Longfield, chair of the commission, and the former children’s commissioner of England, warns that post-Covid children’s mental health services are not fit-for-purpose and are putting vulnerable children at risk.
One in six children, aged from six- to-16, are now identified as having a probable mental health problem, but less than a quarter of children referred to mental health services start treatment within a four-week waiting target.
Co-authored with the leading thinktank Centre for Mental Health, and the Children and Young People’s Mental Health Coalition, the report reveals ‘a profound crisis’ in children and young people’s mental health services in England and a system of support that is ‘buckling under pressure, frequently over-medicalised and bureaucratic, unresponsive, outdated, and siloed’.
In her foreword to the report Longfield said, ‘a collapse in many of the family and youth support services that existed ten or twenty years ago leaves us playing catch up. As one parent put it to us during our evidence sessions: “all the stuff that used to be there to prevent things happening isn’t there anymore.”’
The Commission's fourth thematic report, ‘Heads Up: Rethinking mental health services for vulnerable young people’, published on Saturday (30 July), looks at the growing crisis of mental health problems among children and young people in England and recommends ways to redesign young people’s mental health services, particularly for young people at risk of harm.
This includes an NHS guarantee that ensures an improvement in the quality and effectiveness of treatment and ensures all children needing mental health treatment are seen within a four-week period.
Speaking with professionals who work with children, and to children and families, the Commission heard about young people who have barely returned to school since Covid, a rise in many young people’s mental health problems, and how self-harm and suicide attempts are a much more regular feature of school and college life.
The report highlights how the Covid pandemic was a disaster for the mental health of many children:
- One in six children aged 6-16 were identified as having a probable mental health problem in July 2021, up from one in nine in 2017.
- There was a 47 per cent increase in the number of new emergency referrals to crisis care teams in under-18-year-olds between December 2019 and April 2021.
- At the end of April 2022, 388,887 people were in contact with children and young people’s mental health services, and 352,866 new referrals were received. Yet in 2020/2021, just 23 per cent of children referred to services started treatment within the 4-week waiting target.
It highlights how there will be mental health teams in just a third of all schools, leaving two thirds of children in schools without this important resource. There are no immediate plans or funds to extend this number further.
Longfield said, ‘The children’s mental health emergency in England is so profound that we face a generational threat to our country’s future national prosperity and success. The scale of the problem is growing, rocket-boosted by the pandemic and the system is buckling under pressure and unable to cope with the explosion in demand for help.
‘Thousands of vulnerable children are falling through gaps in the mental health support system, boosting the chances of those resourceful, manipulative, and ruthless criminals and abusers who are so good at grooming them.
‘I am particularly worried that we will see an increase in school exclusions of children with mental health problems who are not receiving the support they need. Some of these children will be at greater risk of harm.
‘The overall response from the Government to this children’s mental health crisis has so far been too slow and inadequate, and we are failing to support hundreds of thousands of children with mental health problems. It is shocking to hear that some young people who attempt suicide still do not receive an immediate referral for help and are discharged without any extra support.
‘The next Prime Minister will have an opportunity to show they care about tackling this children’s mental health emergency. I would like both candidates in the Conservative leadership contest to commit to an immediate £1bn mental health wellbeing recovery fund for children and young people. This should include a guarantee that all requiring CYPMHS treatment are seen within a 4-week period, with guaranteed next day emergency appointments for children at risk of serious self-harm and suicide.
‘Young people have told us what help they need. Unless we rethink and improve access to mental health support, we risk putting the post Covid generation of vulnerable children in even greater danger of exploitation, abuse, and poor life chances. A generation of young people is struggling and as a society we have a moral duty to respond.’
Young children
The negative impact of poverty on children’s wellbeing emerges early in life and become more pronounced throughout childhood, the report said.
It cites one cohort study which found that 7.3 per cent of four-year-olds in the most deprived areas of Glasgow were rated by their teachers as displaying “abnormal” social, behavioural, and emotional difficulties, compared with only 4.1 per cent in the least deprived areas. By the age of seven, the gap between these groups had widened substantially: 14.7 per cent of children in the most deprived areas were rated as having ‘abnormal’ difficulties, compared with 3.6 per cent of children in the least deprived.
Submissions to the report’s call of evidence pointed to research showing that children in the poorest households are three times more likely to have a mental illness than children in the best-off households, while one in ten children in the UK suffers from a poverty related mental health problem.
Children and young people with special educational needs and disabilities and their families are also at greater risk of experiencing poor mental health.
The report warns that failing to support some young people with mental health problems could lead to more behavioural incidents at school, a rise in exclusions, and more children then becoming at risk of grooming and exploitation.
It does, however, recognise how some children’s mental health services have widened the support they provide following increased investment. It also highlights the positive work being done by many organisations, charities, and community groups to provide support to children with mental health problems, including programmes that divert children with mental health problems away from crime.
'Rocketing demand for help'
But it argues that Children and Young People’s Mental Health Services are losing the battle against rocketing demand for help and failing to meet the needs of thousands of children in crisis.
Centre for Mental Health chief executive Dr Sarah Hughes said, 'Children and young people’s mental health is at risk from the after-effects of the pandemic, the cost of living crisis and the ongoing effects of endemic racism and inequality. We need action now to protect the mental health of those at greatest risk, including the poorest and the most marginalised children in society.
'Expanding mental health support for children and young people is essential. But alongside it we need to reduce child poverty, support young families, make schools mentally healthier and rebuild youth services.'
Steve Chalke, the founder and leader of Oasis, which hosts the Commission on Young Lives, said, 'Children and young people's mental health services just aren’t working for many of those who desperately need help. I regularly meet children and their families who are struggling with serious mental health problems but are on long waiting lists for treatment, can't even get a referral or don't trust that they will get the kind of help they need.'
The Children’s Society is backing the commission’s recommendations.
Policy manager Amy Dicks, said, ‘Even before the pandemic, many children and young people were being turned away by overstretched mental health services or facing unacceptable delays in accessing vital help,’ she said.
‘Now this situation has got worse still, with successive lockdowns causing enormous harm to children’s mental health and placing even more strain on frontline services which are also struggling to recruit and retain staff.’
In its frontline support, she said the charity saw young people needing help with issues such as anxiety, depression and self-harm, and being vulnerable to grooming and exploitation by predators.
‘We need to see government investment not just in crisis support, but also in walk-in hubs offering children immediate early support before issues escalate. Specialist services must offer better help to vulnerable groups including children in care, migrant children and children affected by poverty, exploitation and abuse.
‘The roll-out of mental health support in schools must be accelerated and schools must be supported to recognise changes in children’s behaviour may be a sign of trauma and problems in their lives, and to offer help, with exclusion a last resort.
‘Only with decisive action and investment will we begin to turn around the long-term decline in our children’s well-being and address the severe damage caused by Covid.’