Failing our Children’s Mental Health: What Next?

Did you read the shocking news about the children born in the millennium year? They are, very sadly, some of the most ill children in the history of western medicine. Why so?

If you are a girl, one in four of you will be suffering from anxiety or depression, and if your genes are XY your chances improve significantly – to just one in ten. One in ten of you, whatever your sex, will also self-harm.

Is this really happening? Are we really creating an epidemic of mental ill-health? Our young people seem to think so, and the evidence backs this up.  The Scottish Youth Parliament has recently voted mental health improvement at it is number one priority.  Take a look at its ‘Speak Your Mind’ campaign, which outlines three priorities:

  • Prevention: working to prevent mental health problems before they arise;
  • Early Intervention: Recognising early warning signs and knowing how to positively intervene;
  • Services and Support: improving the quality of services and support.

There are other movements afoot. For example, NHS England’s report, Future in Mind advocated a whole system approach to Children and Young People’s Mental Health, in part a response to salutatory statistics that 36% of children with Learning Disability have mental health conditions, as do 71% of children with Autism and 60% of children in care.

There also needs to be significant improvements in the reach of children’s mental health services. Only 15% of people who need it are currently getting professional support, the NHS Five Year Forward View aims to increase this to 33%. It’s useful to see the figures in the implementation plan in the context of population need, the scale the problem needs to be understood in order for us to respond to it effectively.

A graphic on statistics about children's mental health: "70% of those respondents who considered themselves to have a mental health problem did not know what services were available."
Photo Credit: Scottish Youth Parliament “Our Generation’s Epidemic”

Given that 75% of our adult population who have mental health conditions first experienced them before they were 18 years old, today’s statistics suggest a time bomb of mental ill health is festering away under the veneer of a civil society. Everybody agrees about the need for a joined up approach, but historically health, social, and educational sector providers have all worked in their own silos and it’s not at all easy to cut across these to do things differently; but change we must. It’s clear that children’s mental health is deteriorating at an increasing pace, suggesting that current responses are not working.

Disheartened? There are several glimmers of hope, and after all hope is one of the central tenets of the ‘Recovery Model’ in mental health.  The Secretary of State for Health and the Secretary of State for Education are jointly working on a Green Paper which is due out in October, let’s hope it addresses the whole child and supports their mental health and wellbeing. The UK Prime Minister at least pledged to prioritise mental health and give it parity of esteem in in January 2017.

But we need to look to evidence too. The evidence is, that time and time again, budgets for mental health support and for public health are being reduced year on year. Prevention takes a back seat and budgets get raided every time there is a crisis elsewhere in the system, no money is ring-fenced for prevention and early intervention. I have hope that the treasury economists and politicians will see the need to protect budgets for prevention, some evidence would be very welcome. The figures are appalling, we would not stand for this lack of treatment if life threatening physical illnesses were being side-lined, and mental ill health is life threatening too.

However, the picture is a complex one, healthcare alone will not fix the issues facing our children and families. Changes need to happen in our schools and communities, and we need to invest in our parents and our community infrastructure. There is no clear consensus on how, but plenty of people are being positive and experimental and making a real difference in their local communities.

One innovative partnership IBI Group is working on is at the Hugh Baird FE College.  Together, they  are working with Mersey Care NHS Trust to build a community based resource centre to help children and their parents to learn about mental health along with many other things, which ultimately could improve their wellbeing.

To conclude, currently we are failing our children and a recognition of the scale of the problem is a good first step.  Several initiatives have come out of the implementation plan for the ‘Five Year Forward View’ on Mental Health and more are in the pipeline. Some young people are working with professionals to co-design their way out of this avalanche of mental ill-health. We urgently need system change, I think it’s time for us to become less risk averse and accept that there may be some miss-steps along the way. These risks would be worth taking to give our children a happier, more hopeful childhood.

Wendy de Silva

Wendy is an architect and the IBI Healthcare+ Mental Health Lead in the UK. She has worked with clients who are at the forefront of best practice in the delivery of mental health services and is passionate about service improvements. Projects in Wendy’s portfolio have been recognised with awards for innovation and for providing best in class mental health facilities. Based in London, she enjoys collaborating with clients and artists to push at the boundaries of what is possible. Currently she is exploring the links between architecture and sound, and people powered movements in health.

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