A study by the University of Cambridge indicates that many vulnerable children and young people are not receiving the mental health support they require, despite evidence of increased need. The findings show that less than 20% of those on child protection plans or in care, who are at a heightened risk for serious mental health issues, accessed mental health services in a given year.
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In England, an estimated 18% of children and young people are thought to have a probable mental health disorder, with about one-third of mental health problems beginning before the age of 14. Timely access to appropriate services is critical; however, fewer than half of those identified with probable disorders receive a referral. Approximately 50,000 children are on child protection plans, while about 84,000 are in care. Many of these children face challenges such as abuse and neglect, which increase their likelihood of developing mental health issues, with studies suggesting that up to half may experience significant mental health problems.
Researchers analyzed data from NHS Digital covering children and young people referred to or receiving mental health support between April 2020 and March 2021. Their results, published in Child and Adolescent Mental Health, show nearly 2 million children were in contact with mental health services during this timeframe, a number that has been rising annually. Common reasons for referrals included anxiety (13%), being ‘in crisis’ (10%), depression (7%), neurodevelopmental conditions (6%), and self-harm (6%). Notably, the primary reason for referral was unrecorded in 67% of cases.
Children on protection plans or in care were found to be two to three times more likely than their peers to engage with mental health services, yet only 9-18% had contact with these services in a given year. One contributing factor may be the reluctance of Child and Adolescent Mental Health Services (CAMHS) to accept referrals involving children connected to social services, which often leaves families and social services to navigate significant gaps in mental health provision. Instances of children being denied access to necessary support due to perceived complexities of their cases have been documented; in one case, a 12-year-old girl who attempted suicide and was referred to CAMHS was deemed too complex for support.
Professor Robbie Duschinsky, head of the Child Health & Development Research Group at the University of Cambridge, noted the troubling trend of children with mental health difficulties being denied treatment based on their living situations. The data also revealed a decline in service contact for young people aged 17-18, despite this being a high-risk age for mental health issues, potentially due to a lack of advocacy or a desire among individuals in this age group to disengage from services.
The study also highlighted disparities in service access among different ethnic groups, particularly indicating that Asian and Black children were less likely to engage with mental health services than expected based on population estimates. Dr. Barry Coughlan, the study's first author, underscored the growing demand for mental health services and the urgent need for support, especially for those at risk, to prevent long-term mental health issues that can lead to self-harm or suicide in adulthood.
Despite some signs of increased contact with mental health services for children in care during the 2020-21 period compared to the previous year, the researchers emphasize this research, the first of its kind utilizing NHS Digital data, sheds light on significant health inequalities. The study was funded by Wellcome and the British Academy.