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Mental health services for young people ‘buckling under pressure’

The system for supporting children and young people with mental health problems is “buckling under pressure”, the former children’s commissioner has warned.

Anne Longfield, chair Commission for Young Lives

The Commission on Young Lives, chaired by Anne Longfield, alongside the leading thinktank Centre for Mental Health, and the Children and Young People's Mental Health Coalition has published a report examining the growing crisis of mental health problems among children and young people in England.

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and a system of support that is buckling under pressure, frequently over-medicalised and bureaucratic, unresponsive, outdated, and siloed”.

Speaking with professionals who work with children, and to children and families themselves, the Commission has heard about:

- Young people who have barely returned to school since Covid

- The increase in the regularity and extreme nature of many young people's mental health problems

- How self-harm and suicide attempts are a much more regular feature of school and college life.

Anne Longfield, Chair of the Commission on Young Lives, 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.”

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
  • More children becoming at risk of grooming and exploitation
  • More children becoming exposed to exploitation, crime, and offending.
  • An increase in the likelihood of young offenders persisting with criminal activity into adulthood.

The report 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. However, it argues that Children and Young People's Mental Health Services is still losing the battle against rocketing demand for help and failing to meet the needs of thousands of children in crisis.

The Commission on Young Lives 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% 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% of children referred to services started treatment within the 4-week waiting target.
  • There will be mental health teams in only 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.

“The Commission has also been shocked to hear from those working with young people about how often those suffering from serious mental health conditions are unable to receive treatment in some areas until they have had multiple suicide attempts 'with serious intent',” said the report. “It has heard traumatic stories of teenagers who have attempted suicide but still not received an immediate referral for help, and from teaching staff in schools and colleges who are seeing a large increase in the number of their students attempting suicide.”

Many young people and their families are not receiving the right kind of mental health support and mental health services for young people are still not set up to support all those with multiple and complex needs, with clinical thresholds too rigid, some children ricocheting around services, and too many children only receiving help at crisis point.

Early prevention services are underfunded and to not reaching most children, particularly the most vulnerable or marginalised, the report adds.

Anne Longfield added: “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,” she added.

The report urges a number of recommendations, including:

  • A commitment from the next Prime Minister to fund an immediate £1bn children and young people's mental health wellbeing recovery programme to improve the quality and effectiveness of mental health care and support.
  • Guaranteed mental health assessments for children and young people at points of vulnerability.
  • A national implementation programme to embed a whole school and college approach to mental health and wellbeing across all education settings in the country.
  • An ambitious programme of drop in mental health hubs delivered in the community.
  • A national 'Programmes on Prescription' scheme in every area.
  • A major recruitment programme with ambitious targets to build the children and young people workforce required to meet this expansion of services.

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.

“Government needs to put in the right resources, and we need to have an urgent rethink about the kind of support we provide in communities and through schools.

“Until we tackle the drivers of youth crime, including underlying psychological and mental health issues, we will continue to fail children and young people at risk of being excluded, exploited and criminalised,” he concluded.

Heads Up: Rethinking mental health services for vulnerable young people

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