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  • Children’s Commissioner: Children’s Mental Health Services 2021-22 (8 March 2023)

    • UK
    • Reports and articles
    • Pre-existing
    • Original author
    • No
    • Children’s Commissioner
    • 08/03/23
    • Everyone


    This is an annual report by the Children’s Commissioner review in children’s mental health services in England during 2021-22. It considers key trends in children’s access to mental health services and considers the current state of care provided to children who are admitted to inpatient mental health settings.


    The Office of the Children’s Commissioner

    The Office of the Children's Commissioner promotes the rights, views and interests of children in policies or decisions affecting their lives. They particularly represent children who are vulnerable or who find it hard to make their views known. The Office of the Children's Commissioner is an executive non-departmental public body, sponsored by the Department for Education.

    Report findings

    This report outlines its main findings in understanding children’s access to mental health services in England in financial year 2021-22 as follows:

    • Of the 1.4 million children estimated to have a mental health disorder, less than half (48%) received at least 1 contact with Children and young people’s mental health services (CYPMHS) and 34% received at least 2 contacts with CYPMHS.
    • The percentage of children who had their referrals closed before treatment has increased for the first time in years. In 2021-22, 32% of children who were referred did not receive treatment compared to lower numbers in 2020-21 (24%), 2019-20 (27%) and 2018-19 (36%). There remains wide variation across the country in how many children’s referrals were closed without treatment, from as low as 5% of referrals in NHS East Sussex to 50% in NHS North Cumbria.
    • The average waiting time between a child being referred to CYPMHS and starting treatment increased from 32 days in 2020-21 to 40 days in 2021-22. The average waiting time for children to enter treatment (defined as having two contacts with CYPMHS) varies widely by CCG from as quick as 13 days in NHS Leicester City to as long as 80 days in NHS Sunderland.
    • Spending on children’s mental health services has increased every year, after adjusting for inflation, since 2017-18. CCGs spent £927 million on CYPMHS in 2021-22, equal to 1% of the total budget allocated to them. This compares to £869 million in 2020-21 – an increase of 7% in real terms. The share of CCGs spending over 1% of their total budget increased from 30% in 2020- 21 to 45% in 2021-22.
    • The number of children admitted to inpatient mental health wards continues to fall, as does the number of detentions of children under the Mental Health Act each year. Of the 869 detentions of children under the Mental Health Act in 2021-22, 71% were of girls
    • An increasing number of children, many of whom have mental health difficulties but are not admitted to hospital, are being deprived of their liberty in other settings. These children are hidden from view as they do not appear in any official statistics, but research suggests that over ten times as many children are being deprived of liberty in this way in 2023 as in 2017-18.
    • Children in inpatient mental health settings who we spoke to wanted more, earlier intervention to prevent crisis admissions – sometimes children are presenting multiple times at A&E before an inpatient admission is considered.
    • Much more can be done to make inpatient mental health wards feel safe and familial. Children reported a huge variation in the quality of relationships they had with staff. For example, while some children felt they knew staff genuinely cared about them, one child described how staff would only refer to children by their initials, rather than their name. There appears to be a particularly acute issue with the quality of night staff.
    • Education was viewed very positively by most of the children spoken to for this report, and highlights the importance of high-quality education in these settings for children’s recovery as well as their learning.
    • The data collected on children in inpatient settings, including demographic information and information about key safeguards for children, is patchy and makes it harder to improve quality.
    Children’s Commissioner: Children’s Mental Health Services 2021-22 (8 March 2023) https://www.childrenscommissioner.gov.uk/report/29751/
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