Commission on Young Lives - Heads Up: Rethinking mental health services for vulnerable young people (29 July 2022)

Summary

The Commission on Young Lives (COYL) was set up in September 2021, to propose a new settlement to prevent marginalised children and young people from falling into violence, exploitation and the criminal justice system, and to support them to thrive. Its national action plan will include ambitious practical, affordable proposals that government, councils, police, social services and communities can put into place.

This detailed report by COYL examines the state of children and young people's mental health, describing the current situation as "a profound crisis." It examines the impact of the pandemic on young people's mental health, as well highlighting the lack of capacity and inequalities present in children and young people's mental health services. It then looks in detail at factors that contribute to mental health issues in children and young people and prevent marginalised groups from accessing mental health support.

Content

Key points

The report highlights the following key findings about children and young people's mental health:

• One in six children aged 6 to 16 were identified as having a probable mental health problem in July 2021, a huge increase from one in nine in 2017.
• Boys aged 6 to 10 are more likely to have a probable mental disorder than girls, but in 17 to 19-year-olds this pattern reverses, with rates higher in young women than young men.
• By the age of eight, 7 in 10 children report at least one adverse childhood experience (ACE).Three in four adolescents exposed to ACEs develop mental health problems by the age of 18, including major depression, conduct disorder, alcohol dependence, self harm, suicide attempts, and posttraumatic stress disorders (PTSD).
• In 2018, the suicide rate in women aged under 25 years had significantly increased since 2012 to its highest ever recorded level of 3.3 per 100,000.
• Nearly half of 17–19-year-olds with a diagnosable mental health disorder have selfharmed or attempted suicide at some point, rising to 53% for young women.
• In 2018-19, 24% of 17-year-olds reported having self-harmed in the previous year, and seven percent reported having self-harmed with suicidal intent at some point in their lives. 16% reported high levels of psychological distress.
• 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.
• Consistent findings showing people in marginalised groups are at greater risk of mental health problems, including people from Black, Asian and other minority ethnic backgrounds, lesbian, gay, bisexual and transgender people, disabled people and people who have had contact with the criminal justice system, among others.

Recommendations

• 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, with guaranteed appointment and treatment times as part of a wider post pandemic commitment to children and young people.
• New local frameworks for children and young people’s wellbeing (aged 0-25) between health, children’s services, schools, youth offending teams and the police to provide an integrated approach with common performance targets and pooled financial contributions from all partners.
• Guaranteed mental health assessments for children and young people at points of vulnerability. This would mean an automatic assessment and guaranteed mental health package for children entering care and automatic assessments for children and young people at risk of exclusion from school, who go missing, at the point of arrest, or are involved in violence or crime. It would include a guarantee of assessment by education psychologists for any child at risk of exclusion.
• A national implementation programme to embed a whole school and college approach to mental health and wellbeing across all education settings in the country. This should include a commitment from Government to provide a funding package for Mental Health Support Teams beyond 2023/24 to ensure that all schools have access to this vital additional support by 2030.
• An ambitious programme of drop in mental health hubs delivered in the community. These new community drop-in centres will provide vital drop in access and work with local community groups to provide outreach support, funded by the new recovery programme.
• A national ‘Programmes on Prescription’ scheme in every area. Building on emerging local approaches, the roll out of a major funded programme of social prescribing for mental health wellbeing that enables GPs and health professionals to pay for sports and arts sessions, music, drama, activities, youth clubs, outings, and volunteering programmes to improve young people’s confidence, self-esteem, and skills and make friends.
• A major recruitment programme with ambitious targets to build the children and young people workforce required to meet this expansion of services. It is vitally important to ensure that this workforce is diverse and culturally competent.
• Wellbeing and mental health training and support for all professionals working with children and young people. Identifying and understanding the mental health needs of children is vital if they are to be offered the help they need.
• Make co-production and community work a cornerstone of mental health care to ensure long-term trusted relationships for young people and to give them a constant point of contact.
• Improved wellbeing on digital platforms. We know that many children feel more comfortable and sometimes prefer help online, which should also be extended and supported as an important strand of a local strategy.
• Better information and support for parents to support children and young people’s positive mental health and wellbeing.
• Improving the mental health and well-being of young people at risk of harm and being involved in the criminal justice system. This should be measured as a core aspect of NHS equality targets with leadership, resources, and delivery plans.