Briefing: Children and Young People’s Mental Wellbeing
Venue: The Kaleidoscope Plus Group, 1st Floor, Hawthorns House, Halfords Lane, West Bromwich, B66 1BB
Date: Tuesday 5th September
The Young Minds presentation showed that nationally, there are 1 in 10 children and young people that have a diagnosable mental health condition. Many more show signs of emotional distress or mental health problems according to the Government’s wellbeing measures. Half of all mental health problems manifest themselves before the age of 14 years and 75% by the age of 24. Dr Karen Newbigging’s presentation showed that in the West Midlands, 21.3% of the population are children and young people aged 0-17. Birmingham as the second city in the UK is a youthful and ethnically diverse city with 54.7% of the population under 30 and 42% from BAME communities.
All three of the panel speakers highlighted the pressures and issues that face children and young people that can lead to mental health issues: family breakdown, abuse, social media, body image, drugs and alcohol, as well as sexual pressures, school pressures, bullying, unemployment to name a few. These can lead to episodes of anxiety, stress, unhappiness, tantrums to more extreme and severe mental health issues such as eating disorders, behavioural problems, self-harm, suicide, psychosis, depression.
Ellie Saltrick, Young Minds, highlighted the national policy agenda and resourcing of health and social care provision that has been developed so far on addressing the mental wellbeing of children and young people. Mental health generally has been the ‘poor relation’ of health services with children and young people’s mental health not being addressed to the same extent as adult mental health. She eluded to the kind of pressures on the health and social care system where GPs and teachers are reporting that they are acting outside of their competence and capacity to deal with children’s mental health in a school setting. Three out of 4 children with a diagnosable mental health condition do not get access to the support they need. More recently, the changes in Child and Adolesent Mental Health services (CAMHS) eligibility criteria has meant that 1in 4 CAMHS are turning away children referred to them. Both Ellie and Claire Dale, Kaleidoscope referred to the increase in waiting times to get an appointment and then for treatment to start as well as the length of the treatment available.
Ellie particularly highlighted that suicide is more common amongst boys although rates are decreasing amongst boys and increasing amongst girls. Self-harm is more common amongst girls, although rates are decreasing amongst girls and increasing amongst boys.
Though the current government has undertaken a policy review on mental health of children and young people and undertaken inquiries into the existing health and social care provision, it has only confirmed that there has been an under-investment over many years and resources are not reaching frontline services. More recent policy introductions such as Future in Minds (FIM) has introduced Local Transformation Plans to 2020/21 and the Five Year Forward View (on mental health) introduces Sustainability and Transformations Plans (STP) that Clinical Commissioning Groups (CCGs) have had to submit to Government on how they will address national priorities such as suicide prevention for example. A copy of Young Minds presentation can be found here.
Young Minds are also undertaking an analysis of the STPs to assess the extent to which they prioritise the transformation of children and young people’s mental health in accordance with the FIM agenda and the Five Year Forward View on Mental Health. The results will be published late September and will be represented by a traffic light system on a heat map for each category – green for good, red for bad.
In understanding the context in the West Midlands and the role of the voluntary and community sector, both Dr Karen Newbigging, University of Birmingham and Claire Dale, Kaleidoscope provided an insight into the challenges and opportunities to address the mental wellbeing of children and young people. In terms of the policy agenda and resourcing of services, there are 5 STPs that cover the West Midlands: Birmingham and Solihull, Coventry and Warwickshire, Shropshire and Telford and Wrekin, Staffordshire and Stoke on Trent and the Black Country. An interesting key theme relating to the West Midlands STPs is the level of joined up working at STP-level and across multiple STPs in relation to mental health. It appears to be related to the development of the West Midlands Combined Authority Mental Health Commission, who has written a report on the state of mental health provision in the region. Both Karen and Claire emphasised the importance of early intervention and prevention to reduce mental health problems into adulthood that can then affect their education, employment opportunities, social participation, personal relationships and physical health. Clare in particular, emphasised the need to balance resources between the funding of preventative services, statutory and crisis care and any Investment in prevention, should not be at the cost of statutory or crisis services. Karen particularly highlighted the cost of not addressing the mental wellbeing of children and young people, for example: there is a high prevalence of perinatal depression and anxiety, this can have an adverse impact on the wellbeing of mothers and compromise the healthy emotional, behavioural, cognitive and even physical development of children. The risks of adverse developmental consequences are roughly doubled as a result of perinatal mental health problems. It is estimated that the average long-term cost to society of one case of perinatal depression is around £74,000. Karen suggested that it could cost the nation £12.6 billion – approximately £3100 per head if the mental wellbeing of children and young people is not addressed. A copy of Karen’s presentation can be found here.
Both Karen and Claire emphasised the important role of the third sector in addressing the mental wellbeing of children and young people. There is a wealth and diversity of third sector organisations in the West Midlands supporting local communities’ mental wellbeing – from those that provide specialist mental health services to those that promote mental wellbeing, those that work with particular social and vulnerable groups and provide support to carers of individuals with mental health problems to those who advocate to enable people to have a voice and greater control and choice. The closeness of voluntary and community sector organisations to children and young people and communities places them in a valuable position to co-design and produce initiatives that take a more preventative and early intervention approach.
However, Claire in particular raised some of the challenges that face the voluntary and community sector such as increase in demand for services when funding is being cut; unrealistic expectations of commissioners on level of resources given and services to be delivered; competitive approach to how resources are allocated; uncertainty of ongoing contracts or funding for services provided. A copy of Claire’s presentation can be found here.
In conclusion and from the discussion that followed the presentations, there was an agreement that there should be an increased focus on prevention and early intervention that included work with parents and families in a child’s early years. The closure of Sure Start and Children’s Centres has undermined the important work that has been done to date. Continuing and expanding work within schools to support the social and emotional development of children and young people. Addressing the underlying social inequalities that can increase the risk of mental health issues for particular children and young people. From an organisational and strategic view, sustaining strategic partnerships that would co-design and produce services and support based on an early intervention approach. Also developing measurement indicators for third sector organisations that demonstrate the value of a preventative and early intervention approach to funders and commissioners.
Report on Children, Young People and Family Engagement – Young Minds 2014
Vulnerable Groups and Inequalities Task and Finish group Report: Children and Young People’s Mental Health and Wellbeing Taskforce, Department of Health 2015