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Young people’s mental health services reaching ‘tipping point’

Children’s mental health services are fast approaching “tipping point,” with the COVID-19 pandemic having exacerbated existing challenges, including mental health inequalities.

The NHS Federation has warned that 1.5 million children and young people may need new or additional mental health support as a result of the pandemic – and the figure could be even higher when considering unmet need.

“While the majority of children and young people are generally resilient, a significant number require support for their mental health. This was the case before the pandemic and forecasts predict a worrying increase in demand for mental health services in light of the crisis,” said the report.

“Yet a considerable proportion of children and young people who would benefit from specialist mental health services fail to access them, with crisis point all too often the first time a young person speaks up about their problems,” it added.

The reasons that young people often reach crisis point before receiving help includes:

  • Not been considered ‘ill’ enough to meet thresholds for services
  • A lack of capacity within the system
  • Long waiting times for services
  • Stigma attached to mental health problems
  • Services not being accessible or designed to meet their needs.

“With the pandemic fuelling demand for services and exacerbating existing challenges, there is mounting concern that the mental health system for children and young people in England is reaching tipping point,” warned the report.

Even before the pandemic, the prevalence of mental health problems in children and young people was increasing. The rate of probable mental disorder has increased in five-to-16-year-olds, from one in nine in 2017, to one in six in 2020. While it is difficult to categorise why mental health problems have risen, the report says it is likely that the uncertainty and anxieties caused by the lockdowns, the closure of schools, isolation from peer groups, bereavement, and the stresses and pressures on families are all contributing factors.

There are significant increases in demand for mental health support for children and young people across all services – from primary care to NHS specialist mental health services, voluntary sector, independent sector, and digital providers - but also pressures on acute trusts and local authorities.

The demand for support for eating disorders has risen dramatically in the last year and the number of young people completing an urgent pathway for eating disorders has increased by 141 per cent between the last quarter of 2019/20 and the first quarter of 2021/22.

The NHS Confederation report urges further funding to address the increase in demand and to continue the transformation of services and support for children and young people, especially support in schools and other educational settings.

There should be a greater focus on early intervention and addressing the social determinants of mental health. While there is intense pressure on beds now, priority must be given to preventative and early intervention services over the medium-to-long term, the report adds.

Funding alone, however, will not address the problems and the “chronic staffing shortages and challenges” need to be addressed, including by investing in more children and young people’s mental health specialists and in training and education of the wider workforce.

“Children and young people’s mental health must be a priority for integrated care systems (ICS). They need to focus on addressing the fragmentation of children and young people’s mental health services that many people experience and improve access to both early intervention and specialist mental health services,” the report concludes.

Reaching the tipping point

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