The Children’s Commissioner, Dame Rachel de Souza’s, annual report, published today, finds over a million children in England were referred to children and young people’s mental health services last year, with referrals almost doubling since 2018-19. It is deeply concerning that 6% of these referrals, equating to over 60,000 people, were for were children and young people in crisis.
We know that the nation’s mental health has been deteriorating over the last decade, and most of the increase in the prevalence of common mental health problems has been among younger age groups. This report shows what this means for referrals and wait lists to mental health support, and exposes inequalities within this.
The interim prevalence review published in May made clear that the rise in mental health problems amongst children and young people is caused by the conditions in which they are growing up. Rising poverty and inequality are part of the picture, as are housing conditions, money worries, smart phone and social media use, academic pressures and the impact of the Covid pandemic.
The report finds anxiety remains the most common reason for referrals, accounting for 16% of all referrals. It also finds large rises in referrals and wait list times for children and young people being referred for lifelong neurodevelopmental conditions, in particular for autism. It is important to distinguish between mental health conditions – such as depression, anxiety and psychosis and neurodevelopmental conditions such as ADHD and autism because the process for diagnosis, support and treatment for these conditions differ significantly.
The report exposes racial inequalities in access to mental health services, with one in four Black children being referred to mental health services already in crisis when they receive care, compare to 7.4% of white children. This is unjust and exposes structural racism in the system This also highlights a need for expanding early intervention in schools, where Black children are likely to be presenting with symptoms of a mental health problem which may be ignored or characterised as poor behaviour.
Eradicating racial inequalities in mental health requires concerted action to address their causes. To ensure that mental health support meets the needs of children and young people from racialised communities, mental health services must commit to anti-racist and trauma-informed approaches in all aspects of mental health care. Care must be culturally sensitive and responsive to the needs of people from racialised communities. This must be embedded across prevention, early intervention and specialist crisis care.
The new cross government mental health strategy presents a huge opportunity to make children and young people’s mental health a national priority. It must include action to promote and protect mental health throughout our lives, including help for new parents, an education that prepares children for life in mentally healthier schools, and early support hubs in every community.
The strategy must combine effective action at scale to promote and protect mental health, to tackle inequalities and injustices and improve and where necessary transform mental health services.
