Written evidence submitted by the Mental Health Network (CYP0020)

Key Points

• Significant progress made on improving children and young people’s mental health services, but still much more to do.
• Concerns that 1.5 million children and young people will need either new or additional mental health support as a result of the pandemic.
• We are already seeing some signs of an increase in mental health problems.
• Referrals to children and young people’s mental health services dipped during the 1st lockdown and are now increasing.  This is despite mental health services still being open.
• Our members have told us they are seeing an increase in acuity in cases, which is more challenging than the increase in numbers.
• There are pressures on inpatient beds for young people, especially for eating disorder beds.

The Mental Health Network of the NHS Confederation is the voice for NHS funded mental health and learning disability service providers in England.  We represent NHS providers from across the statutory, independent and third sectors, and mental health commissioners.

There has been progress made on improving children and young people’s mental health, but even before the pandemic there was still more to do.  The prevalence of mental disorder in children and young people was increasing before the pandemic.  According to the latest data from July 2020, one in six five to 16 year olds have a probable mental disorder. This has increased from one in nine in 2017. Centre for Mental Health have forecasted that the pandemic will severely impact on children and young people’s mental health. They anticipate that 1.5 million children and young people will need either new or additional mental health support as a result of the pandemic.

There has been progress in improving access to mental health services as set out in the Five Year Forward view, and subsequently in the Long Term Plan.  The number of young people with a diagnosable mental disorder accessing mental health services has increased from 25% to about 36% and there is a commitment in the LTP for 345,000 children and young people aged 0-25 to access mental health support by 2023/24.  This is an ambitious aim, but if the forecasts for the increase in mental health issues as a result of the pandemic are actualised, it will make it even harder to achieve.

We know that whilst mental health services were still open during the pandemic and considerable progress was made in moving to digital, some services saw a significant dip in referrals to children and young people’s mental health services by about 50% during lockdown one in 2020 and they have been picking up ever since.  In November 2020, there was a 27% increase in the number of people in contact with children and young people’s mental health services, compared to March 2020.

We have heard from members, that they have seen an increase in children and young people seeking mental health support, but what is more challenging is that they are also seeing an increase in the acuity of these cases.  There is some evidence that more children and young people are presenting in crisis.  Our members have reported that there are significant pressures for specialist mental health inpatient beds for children and young people, especially eating disorder beds.

It is unclear whether these pressures are due to a surge in demand resulting from a delay in accessing services during the 1st lock down or is related to the impact of the pandemic on their mental health.  It is likely to be a combination of the two, particularly for children and young people who have existing mental health problems.

We welcome the roll out of mental health support teams in schools, as they provide additional workforce capacity and essential support to schools.  However, we have heard that in some instances, the development of these teams is not taking into consideration services that have been working in local schools for many years providing mental health support.  We call for a joined up approach that maximises the existing knowledge and experience of voluntary sector services already working in schools, rather than duplicating effort.

There are some positives though. Some of our members from the voluntary and private sector that provide digital support have come to the fore.  The charity, Place2Be  provides support for children in schools, and during the lockdown they teamed up with other providers including Kooth and Healios who provide digital interventions, to ensure children and young people could still access support even when schools were closed. 

March 2021