Britain’s children are becoming unhappier, more anxious, more depressed, and more likely to self-harm, suffer from an eating disorder or have suicidal thoughts. Addressing that sobering reality is a challenge not only for the government and the NHS but for society as a whole. Evidence for the ongoing deterioration in youth wellbeing is detailed, considerable and overwhelming.
The Children’s Society has found that happiness levels among children and young people have declined to the extent that 7% of 10- to 15-year-olds in the UK are unhappy with their lives. They identify school, appearance and friends as the main drivers of their discontent. Experts also cite other reasons for the fact that growing numbers of school-age children are unhappy – bullying, problems at home, sexual assault and damage inflicted by social media to name but a few.
Concern about the phenomenon had been growing for years before Covid struck in March 2020, and the pandemic has made a bad situation an awful lot worse. NHS Digital’s most recent survey of the mental heath of children and young people in England, published last September and based on data collected in February and March 2021, provided stark evidence of the sharp downturn. There were 534,000 under-18s in touch with services before the pandemic, a figure that has risen to 650,000.
Rates of probable mental disorders among six- to 16-year-olds increased from 11.6%, or one in nine, in 2017 to 17.4%, or one in six, the health service’s statistical research agency found. Among the same age group, 39.2% experienced a downturn in their mental health while only 21.8% reported an improvement. Among 17- to 23-year-olds the picture was even more pronounced: 52.5% said their mental health had declined and only 15.2% that it had improved. The proportion with possible eating problems had also risen in both age groups.
About 1.5 million under-18s will need new or extra help with their mental health as a direct result of Covid, according to the Centre for Mental Health thinktank. The record 420,314 young people being treated every month by NHS services are likely to be part of the total, but even if they all are that still leaves almost 1.1 million more yet to seek help.
Child and adolescent mental health services (CAMHS), however, are already unable to help all those seeking care. Many would-be patients are rejected for not being ill enough despite their distress, vulnerability and worrying behaviour – backdoor rationing to try to reduce the huge pressure on the system. Delays of as long as 81 days await those who are deemed eligible. Given the lack of capacity, what chance does this Covid-induced wave of new cases have of getting the treatment they need?
There are some hopeful signs. The money going into children’s mental heath services is rising. NHS England is making good progress in using new support teams to provide help in schools and colleges with problems such as anxiety and depression. Claire Murdoch, the NHS’s national mental health director, is passionately committed to improving the situation.
The Commons health select committee noted last December that “the number of young people receiving treatment has risen from just 25% to around 40% of those with a diagnosable condition pre-pandemic”. But, the MPs added, “it is not acceptable that more than half of young people do not receive the mental health support they need” – a damning observation.
The NHS is increasingly characterised by care gaps – the mismatch between needs and its ability to meet them quickly – as illustrated by the long waits for elective surgery, GP appointments, A&E treatment and ambulances to arrive. CAMHS is another case in point.
It is hampered in its ability to offer fast, high-quality and appropriate care to all who need it by its longstanding lack of everything needed to run a responsive service: staff, community-based teams to keep people out of hospital and beds for those ill enough to need a spell as an inpatient.
Given that, and Covid’s devastating impact on our collective mental health, it would be naive to expect the NHS to be able to treat the pandemic’s many young casualties any better and any more quickly than it can now.