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Children's Mental Health task and finish group: Key findings and recommendations

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The task and finish group has developed a number of recommendations for both central and local government, setting out what more can be done to support children and young people’s mental health.

Summary

On 5 October 2023, the Children and Young People Board agreed to establish a cross-party working group to consider improving support for children’s mental health and wellbeing. Children and young people’s mental health is well documented and has been highlighted in numerous Local Government Association (LGA) reports including the suite of resources available on the LGA website. Therefore, this report will not reiterate the statistics and pressures facing young people.

The task and finish group has developed a number of recommendations for both central and local government, setting out what more can be done to support children and young people’s mental health.

Introduction

Purpose

  • The working group will bring together one councillor from each political group to consider the issue of children’s mental health and emotional wellbeing.
  • the group will: 
    • Consider existing evidence in relation to the prevalence, causes, and opportunities to support children with their mental health and wellbeing.
    • Identify new proposals to support councils in improving children’s mental health and wellbeing, which may include new calls on the Government or new forms of support for councils and partners.
    • Help to identify good practice to share with councils.

Terms of Reference

  • The focus of this working group is on the emotional wellbeing and mental health for all children and young people.
  • Members will use the first meeting to set the scope of the working group, reflecting the nature of children’s mental health and wellbeing and the impact that poor mental health can have on children engaging in education, training, work, with their families, friends, and communities, and leading thriving lives.
  • The focus of the group could be shaped around, for example, wider determinants that impact mental health and wellbeing, early intervention and prevention, the role of local authorities in tackling rising mental health needs among children and young people, or support for children in care or with complex mental health needs. Consideration of key partners such as health, education, and the third and community sectors could be included. The working group will not consider in detail clinical interventions and treatment for mental ill health, though it may want to consider effective working within local systems such as ICSs.
  • Members are expected to bring the views of young people with lived experience to the conversation through their local routes.
  • Members of the working group will consult with their own political groups and draw on their own experience to inform group discussions and recommendations.
  • Working with other Boards at the LGA will also be considered.

Governance

  • The working group will elect a chair at its first meeting, who will lead reports back to the Children and Young People Board.
  • Members may send substitutes to working group meetings. These should be members of the Children and Young People Board (including substitutes) to ensure a clear link between the group and the board.
  • The group will need to be quorate when it meets.
  • Any recommendations should be agreed by all members of the working group.
  • All recommendations made by the group will be submitted to the Children and Young People Board for approval prior to being adopted as LGA policy.
  • Where swift agreement is needed on recommendations developed by the working group, these will be agreed through the Children and Young People Board Lead Members, in line with normal process.

Operation

  • The working group will meet virtually for meetings of no more than 90 minutes. The group will meet bi-monthly, with the option for additional meetings where required and agreed by the chair.
  • Work will also be carried out via email in between meetings.
  • The working group will operate until the final meeting of the Children and Young People Board in the 2023/24 board cycle, which will take place on 20 June 2024. The group may cease prior to this if appropriate and by agreement of all members of the working group.
  • The working group will be supported by an Adviser within the Children, Welfare, Equalities, and Democracy team.

Policy landscape on children and young people’s mental health

Policy landscape on mental health – further information is available in the LGA commissioned research – Children and young people’s mental health: An independent review into policy success and challenges over the last decade.

Table 1:Policy landscape on mental health
Year Policy/Strategy Responsible department/s Areas of focus
2011 No Health without Mental Health Strategy Department of Health and Social Care Intended to show the commitment to the Government’s aim of achieving parity of esteem and set out six shared objectives to improve mental health and wellbeing
2012

The National Suicide Prevention Strategy 

The Health and Social Care Act

Department of Health and Social Care The Health and Social Care Act 2012 moved the responsibility and funding for an extensive range of public health services from the NHS to councils in April 2013.
2014 Closing the Gap: Priorities for Essential Change in Mental Health Closing the Gap: Priorities for Essential Change in Mental Health Department of Health and Social Care Department for Education

Set out the short-term actions and changes needed to support the long-term vision set out in No Health Without Mental Health. This identified 25 aspects of mental health care and support where action was required and included ambitions to increase access to mental health services, to better integrate physical and mental care, and to act early to prevent mental health problems from occurring. For the first time, this strategy introduced waiting time targets for mental health services.

 

2014 The Children and Families Act Department of Health and Social Care Department for Education The Children and Families Act 2014 introduced wide-ranging reforms to change the way children with SEND are supported, including new duties on local authorities for how services and support are delivered.
2015

Future in Mind 

Mental Health and Schools Link Pilot launched

Department of Health and Social Care and NHS England

Department for Education

Future in Mind established a clear national ambition to make it easier for children and young people to access high quality mental health care when they need it. The strategy introduced Local Transformation Plans for children and young people’s mental health and wellbeing. Clinical Commissioning Groups were expected to work with local partners to develop local plans to transform the local offer to improve children and young people’s mental health
2016

The Five Year Forward View for Mental Health 

NHS Health and Justice Specialised Commissioning Workstream established

NHS England

It set out 58 recommendations for the Government and NHS England to implement by 2020, including targets for children and young people. 

The Health and Justice Specialised Workstream was established by NHSE Health and Justice in order to focus on the needs of vulnerable children and young people whose needs cannot be met in conventional services as a result of their complex circumstances

2017

The Children and Social Work Act

 Prevention Concordat for Better Mental Health established

Department for Education 

Office for Health Improvement and Disparities

The Prevention Concordat for Better Mental Health aims to facilitate local and national action around preventing mental health problems and promoting good mental health.

The Prevention Concordat for Better Mental Health aims to facilitate local and national action around preventing mental health problems and promoting good mental health.

2018

The Transforming Children and Young People’s Mental Health Provision: A Green Paper

Independent Review of Mental Health Act 1983 published

Department for Education & Department of Health and Social Care 

Department of Health and Social Care

The Transforming Children and Young People’s Mental Health Provision: Green Paper committed to expanding access to early intervention support within education settings through mental health support teams in schools, designated senior leads and a pilot of a 4 week waiting time.
2019

The NHS Long Term Plan

Introduction of statutory relationships and sex education and health education

NHS England Department for Education

The Long Term Plan reinforced the importance of preventative action, early intervention, and of ensuring prompt access to help for children and young people. At the centre of this was the commitment that funding for children and young people’s mental health services will grow faster than both overall NHS funding and total mental health spending (NHS England, 2019). In total, the plan committed at least £2.3 billion a year for mental health services by 2023/24.

The Children and Social Work Act 2017 made Relationships Education compulsory for all pupils receiving primary education and Relationships and Sex Education (RSE) compulsory for all pupils receiving secondary education. Health Education was also made mandatory for all schools. In 2019, statutory guidance was issued to schools on the RSHE curriculum and since 2020 this has become a required part of the curriculum. The Department for Education has since announced that it will conduct a review of how the RSHE curriculum is taught in schools, with a consultation expected later this year (BBC, 2023)

2019 Mental health assessments pilots for looked-after children launched Every Mind Matters campaign and online platform launched Department for Education Office for Health Improvement and Disparities Pilot a new approach to mental health assessments for children in care in nine local authority areas over two years (with delivery running from July 2019 to March 2021) to develop and test changes to the assessment system for children on entry into care.The campaign seeks to empower people to look after their own mental health and is supported by an online platform with free resources and tools people can use
2020 Wellbeing for Education Return and Recovery programme launched Department for Education The Wellbeing for Education Return programme ran from August 2020 to March 2021. It made £8 million available to local authorities in England. The funds were intended to support schools and colleges to address immediate mental health and wellbeing challenges during the pandemic
2021

Covid-19 Mental Health and Wellbeing Recovery Action plan

 

Reforming the Mental Health Act: White Paper published

Cross-departmental

NHS England

 

Department of Health and Social Care

This plan identifies key commitments for 2021 to 2022, building on the actions we have taken to date in response to the covid-19 pandemic. The NHS National Medical Director was asked to review NHS access standards to ensure they measure what matters most to patients and clinically. For mental health, we have developed new standards with service users, their families, staff and key partners for urgent and emergency care and community NHS-funded mental health services. These are additional to the existing standards in mental health covering access to IAPT (Improving Access to Psychological Therapies) services, children and young people’s (CYP) eating disorder services and people experiencing a first episode of psychosis services.

 

The Mental Health Act 1983 provides a legal framework to authorise the detention for assessment and compulsory treatment of people who have a mental health disorder and are considered a risk of harm to themselves or others and applies to all children and young people under the age of 18. The Government committed to modernising the Act, following the Independent Review of the Mental Health Act in 2018, which found that the Act does not work as well as it should for patients.

 

2022

Independent Review of Children’s Social Care published

Draft Mental Health Bill published

Youth Review published

National Youth Guarantee

Department for Education

Department of Health and Social Care

Department for Culture, Media and Sport

Department for Culture, Media and Sport

The Review highlighted mental health as one of the top issues brought to the attention of the Review and put forward a series of recommendations to increase the support available to children in care and care leavers.

The review sought to strengthen the youth policy agenda and inform funding decisions relating to the Youth Investment Fund and the NCS programme. It also sought to respond to ambitions set out in the Levelling Up White Paper.

2022

Health and Care Act

 

Ten Year Mental Health Plan announced, and consultation published

Department of Health and Social Care

Department of Health and Social Care

Introduced wide-ranging reforms to the health landscape by formalising Integrated Care Systems (ICSs) as legal entities with statutory powers and responsibilities.
2023

Major Conditions Strategy announced 

Stable Homes, Built on Love Strategy published 

Rapid Review of Data on Inpatient Settings

Department of Health and Social Care

 Department for Education

 Department of Health and Social Care

A key ambition of the strategy is to decrease the mental health and physical health disparities faced by children in care and care leavers. The strategy references the importance of the NHS Long Term Plan commitments in increasing investment and expanding access to specialist services. In addition to this, the strategy commits to building social workers’ and other practitioners’ understanding and skills to respond to children’s mental health needs, and states it will work with health partners to drive high expectations and service delivery for physical and mental health support.

Statistics on children’s mental health

At least one in six children and young people aged seven to 16 years have a probable mental health disorder. This increases to one in four for young people aged 17 to 19 years

Boys aged seven to 10 years were more likely to have a probable mental disorder than girls (nearly double), but in 17 to 23-year-olds, this pattern was reversed, with rates higher in young women than young men. There is a less significant difference in 11-16-year-olds

Over half of all mental health disorders start before the age of 14, with 75 per cent by 24 years of age

In 2021/22, children spent 312,000 bed days in Tier 4 wards, but this is likely not the whole picture

Inequalities

  • Children and young people are more likely to have poor mental health if they experience some form of adversity, such as living in poverty, parental separation, or financial crisis, where there is a problem with the way their family functions, or whose parents already have poor mental health.
  • Young people who identify as LGBQT are also more likely to suffer from a mental health condition.
  • Looked after children are four times more likely to experience mental health issues than their peers, and this increases to 72 per cent for those in residential care.
  • For nearly three-quarters of children sentenced in the year ending March 2020, there were concerns regarding their mental health. Nearly three-quarters of children with a mental health condition also have a physical health condition or developmental problem.

Demand

  • The rate for children aged 10-14 admitted to hospital for self-harming increased from 124 per 100,000 population in 2011/12 to 307 per 100,000 population in 2021/22.
  • The rate of females self-harming (aged 10-24) is considerably higher than for males, at 711 per 100,000 population compared to 154 per 100,000 population.
  • 734,000 children were referred to children and young people’s mental health services in 2021/22, which is an 84 per cent increase from 2018/19.
  • This increase may in part be due to methodological changes. The rate of possible eating problems in 2022 was 12.9 per cent in children aged 11 to 16 years, up from 6.7 per cent in 2017. This rose to 60.3 per cent in young people aged 17 to 19 years, up from 44.6 per cent in 2017.
  • The average waiting time for children and young people to access mental health services ranges from 13 to 80 days.
  • The average waiting time has increased from 32 days to 40 days in 2022. In 2021/22, only 20 per cent of children and young people started treatment within four weeks.
  • Four per cent of children accessed mental health services in 2019/20.
  • This is equivalent to about one in four children who needed mental health services.
  • Around 75 per cent of young people experiencing a mental health problem are forced to wait so long that their condition gets worse or are unable to access any treatment at all.
  • Children often end up without support, leaving them without access to specialist staff by being admitted to non-psychiatric hospitals (2,838 children in 2022), on adult wards, or waiting in A&E (70,000 children in 2022).
  • There are increasing numbers of Deprivation of Liberty applications applied to children.
  • These children have multiple and complex needs, and there are concerns about their mental health or emotional difficulties in 60 per cent of cases.
  • There has been a 53 per cent rise in children presenting to councils with mental health needs in 2022 compared with 2018.

Funding

  • Spend per child ranges from £34 to £131. On average, local CCG areas spend less than 1 per cent of their overall budget on children’s mental health and 13 times more on adult mental health services than on services for children. However, some local areas are spending considerably more.
  • In addition, spending on children’s mental health services has increased 7 per cent in real terms, and more CCGs are spending over 1 per cent of their budget.
  • Government funding for the Early Intervention Grant has been cut by almost £1 billion.
  • Public health funding, which funds school nurses and public mental health services, has been reduced. Councils have seen a £770 million real-terms reduction in funding between 2014/15 and 2020/21 – a fall of almost a quarter (22.3 per cent) per person.
  • In 2021/22, specialist services are turning away one in three of the children referred to them for treatment.

Literature Review

Introduction 

The statistics show a marked decline in children’s mental health and wellbeing. Some of this has been attributed to the impact of Covid-19 and the associated pressures on young people as part of this experience. However, mental health needs were rising long before this, a pattern that is reflected across other countries. 

A range of different factors have been suggested as the cause of this, yet finding direct causation is challenging given the range of different interventions and experiences that young people have. This short literature review will consider some of the main factors and provide the existing evidence in response.

Increased prevalence – the statistical picture 

One in five children and young people in England aged eight to 25 had a probable mental disorder in 2023. The Mental Health of Children and Young People in England 2023 report, published by NHS England, found that 20 per cent of eight to 16-year-olds had a probable mental disorder in 2023. Among 17 to 19-year-olds, the proportion was 23 per cent, while in 20 to 25-year-olds it was 22 per cent. This is a rise from one in nine (12 per cent) from the same survey in 2017. After a rise in rates of probable mental disorders between 2017 and 2020, prevalence continued at similar levels in all age groups between 2022 and 2023.

Participants were also questioned about eating disorders for the first time since the 2017 survey. In 2023, 12.5 per cent of 17 to 19-year-olds had an eating disorder, an increase from 0.8 per cent in 2017. Between 2017 and 2023, rates rose both in young women (from 1.6 per cent to 20.8 per cent) and young men (from 0.0 per cent to 5.1 per cent) in this age group.

Other studies suggest that mental health needs for children and young people have been underestimated for some time. For example, a 2019 study (Deighton et al., 2019) suggested that two in five young people scored above the ‘abnormal’ thresholds for three of the four problem areas measured (emotional problems, conduct problems, and hyperactivity).

Another study (Pitchforth et al., 2019) found an increase in the reported prevalence of long-standing mental health conditions since 1995 to 2014. Although, there was no consistent increase in reported psychological distress among children and young people over the last two decades, when measured using scores in validated questionnaires, there was some evidence of worsening trends in psychological distress and well-being of young adults since 2011. 

Increased recognition, reporting and diagnosis 

There is likely some impact of increased awareness of mental health, reduced stigma, better knowledge of services and tools for diagnosis and screening on the numbers of children and young people with poor mental health. In 2021, the BACP highlighted that 90 per cent of people in the UK think mental health has a higher public profile than five years ago with 85 per cent agreeing that it is a good idea to seek counselling or psychotherapy for a problem before it gets out of hand. There is also an argument highlighting that while increased rates of mental health problems drive more awareness efforts, the awareness efforts themselves might also lead to increased reporting and experiencing of symptoms which may be leader to the misinterpretation of milder and more transient forms of distress as mental health problems. 

Social Media and screen time 

The use of screens and social media is often posited as a reason for worsening mental health. This is in part due to the physiological impact of sitting behind a screen, the impact of changing social interactions and the experience of young people feeling they are constantly having to compare themselves, as well as different ways to be bullied where young people feel they can’t get away (so bullying no longer ends at the school gates). 

There are also multiple examples of young people highlighting the positive impact that social media and technology can have on them, including for some young people who are able to find new communities and a sense of belonging online. 

Empirical evidence on the impact of social media is limited (Khalaf et al., 2023). Some reviews do highlight the harmful effects of social media and associations with specific mental health needs such as increased rates of depression, anxiety and reduced self-esteem. In addition, exposure to self-harm content on social media has been linked to psychological harm and self-harm and suicidal ideation, particularly amongst vulnerable users (Popat and Tarrant, 2023).  Yet studies also highlight the difficulties with the evidence base behind this with the use of cross-sectional studies that are not sufficiently representative, are biased, or do not explore underlying factors behind screen and social media use (Sohn et al., 2019). Benefits included social support, self-expression and access to online mental health resources. Importantly, the purpose and context of social media use is crucial and supersedes the variable of ‘screen time’ which has been recognised to lack causal influence on psychological wellbeing (Popat and Tarrant, 2023). 

The effects of social media on mental health are complex, as different goals are served by different behaviours and different outcomes are produced by distinct patterns of use. The focus on time spent can be distracting, and the quality of interactions can be key. 

Family life 

The Children’s Society Childhood Good Childhood Report consistently finds that young people are happy in their family life, the one aspect that has not declined over the past ten years – since the start of the report. Good family relationships can act as a protective factor against other challenges a young person might experience, reflecting other research (Children’s Commissioner, 2023). This is the one factor that has not declined over time in their report. However, for certain groups of young people family can have a negative impact. This can include those with family members with mental health needs, those who have experienced family breakdown, domestic abuse in the home or those who are no longer living with their birth family (Behere et al., 2017; Luvira et al., 2023). Furthermore, those who have experienced stress in the family are also more likely to experience mental health. 

Cost of living and financial pressures 

The Good Childhood Report (2024) outlined one of the main concerns for young people was the rising costs when considering societal concerns. This was also a particular concern among parents and carers about the cost of living and its impact on family life and therefore on young people. There are well known links between financial problems and mental illness among adults with unemployment, debt, housing problems and social deprivation leading to lower wellbeing and poor mental health (Knapp, 2012). School and education (behaviour, bullying, extra curricular activities) Children’s happiness at school and with schoolwork was at the lowest since the Good Childhood Report (2024) started in 2010. 

Curriculum and exams 

Evidence highlights that a focus on high stakes testing has a negative impact on children and young people from both English and international research (Berliner, 2011). This has both a negative impact on the child, and a negative impact on the teacher who will focus overtly on exams rather than responding accurately to children’s needs. This is even to the extent where children are not supported to remain in school. This also leads to a narrowing of curriculum where there is less focus placed on subjects such as arts. 

The changes to the national curriculum has had a particular impact on:

  • physical activity 
  • external pressures (climate change, job markets) 

Reimagine Where Schools Fit: Purpose and Context

National Curriculum and Assessment in England and the continuing narrowed experiences of lower-attainers in primary schools

Written evidence from the National Union of Teachers (NUT)

Biology 

There are several gender differences with relation to children’s happiness. For example, the Good Childhood Report (2024) finds that more girls are unhappy in their friendships and their appearance whilst boys are more likely to be unhappy about schoolwork. This has continued to decline since the report started in 2010. 

International lessons – how does the growth in England compare internationally?

Case studies

Summary of discussions with children and young people

To support the conclusions of this report, the LGA spoke to children and young people who are part of the UK Youth Parliament and from Wiltshire Youth Council. This group was comprised of young people who were in care, care leavers, part of the youth parliament, SEND voice group and school councils. 

A range of common themes came across from the young people that provided essential insight and provided support for the basis of the recommendations for this report. 

The groups highlighted the lack of accessible and proactive mental health resources, particularly for those experiencing early or moderate mental health issues, punitive approaches in schools which can be damaging and block young people from accessing support and called for reduction in stigma related to mental health, and an increase in holistic, youth-centric adjustments across school and community settings.

Key themes include:

Drivers of poor mental health 

  • Young people feel under pressure to look and appear a certain way at all times, this can make them feel like they aren’t good enough and always need to be putting on a façade.
     
  • Some young people feel very lonely, and like they have nowhere to turn or no one to talk to.

The situation around youth mental health is dire – we need to be listened to”

Support Over Sanctions

  • School environments can overly focus on punishment rather than support, which can exacerbate young people’s mental health issues.
  • There were examples of good practice where in some schools, if a young person exhibits a particular behaviour the teacher will take time to understand the concerns driving the behaviour.
    • “Reset rooms” illustrate a practical model, where students work through behavioural issues with staff to understand causes and potential solutions, transforming a punitive experience into a learning opportunity.
  • Some young people are hesitant to express their concerns with teachers and professionals in schools due to fears of confidentiality breaches, lack of trust in staff to address issues, and a sense of feeling unheard—especially in early secondary years (Years 7-9).

Accessible and Relatable Mental Health Resources and services 

  • Some young people felt that counsellors may be out of touch with their experiences. A younger, more relatable support staff, as suggested, could address this disconnect.
    • In some areas, there is access to counsellors and even a therapy dog in schools which provided young people support in welcoming spaces.
  • Peer support programs and younger counsellors could bridge the generational gap and create a more approachable and empathetic support network
  • The focus on 6-8 week sessions does not work for some young people as they feel unable to open up and engage, or feel they are always going to be moved onto another which prevents them from effectively engaging.

 I don’t tell anyone anything anymore, as I feel like I am being passed around, I feel like pass the parcel”

 

Social media and mental health 

  • Social media intensifies stress and safety concerns, particularly with the risk of bullying or privacy invasion in online group interactions.

Early Intervention and Prevention over Crisis Management 

  • Young people stressed the need for early intervention rather than waiting to reach a crisis point. Currently, there is a lack of access for those with less severe mental health concerns, often resulting in escalation before help is offered.
  • Young people listed their negative experiences with Child and Adolescent Mental Health Services (CAMHS), highlighting lengthy waits and a cycle of retelling traumatic stories to new practitioners.
    • Issues with long waiting times, rushed services, and, often, a lack of continuity in care. Young people feel dismissed, especially when asked to repeat personal stories to different practitioners repeatedly
  • There were some really positive experiences over early intervention through crisis lines, conversations with voluntary sector practitioners or other professionals where young people felt safe to engage and provided direct access to support with people they trusted and understood their story and experience.
  • Strong personal support networks, including relationships with friends, spouses, tutors, and community groups, are crucial in maintaining mental health. Relationships characterised by trust and understanding (e.g., with a college tutor and art class friends) provide a sense of belonging, especially when formal services fall short.

I feel like I am at the front of somebody’s mind – rather than just being another client on a long list of the day, I feel listened to, I feel prioritised” 

  • In addition, community support like police cadets, youth groups, and charities, such as New Beginnings, offer accessible outlets and foster a sense of purpose. Having people within these networks who listen without judgment and provide practical support (e.g., Childline’s online text service) has been valuable in crises. 
  • Art and physical activities, such as going to the gym, are highlighted as essential forms of self-expression and emotional release. For example, engaging in art as a means of connection and emotional support within peer groups (like designing tattoos) provides both creative satisfaction and a therapeutic outlet.
  •  Personal interests and hobbies, such as gym workouts, help channel energy constructively, reducing tendencies toward self-harm and substance abuse.

I was going through a bad, rough patch… I went to speak to my college tutor as I was concerned I was on the verge of doing something stupid… he said to go and do what I loved doing and focus on the positive rather than the negative… I have been much happier since then”.

 

Educational Gaps and Stigma Reduction 

  • Some young people highlighted that Personal, Social, Health, and Economic (PSHE) education still does not go far enough in focusing on mental health topics. In some areas, PSHE is limited to a few annual enrichment days, often perceived as disconnected from young people's lived experiences.
  • Young people wanted there to be conversations about mental health discussions earlier in their lives and regularly to demystify and destigmatise these issues.
  • There were calls for targeted training to address stigma, including teacher training on mental health awareness, which could help mitigate potential issues with disclosure confidentiality and peer bullying.
  • Suggestions included reducing the stigma by normalising conversations about mental health in schools, creating regular mental health check-ins alongside physical health assessments, and providing anonymous, accessible channels for support (e.g., text-based services for non-verbal individuals).

 Mental health is still treated like a taboo subject, or it is treated like a stereotypical issue” 

 

Creating Safe, Inclusive, and Youth-Accessible Spaces

  • The lack of youth-specific, non-commercial spaces where young people feel safe and supported was a significant concern. Public areas and schools currently lack dedicated mental health and wellness spaces that are both appealing and accessible and are properly private spaces so young people do not feel like they are sharing personal information where their peers can overhear. 
  • It is particularly important that spaces that are dedicated to children’s mental health in schools, the community and in health settings should be more inviting and young-person friendly. They should also be co-designed with young people.
  • There is also a strong desire for professionals with lived experiences in mental health who may better understand the daily struggles young people face. Participants expressed that sympathy from practitioners is insufficient without practical insight into their lived realities.

Lots of young people don’t feel safe in their local area”. 

Autonomy in Mental Health Support

  • Young people reflected on the importance of self-referral processes, enabling young people to control their mental health journey and connect to services without stigma or unnecessary procedural delays. Ideas such as using QR codes to signpost to mental health services would empower young people to independently seek help without feeling pushed through a bureaucratic system. This approach fosters a sense of agency and reduces the dependency on school systems that may inadvertently delay needed support.
  • There was consideration of engagement with adults being part of a broader discussion with young people and them feeling in charge of these discussions.

 Mental Health and disabilities 

  • The recent ADHD diagnosis and struggles to receive treatment highlight common barriers young people face in obtaining mental health support and medication. The experience suggests a sense of relief at finally being acknowledged, yet there remains stigma and hesitance, especially from family members, about medication.
    • Accessibility is also a challenge for disabled and non-verbal individuals, as most services depend on verbal interactions, which can exclude some young people. There is a call for mental health services to better accommodate diverse needs through varied communication options and improved signposting to available resources.

Specific Proposals for Improvement in Mental Health Services

  • Young people recommend several systemic changes, including:
    • Increased Funding and Reduced Wait Times: More funding for mental health services to reduce wait times and prevent deterioration before treatment is available.
    • Improved School Support: Establishing better school-based mental health support, including mental health first-aid training, more routine check-ins, and reduced stigma surrounding mental health counselling.
    • Continuity of Care: Creating a streamlined record-keeping process to avoid repeatedly recounting trauma and allow for a seamless transition between caregivers.
    • Mental Health Awareness in Schools: Embedding mental health education in school curricula, akin to physical health education, could promote awareness and normalise seeking help.
    • Building Resilience and Self-Esteem: Addressing societal pressures, such as peer pressure and self-worth tied to appearance, which impact self-esteem, was noted as an area where schools and communities could provide preventive support.
    • Supportive Approach to Discipline: Schools could benefit from adopting a more supportive approach to discipline and mental health, including confidential “reset rooms” and well-being coaches.
    • Improved CAMHS Communication: CAMHS and other services need to improve communication, provide interim support between sessions, and better advertise available services.
    • Updated PSHE Curriculum: Schools should update PSHE curriculum and training to address mental health more effectively and reduce stigma.
    • Government Investment in Youth Mental Health: Government investment in youth mental health, safe public spaces, and community resources is critical for sustaining young people’s well-being.

Recommendations

The LGA has had a focus on children’s mental health for some time – there are a range of recommendations that already exist so these should be read in addition to established asks. 

Recommendations for central government: 

  •  Children’s mental health is a crisis and deserves to be treated as so by central government. This means:
    • a cross-government plan for children that includes focus on children’s mental health
    • the establishment of a mental health Tsar to hold government departments and partners to account
    • a cross-government task and finish group such as that on child poverty to bring together relevant government departments and partners to deliver concerted action
  • Immediate investment into early intervention and prevention that can have a positive impact on improving and preventing poor mental health.
    •  this should consider the wide range of factors that support young people such as culture, leisure, green space and sport
  • Mental health support teams (or mental health professionals) in schools should be driven by local understanding of need and the local operational context therefore flexibility is central to delivery to enable a response appropriate to the needs of the local community.
    • Review, embed and enhance the mental health support teams in school model to ensure there is a named mental health professional supporting each school, can provide support to teachers and students and has capacity to support individual students as well as facilitate onwards referrals 
  • The development of the Young Futures programme, which includes a focus on mental health, is welcome. However, there is a concern that the focus on youth violence may dilute the emphasis on support for mental health.
    • There should be a concerted focus on open-access hubs for mental health support alongside the wider framework of early intervention. Open-access mental health support hubs should be available in places where children feel safe.
  • The Government should explore support for councils to deliver evidence-based parenting support programmes and set up local peer support networks for parents and carers with children with emotional and mental health needs.
  • Embed whole education approaches to mental health and wellbeing across all education settings (including the early years). This should be supported by an evidence-based understanding of an inclusive school and be a core element of the curriculum review.
    • Consider the current approach to PSHE to ensure that it emphasises mental health, early intervention, and reduces stigma. The curriculum should include information on identifying mental health needs, available resources, and self-care strategies
  • Focus on the mental health workforce, including council provisions such as educational psychologists, youth workers, emotional support workers, early help workers, and specialist social workers for mental health.
    • The workforce should be reflective of its local community and culturally competent to enable young people to feel supported.
  • Make mental health training a core element of training for all staff that support children and young people.
    • Develop training modules for staff on confidentiality and safeguarding concerns, ensuring young people feel safe and supported when disclosing sensitive issues.
  • Undertake a fundamental review of NHS mental health services, particularly child and adolescent mental health services. The recent Darzi report reflected just how little focus is paid to children’s mental health on a national level and how funding and interventions have therefore suffered. This needs to change, starting with a fundamental review of NHS mental health services for children and young people to ensure it is seen on a par with physical health.
    • Ensure young people have quicker access to services and continuity with practitioners in their mental health journey, reducing the need for young people to retell traumatic experiences multiple times.
    • Challenge the existing model of six to eight sessions for support and ensure flexibility in arrangements that respond to young people’s needs, rather than being constrained by established commissioned contracts.
    • Consider progress and areas for improvement on the NHS Long-Term Plan for improving transition arrangements for young people who are 18. Improve the ability for young people to self-refer.
  • Tackle the root causes of poor mental health and family dysfunction, which includes poverty, isolation, and unstable work.
  • Reduce stigma through national campaigns that focus on raising awareness, early intervention, and acceptance. This could include resources and information that make it easier for young people to discuss mental health needs with family, peers, and school staff.
  • Promote Mental Health First Aid training for both teachers and students, which can help create a supportive environment and facilitate peer-to-peer conversations about mental health.
  • Encourage public-private partnerships to extend resources such as therapy animals, innovative counselling spaces, and virtual services, enabling support to reach even young people who might not traditionally engage with school-based services.

Recommendations for councils 

  • Children’s mental health is not just a children’s services issue. Poor mental health is driven by a range of different factors, and a whole council focus can make significant improvements for young people and their families.
  • Consider the levers available to local leaders to tackle the rising need for children’s mental health support. This includes planning to consider youth-friendly spaces, access to green spaces for young people, access to youth services, and facilitating support around schools.
    • This could include making towns, communities, and cities child-friendly spaces, such as the activities undertaken by Leeds City Council.
    • Work with the local community to identify safe places for children and ensure there are allies to deliver support for young people, as demonstrated by St Neots Council.
    • Use existing partnerships and positive ways of working with schools and other stakeholders to provide flexible support to children who require mental health support, such as shown by Brighton and Hove Council.
  • Utilise with the levers through the Children’s Wellbeing Bill, which will provide councils with a greater opportunity to work more closely with schools. This will highlight good practices and positive ways of working on children’s mental health with schools, providing links with other sectors to offer support and ensure connections with services available locally.
  • Work with young people to co-design mental health support and young people’s spaces that reflect the needs and preferences of young people directly.
    • Encourage youth councils to organise events and discussions that bring mental health into a positive light, including World Mental Health Day events and similar initiatives, which can reduce stigma and promote open conversations about mental wellness.
    • Explore peer to peer support programmes for improved mental health for both children and young people and for parents of children with mental health needs.
  • Improve signposting and availability of information that enables young people and their parents/carers to understand what sort of support is available.
  • Consider the specific needs of some groups who may be more likely to have poor mental health such as children in care, young carers, children with SEND.