are unhappier now than they were several years ago. Available data suggests that factors contributing to low well-being may include everything from school, appearance and excessive use of social media to bullying, poverty, sexuality and fear of crime. Low well-being needs to be taken seriously – it is often linked to mental health conditions like depression and anxiety.
It’s vital that children struggling with any mental health condition, or the first signs of mental ill-health, get timely help. But our latest briefing, Finding Help, found that too often, this is not happening. Children may have to reach crisis point before their problems are deemed serious enough to warrant support.
Using responses to Freedom of Information requests sent to mental health trusts across England, we estimated that 185,000 young people aged 10-17 were referred to child and adolescent mental health services (CAMHS) in 2017. Shockingly, of these, only four in ten – 79,000 – received treatment that year, meaning almost 110,000 did not.
In many cases, this may be due to high thresholds for support. In others, long waiting times may be to blame. The government has proposed a four week waiting time but responses from trusts revealed children are waiting 12 weeks on average and some for up to a year.
Worryingly, the issue goes beyond those children referred for support. We surveyed more than 1,000 parents with children of school age from across the country. A third said their child had been affected by a mental health issue in the last year and, of those, just under two in five had sought help in vain. Two thirds of parents said they would initially visit their GP, and we would therefore urge clinical commissioning groups and surgeries to consult families and identify potential improvements to support offered by GPs. More than a quarter of parents said they would look to their child’s school for support. However, nearly six in ten said counselling was not on offer in their child’s school and nearly a third did not know if it was available.
The NHS and Government acknowledge that more needs to be done. An additional £2bn a year has been pledged for all mental health services and the NHS Long Term Plan says spending on children and young people’s mental health will rise faster than overall NHS and mental health spending.
The NHS plan commits to reaching an extra 345,000 young people aged 0-25 by 2023/24 with an aspiration that everyone who needs specialist care will be able to access it within 10 years. The Government ‘Green Paper’ also proposed a pilot scheme under which there will be a designated mental health lead in schools and support teams working with clusters of schools to support children with low to moderate needs.
While these are steps in the right direction, we have several concerns. Following the last big investment in children’s mental health mid-way through the decade, more than half of clinical commissioning groups admitted to spending some of the money on other priorities. This cannot be repeated. It’s vital that funding reaches the frontline.
We also fear that existing proposals do not go fast enough or far enough – especially in reaching children with low to moderate mental health difficulties. Plans to improve access to specialist mental health support will not be fully realised for another 10 years and do not address pressing problems of high clinical thresholds and long waiting times. The schools pilot will benefit only around one-fifth of the country by 2022/23, with no separate proposals to boost access to school counselling in the meantime. All schools and colleges should be required to offer mental health support for children as soon as possible. There is good evidence to demonstrate the effectiveness of school counselling and while there may be shortages of some kinds of mental health practitioner, the counselling workforce is not as stretched.
However, we understand that some young people may prefer support they can access on their own terms, with greater privacy. That’s why we also want to see better community support like more drop-in mental health hubs, access to digital platforms, help for parents to support their children and mental health first aid for youth clubs and community groups. Our Midlands drop-in hubs operate without waiting lists, offering brief interventions, guided self-help and workshops. Our Pause hub in Birmingham, part of the Forward Thinking Birmingham partnership, reached nearly 10,000 young people in 2017/18 – potentially preventing issues from escalating.
Finally, the Government must address the £3bn funding gap the Local Government Association estimates is facing council children’s services departments by 2025. Cuts to early help for families like children’s centres, youth clubs and support with substance misuse impact upon children and parents’ capacity to support them. Help from such services can be valuable in sustaining children’s recovery alongside mental health interventions.
The diagnosis is clear. Children are not getting the help they need with their mental health and there is not enough early support to prevent issues escalating. The Government and NHS must be more ambitious, bringing forward and broadening plans to ensure every child can access support when they need it. Anything less risks failing thousands of vulnerable children who need support right now.