Thoughts on improving children and young people’s mental health
The LGA is delighted to have heard from so many talented and interesting contributors over the past few months on how we can change the system and improve the situation for children and young people’s mental health.
Since last September, we have been publishing a series of ‘think pieces’ from a range of stakeholders, people with lived experience, researchers, and experts in mental health, including, more recently, David Johnston, Minister for Children, Families and Wellbeing.
We hoped the conversation would bring new and different ways of looking at the challenges we face, while providing opportunities for consensus across different partners, commentators and organisations.
We have seen this, and more – including a challenge to system leaders and policy makers to make a change for children, young people and families. We heard that, for many, the system is not working, with rising numbers of young people needing support from health services.
However, we also heard a lot of good practice and areas that can be built on. I was struck by the core themes and similarities emerging from the think pieces, which are areas for all system leaders to consider as we move forward.
From our contributors from the NSPCC Board for Change, we heard about the importance of engagement with young people who have accessed the system and know what works and what doesn’t. There were also frustrations about the difficulty in accessing mental health services and the need for young people to be better understood by all practitioners who work with them.
“Education emerged as a common theme, reflecting how it can be both a protective factor and a negative impact on young people”
Another contributor highlighted the importance of young people having the freedom to choose and influence their experiences with mental health services’ treatments, and the need for services to provide that opportunity for them.
Education emerged as a common theme, reflecting how it can be both a protective factor and a negative impact on some young people.
There was a suggestion that schools could become part of a culture of wellbeing; a new look at the curriculum could result in a more supportive environment, and interventions in schools – such as the expansion of mental health support teams – could make a significant improvement to children’s mental health.
There was agreement on the importance of early intervention and prevention; unfortunately, we heard that this early support was sometimes challenging for young people to access.
Support outside of schools is equally important for young people – for example, in early support hubs, and for the youngest children through perinatal and infant mental health support.
Partnership and cross-system working underpin the success of services and are the way to ensure young people can feel supported, receive timely and effective help, and thrive.
Although there are some challenges in the existing systems, all contributors from different backgrounds – be that local authority, education, NHS, or voluntary sector – highlighted how better joint working is one part of the solution for supporting holistic and person-centred care.
The importance of family networks and the environment in which young people grow up, such as the impact of financial pressures on them, were also shared by some contributors.
Seeing mental ill health as a systemic issue and ensuring access to some basic factors – including healthy food, good sleep, sufficient financial provision and technology – can help to improve the mental health of young people in society.
International colleagues are experiencing similar challenges to those we are seeing in England.
They provided useful insights into what they are doing to tackle this – in Norway, ensuring that local areas have the flexibility to work on health promotion, rather than a clinical focus; in Austria, tackling the imbalance in access to diagnosis and therapies across regions and communities; and in the Netherlands, tackling the system around the young person instead of focusing solely on individual needs.
“Better joint working is one part of the solution for supporting person-centred care”
We heard calls for: addressing the children’s mental health challenge as a slow disaster that requires a trauma response; ensuring that young people have access to good-quality work and affordable housing; valuing play among young people and the importance of leisure and cultural facilities; and looking differently at how we prevent and treat eating disorders.
As Chair of the Children and Young People Board at the LGA, I would like to thank the contributors to our think-piece series and encourage people to read and share their views.
The board is developing a task and finish group to look at the topic of children’s mental health, and how we can do more in this space, support councils, and continue to make clear asks of, and offer support to, central government.
Mental health professionals in schools
The LGA has briefed MPs on the Schools (Mental Health Professionals) Bill, a private member’s bill that, if enacted, would require schools and academies to provide an education mental health practitioner or school counsellor.
The LGA has long called for school-based counselling to be available and fully funded by the Government in all state-funded secondary schools and academies, to help support rising numbers of children and young people reporting mental health issues.
This should be alongside the expansion of mental health support teams (MHSTs) in schools.
It is essential that a range of professionals can support children and young people’s mental health needs.
While the MHSTs are an essential part of the support landscape, an interim evaluation has shown that there are some young people that they do not support – for example, those with moderate or complex needs. Exploring other ways to help these young people, such as through counsellors, is important.
We also need to ensure that children and young people can access high-quality mental health support outside of school.
Many children and young people face challenges accessing support for their mental health. Patchy implementation of policies has also fuelled a postcode lottery in provision, meaning that children and young people do not get a consistent offer of support.
The mental health needs of children and young people were rising even before the pandemic, but these have been exacerbated by COVID-19.
In 2022, NHS data found that one in six children and young people had a probable mental health disorder, an increase from one in nine in 2017.
This has had a significant impact on the system, with a 53 per cent rise in children presenting to councils with mental health needs in 2022, compared with 2018, and a 77 per cent increase in referrals for specialist mental health services in 2021 compared with 2019.
LGA-commissioned research published last year found that, while there has been a raft of successive policies and strategies to improve mental health outcomes for children, there has been a missed opportunity to significantly ease pressure on the system by increasing the availability of preventative and early intervention support.
Read the LGA’s children’s mental health think pieces in full. It is Children’s Mental Health Week from 5-11 February.
See the LGA briefing on the Schools (Mental Health Professionals) Bill.