Demand is Up, Referrals are Down; Child Mental Health Services During the Pandemic

Children’s mental health and wellbeing has benefitted from an increase in NHS funding from £791 million in 2019 to £881 million in 2021.1 However, a pandemic has complicated the situation since then, and the 2022 report by the children’s commissioner for England on children’s mental health services has revealed that only a third of children in need accessed mental health support in 2021.1

Demand for mental health services has grown significantly over the last 2 years. NHS surveys show that in 2017, 1 in 9 children had a probable mental health disorder; this has now increased to 1 in 6. This demand is expected to increase further in the coming years, as the children of today have shown themselves to be more aware of the important link between physical and mental health and the need to address issues sooner rather than later.

A key take-away from the report is that the number of referrals to mental health support by GPs or teachers dropped significantly from 539,000 in 2019 to 497,502 in 2021. Concerningly, this is thought to be because of disruption to NHS services during the pandemic, the closure of schools, and staff shortages.

The report also highlights the large disparity that exists between England’s CCGs on child mental health service funding. Data have been collected on CCGs with the highest/lowest budget percentage allocated to child mental health services and increased/reduced spend per child for 2 consecutive years. They collate this, alongside waiting times and referral rates, to rank the 20 best performing CCGs in 2020/21 - as well as the 20 worst performing.

There is good news, however - for children accepted into mental health treatment services, average waiting times have decreased from 43 days in 2019 to 32 days in 2021. Additionally, 68 out of 135 (50%) CCGs in England spend at least 1% of their budget on children and young people’s mental health services, an improvement on 2018 when only 59 out of 195 (30%) achieved this NHS Long Term Plan benchmark.

The Health Secretary is to publish a review later this year outlining a strategy to address the level of demand on services, and this is expected to focus on the importance of community-based and digital mental health support. The House of Commons Committee report in December 2021 recommended to the government that they should expand the digital offering for children and young people to access mental health support.2

The reasoning for this is based on the stigma and shame still associated with accessing mental health support, which digital care overcomes by offering anonymity. Many children and young people are also more comfortable talking about psychological issues in an online, digital environment. As always, it is about choice, and the choice of a digital service has the potential to reach children in remote areas and overcome other barriers related to wellbeing services.

References

1. Children’s Commissioner for England. Children’s mental health services 2020-21. February 2022. www.childrenscommissioner.gov.uk/wp-content/uploads/2022/02/cco-briefing-mental-health-services-2021-22.pdf

2. Health and Social Care Committee. Children and young people’s mental health. December 2021. https://publications.parliament.uk/pa/cm5802/cmselect/cmhealth/17/report.html