Image: The Health Foundation
Briefing: Improving children and young people’s mental health services
- Across the UK, the number of children and young people experiencing mental health problems is growing. Mental health services are expanding, but not fast enough to meet rising needs, leaving many children and young people with limited or no support. Too little is known about who receives support and who might be missing out.
- National prevalence data suggest large variations in need by sex, age, and socioeconomic deprivation. But data on who is using services are only publicly available for NHS specialist mental health care and are not detailed enough to capture variation by these characteristics.
- This briefing presents analysis from the Networked Data Lab (NDL) about children and young people’s mental health. Led by the Health Foundation, the NDL is a collaborative network of local analytical teams across England, Scotland and Wales. These teams analysed local, linked data sources to explore trends in mental health presentations across primary, specialist and acute services.
- Analysis by local teams highlights three areas for further investigation, nationally and by locality: the rapid growth of prescribing and use of general practice, the mental health of young women, and marked socioeconomic inequalities.
- Prescribing and use of general practice: Local NDL teams found the use of GPs and medication for mental health problems is growing in their areas. In North West London, the monthly number of those aged 0–25 years with a mental-health related prescription or GP event (diagnosis, observation or referral) grew threefold between 2015 and 2021. In Grampian (Scotland), the proportion of those aged 0–24 years with mental health- related prescriptions increased from 4.7% in 2012 to 6.4% in 2019.
- Adolescent girls and young women: Around 25% of older adolescent girls and young women aged 17–22 years have a probable mental health disorder, a higher share than for any other group of children and young people. In Grampian, young women aged 19–24 years had the highest levels of antidepressant prescribing (17.9% in 2019). Adolescent girls aged 15–17 years had the greatest number of contacts with specialist mental health services in Leeds, as well as in Liverpool and Wirral, and were the group who most frequently presented with mental health crises to acute services in Wales.
- Socioeconomic inequalities: There is a stark contrast between areas of differing socioeconomic deprivation. In the 20% most deprived areas, compared to the 20% least deprived, crisis referrals were 60% higher among children and young people in touch with services in Leeds; there were twice as many prescriptions and 1.7 times as many referrals in Grampian; and there were close to twice as many crisis presentations to acute services in Wales.
- To inform national policy decisions and local service planning and delivery, the quality of data collection, analysis and the linkage of datasets across services and sectors need to be improved. More regular collection of robust and granular prevalence data would better support services to expand in line with need and target support. There must also be improvements in data quality for specialist services, closing of data gaps along the emergency crisis care pathway, and better linkage of data to understand experiences across care pathways. In England, the development of integrated care system (ICS) intelligence platforms – with fully linked, longitudinal datasets across primary, secondary, mental health, social and community care – will be a major step forward. Such platforms will allow ICSs to undertake similar analyses and learn from others.
- To understand whether children and young people can access support outside the NHS, particularly if turned away from specialist services, it is vital that data are collected on support services in schools and services funded by local government or the voluntary sector, and that these are linked to NHS data.
- Governments in all three countries have begun to recognise the scale of the challenge facing children and young people’s mental health. High-quality data and analysis will play a crucial role in targeting preventative interventions, planning services and improving children and young people’s mental health.