Written evidence submitted by the British Psychological Society (CYP0021)





What progress have the Government made on children and young people’s mental health, including but not limited to:


The ambitions laid out in the 2017 Green Paper




The Government has responded the Health and Social Care Committee report on their inquiry: Delivering Core NHS and Care Services during the Pandemic and Beyond - Committees - UK Parliament

The NHS in England has ensured that:

-          Mental health trusts responded rapidly to support people through the pandemic

-          Mental health referrals dropped during the first wave of the pandemic, but have risen to pre pandemic levels since.

-          All mental health trusts have established 24/7 urgent mental health helplines.

-          Waiting targets have been met on Improving Access to Psychological Treatment services and early intervention in psychosis.


However, NHS Digital have highlighted that the rates of probable mental disorder have increased since 2017.


  • In 2020, one in six (16.0%) children aged 5 to 16 years were identified as having a probable mental disorder, increasing from one in nine (10.8%) in 2017.
  • Children and young people with a probable mental disorder were more likely to say that lockdown had made their life worse (54.1% of 11 to 16 year olds, and 59.0% of 17 to 22 year olds). 1


The Children Commissioner’s report The State of Children’s Mental Health Services 2020/21 contains an overview of children’s mental health services. These figures reveal just how many of our young people are affected by mental health conditions and how little is spent on their wellbeing. The report highlights areas that have failed to meet the most basic expectations NHS England set for children’s mental health service. Moreover, it asserts that, ‘CCGs that have consistently deprioritised children’s mental health, ignored the needs of children and failed to meet the expectations of NHS England should face consequences.’ 2


We need a new approach - as the current NHS E staffing and funding model will not work. The Government must prioritise prevention and early intervention using psychological approaches that are proven to work with children and their families to address wider social factors. Psychological and social factors should be at the heart of all high level strategic planning in relation to mental health services.


Additionally, the digital divide has been a considerable source of anxiety for children, families and school staff.


For example, an academy trust with 9000 students was allocated just 350 devices, which does not tally with the number of pupils on free school meals. The academy has been forced to use hard won savings to buy additional devices. It is not just children affected from deprived backgrounds, it is also those with several siblings, a parent(s) working from home, with only one or two devices available. Schools need a long-term strategy that makes sure all children can access the internet for homework, enrichment activities, etc. The challenge of making sure no one is left even further behind - must be addressed.




What progress have the Government made on children and young people’s mental health, including but not limited to:


Provision of mental health support in schools.




Nadine Dorries, has stated that, ‘There are currently 59 mental health support teams operational within schools and colleges. Some teams may, however, have flexed their resources to meet other requirements as part of the COVID-19 response and any subsequent school closures.  192 education mental health practitioners completed their training during 2018/19 and a further 496 trainees are currently in training.’ 3

On the 10 October 2020 Nadine Dorries stated, ‘… the continued roll out Mental Health Support Teams within schools and colleges across the country, provide early intervention on mental health and emotional wellbeing issues. This is in line with its commitment to establishing these teams in up to 25% of the country by 2023, as part of the reforms to provide additional support for children and young people’s mental health in the NHS Long Term Plan.’ 4


It is unacceptable that 75 per cent of schools will receive no additional support at a time when the rates of mental health problems in children are increasing.  The Society has advocated for 100 per cent coverage, to avoid a postcode lottery of support.  Additionally, the funding for the MHSTs is scheduled end in 2023. 


There should be routine outcome measures and on-going evaluation of the effectiveness of the interventions offered by the MHSTs. No such evaluation appears to have been undertaken, although at the start of the implementation stage it was promised by the Department for Education. 


The 2017 Green Paper set out that all schools and colleges would be incentivised and supported to identify and train a Designated Senior Lead for Mental Health.  This lead would oversee the approach to mental health and wellbeing.  This training has not yet been rolled out.   Indeed, in October 2020 officials from the Department of Education asked for assistance with a review and delivery of the training for the Senior Mental Health Leads.  The Society offered its help – unfortunately, we did not receive a response from the Department. 




What progress have the Government made on children and young people’s mental health, including but not limited to:


Provision of support for young people with eating disorders




The eating disorders charity Beat estimates that around 1.25m people in the UK have an eating disorder.  Young people with eating disorders have reported a worsening of symptoms.


An investigation by The Guardian reported that, ‘The number of urgent referrals for children and young people starting treatment in the community has reached an all-time high of 625, up from 328 at the start of the year and 325 in the same quarter last year, NHS England data shows. 5

The number of routine referrals starting treatment in the community rose from 915 in April to June 2016 to 1,850 in the first three months of 2020. After the pandemic began, the number of routine referrals starting treatment fell to 1,347. It then rose to a record high of 2,001 in July to September 2020, 38% higher than the previous few months.’ 6


The Nuffield Trust found that 533 children and young people with an urgent referral started treatment within one week in Q2 2020/21, and 1,792 patients with a routine referral started treatment within four weeks. However, some patients who started treatment had been waiting longer than 12 weeks since referral.  7


Ofsted also reported an increase in eating disorders.  It stated, ‘more pupils were suffering from eating disorders, many of whom had not previously been identified as vulnerable.’ 8




What progress have the Government made on children and young people’s mental health, including but not limited to:


Addressing capacity and training issues in the mental health workforce




There are a significant number of vacancies in the CAMHS mental health workforce. We are concerned the ambitions, particularly regarding children, in the NHS Long Term Plan will not be met. 


In a report published in 2019, The British Medical Association found that, ‘Around 12% of all medical vacancies are in mental health services. Similarly, around 12% of all nursing vacancies are in mental health and the vacancy rate for Clinical Psychologists is also just over 12%.’ 9


We need a long-term cross government children and young people’s recovery strategy, which focusses on prevention and early intervention.  This strategy should have long term sustainable funding. 




What progress have the Government made on children and young people’s mental health, including but not limited to:


Improving access to mental health services




Scaling up the mental health workforce has long been identified as a key challenge for the NHS in improving access to Mental Health Services and delivering the NHS Long Term Plan for children’s mental health.

The BPS is concerned about the workforce for children and young people. The Government roll out of the new Mental Health Support Teams (MHSTs) working in schools, is welcomed, however, needs to be accelerated and extended – with 100% national coverage by 2026/7.

MHSTs are just one part of the workforce that is needed. We need a children and young people’s mental health workforce development plan, inclusive of a recruitment and retention strategy.  For NHS CYPMH services consideration should be given to the whole pathway of care needed for children and young people with mental health needs. There will be such major workforce challenges in the short to medium term that the Government needs to think more creatively and systemically.


There are many people who are already in touch with children in their daily lives, including education staff and parents who could be supported to understand more about what they can do to help. There are also opportunities to develop community peer support structures amongst young people and families who again can build community resilience that will have a positive impact on all children.


Many retired and independent psychological professionals may be prepared to return to enable this type of approach to be scaled up.




How inpatient care can be improved so that it is not creating additional stress on children and young people, and how the use of physical and medical restraint can be reduced








The government should fund and support increased community-based provision to ensure that all young people with complex difficulties can access good quality evidence based care.  This support should be in cultural and gender appropriate settings.



The wider changes needed in the system as a whole, and to what extent it should be reformed in favour of a model that focuses on early intervention in children and young people’s mental health to prevent more severe illness developing




There should be much greater emphasis on evidence based preventative measures, reducing demand on primary and specialist services. Focusing work on children who are in school and who are recognised as having difficulties, is dealing with the tip of an iceberg. What is being seen in schools reflects the wider issues around children’s development and psychological wellbeing in our society that has been further impacted by the pandemic. Trying to support individual children in isolation from their families and the systems that surround them will never meet the needs despite being an expensive model. 


A systemic approach that seeks to provide the building blocks for positive development and minimise the risk factors means taking an ecological perspective, creating integrated systems of provision from the community upwards which sees psychological health woven into every part of children’s lives. The psychological literature contains not just the theory but also the practical examples of how this can be achieved in practice.




How the Government can learn from examples of best practice, including from other countries?




No comment.




What measures are needed to tackle increasing rates of self-harming and suicide among children and young people?



Research published in the Lancet at the end of last year stated, ‘There is no indication that the pandemic has caused self-harm rates to increase in the UK. This finding is consistent with international data on suicidal behaviour.’ 10


Nonetheless, health-care services and high quality assessments must be made available.  People who self-harm or attempt suicide must have access the interventions they need.







  1. NHS Digital (2020) Mental Health of Children and Young People in England 2020 wave 1 follow up to the 2017 Survey. https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-of-children-and-young-people-in-england/2020-wave-1-follow-up


2.       The Children’s Commissioner (2021) The State of Children’s Mental Health Services 2020/21 https://www.childrenscommissioner.gov.uk/wp-content/uploads/2021/01/cco-the-state-of-childrens-mental-health-services-2020-21.pdf and CMH (2020) Covid-19 and the nation’s mental health Forecasting needs and risks in the UK: October 2020 Covid-19 and the nation's mental health: October 2020 | Centre for Mental Health


3.       Nadine Dorries Written questions and answers - Written questions, answers and statements - UK Parliament


4.       Nadine Dorries https://www.gov.uk/government/news/effect-of-pandemic-on-childrens-wellbeing-revealed-in-new-report 


5.       Graell, M. et al. Children and adolescents with eating disorders during COVID-19 confinement: Difficulties and future challenges. Eur Eat Disorders Rev,28 864–870 (2020). doi:10.1002/erv.2763 


6.       The Guardian Sharp rise in number of children in England seeking help for eating disorders https://www.theguardian.com/society/2020/dec/16/shape-rise-in-number-of-children-in-england-seeking-help-for-eating-disorders


7.       Children and Young People with an Eating Disorder – Waiting Times Children and young people with an eating disorder waiting times | The Nuffield Trust


  1. Ofsted COVID-19 series: briefing on schools, October 2020 - Evidence from pilot visits to schools between 29 September and 23 October 2020.



  1. BMA (2019) Measuring progress: Commitments to support and expand the metnal health workforce in England https://www.bma.org.uk/media/2405/bma-measuring-progress-of-commitments-for-mental-health-workforce-jan-2020.pdf


  1. The Lancet, Effects of the COVID-19 pandemic on self-harm DOI:https://doi.org/10.1016/S2215-0366(20)30528-9 https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30528-9/fulltext




February 2021