04/03/20 – Report by the royal college of paediatrics and child health – helen clark reports

‘THE STATE OF CHILD HEALTH’ Royal College of Paediatrics and Child Health 4th March 2020

This comprehensive overall survey into child health was published on 4th March 2020. The summary (below) of mental health findings based on the Mental Health of Children and Young People Survey is applicable to England; the other countries were only able to supply information relating to ‘wellbeing.’

Prevalence of mental health conditions https://stateofchildhealth.rcpch.ac.uk/evidence/mental-health/prevalence

All types of mental health conditions are increasing in England.

  • Half of mental health conditions in adults start before age 14
  • From 1999-2017, prevalence of all mental health disorders among children aged 5-15 rose by 1.5% : from 9.7% – 11.2%
  • Mental health disorders were more common and rose more significantly in older children. Prevalence was 13.6% of children aged 11-15 compared with 9.5% aged 5-10 in 2017
  • The sharpest prevalence rise for children aged 5-15 has been within emotional disorders (including anxiety, depression, OCD, phobias) increasing from 4.3% to 5.8% from 1999-2017. More girls suffered from emotional disorders in 2017 (6.1% compared to 5.6%in boys) although the increasing trend is seen for both genders
  • Prevalence of behavioural disorders and hyperactivity disorders in children aged 5-15 have remained largely stable. Behavioural disorders are more common in boys than girls, 7.1% compared to 3.9% in 2017.

What do children say?

  • ‘Mental health’ means feeling happy, confident and stress-free wherever we are
  • More needs to be done to make us feel as open and safe as possible
  • We don’t want our lives to be marked by this one thing
  • Not many people are supporting us
  • We need help now because this will help our future

Policy recommendations

RCPCH saw a need for increased data collection on the prevalence of mental health problems in children; this would include routine data collection across the UK to better understand the level of need for mental health services.

Recent research on the quality of care for children admitted to hospital for mental health problems concluded that there are huge variations in quality, definitions and accessibility of national data relating to mental health. Children not being seen within a dedicated mental health service are not recorded and are essentially ‘missing’ from the data.

England

  • The 2017 Mental Health of Children and Young People in England Survey is welcome. NHS Digital should conduct the survey every three years to improve data collection on children’s mental health, enabling greater recognition of need levels.

Scotland

  • Scottish Government should introduce and fully fund criteria-free, community-based therapies for all children as well as family therapy to address all levels of mental health needs
  • Local Authorities should provide local pathways, determined by multi-agencies which improve access to support, resources and mental health services
  • Scottish Government should collect data on the prevalence of mental health conditions in children and report this at a minimum of every three years.

Wales

  • Welsh Government should continue to fund ‘Time to Change Wales’ which provides a national campaign to reduce stigma of mental health problems (delivered by Mind Cymru and Hafal)
  • Welsh Government should collect data on prevalence of mental health conditions in children and report this at a minimum of every three years.

Northern Ireland

  • Northern Ireland should improve data collection on children’s mental health. We welcome the transformation funding which was allocated to the HSC Board to conduct a prevalence study which is currently underway and due to complete in 2020. This should be repeated at a minimum of every three years.

What can health professionals do?

  • Health professionals must be alert to signs/symptoms of mental ill health in order to signpost or refer on to appropriate services for support and treatment in a timely manner. This includes being aware of the biopsychosocial model of disease and a recognition that psychological problems often manifest with physical symptoms
  • Mental health training for health professionals must be improved. It should be a core part of the training curriculum for all health professionals who deal with children. A useful resource is the e-learning provided through the MindEd resource which helps professionals to identify and help children with mental heath issues. There are modules for families to which professionals may wish to signpost carers.
  • There must be greater advocacy for the mental health of children. Available data on mental health prevalence should be used to advocate for adequate provision of mental health services to local decision-makers (from NHS commissioners to social care, education and local government)
  • Integrated working between organisations and agencies across the. workforce is to be encouraged. The integration of practice, education, pathways and commissioning will ensure that prevention, recognition, early intervention, support and onward referral is commonly addressed by professionals.

The President of the RCPCH, Professor Russell Viner said:

‘It’s not a pretty sight. On many vital measures, we risk lagging behind other European countries. We’re in danger of failing a generation if we don’t turn this round. The government has made welcome commitments on…mental health but we need to see delivery in this and other areas.’

Separate figures from Childline revealed that in 2018-19, 653 children under eleven contacted its freephone number with suicidal thought and feelings, an increase of 87% since 2015-16.

Founder Esther Rantzen said:

‘Over the last 10 years, we have seen a rise in the number of children describing feelings of such intense unhappiness that they tell Childline they want to end their own lives. It is deeply disturbing that we have reached a point where on average, 67 children a day are receiving help for suicidal thoughts and feelings.’

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