Written evidence submitted by the Children and Young People’s Mental Health Coalition (CYP0043)

The Children and Young People’s Mental Health Coalition brings together over 200 organisations to campaign and influence policy, with and on behalf of children and young people, in relation to their mental health and wellbeing. The Coalition advocates for the better mental health of all infants, children and young people.

We do not represent any one organisation, approach, or professional group, but come together to provide a strong unified voice speaking out about children and young people’s mental health. We are Chaired by Sir Norman Lamb.  

Introduction

We welcome this timely inquiry from the Health and Social Care Committee on the mental health of children and young people. Our members have expressed concern about the rising mental health needs of infants, children and young people and have long been calling for a step change in the mental health system. These concerns have now been exacerbated by the Covid-19 crisis. This response has therefore been informed by the work of our members and the children, young people, and families they work with.

Whilst the long-term impact of the Covid crisis on infants, children and young people is still unknown, we know that it has had an immediate impact on their mental health and wellbeing and has widened already existing inequalities.

We must now take this time to reset the mental health system and strive for renewal rather than a return to pre-pandemic times.  The Children and Young People’s Mental Health Coalition believes that we need a comprehensive, cross-departmental approach that supports infants, children and young people aged from 0-25 in all settings. This inquiry presents the opportunity to really prioritise and protect the mental health of all infants, children, and young people.

Summary

Findings from our members indicate that we still that we still have a long way to go to ensure the mental health needs of all infants, children and young people are effectively met. Members are concerned that policy initiatives such as the Green Paper and NHS Long-Term Plan are not ambitious enough in creating the change in the system that is needed, and in creating the shift that we consider is needed, namely to a system that prioritises prevention and early intervention.

Whilst these reforms recognise the importance of early intervention, there is little emphasis on how early intervention support will be expanded in the community. Early intervention services in the community are crucial in identifying needs early and providing preventative and low-level mental health support and advice, reducing referrals to more costly specialist services.

1. Progress made by the Government

1.1 Over recent years there have been several government-led initiatives in England aimed at transforming mental health provision for infants, children, and young people. Future in Mind (2015), the Transforming children and young people’s mental health: a green paper (2017) and more recently, the NHS Long Term Plan (2019) have all set out proposals to improve mental health support for children and young people.

1.2 Through our annual report process, we asked our 200+ members for their views on several prominent and current policy initiatives such as Future in Mind, the 2017 Green Paper and the NHS Long Term Plan.[1] Through this process, we found that:

• Just over a quarter of members (26%) felt somewhat confident that the Future in Mind programme effectively improved the overall mental health and wellbeing service provision for children and young people.
• Few of our members (6%) were somewhat confident that the green paper would improve services over time for children and young people.
• A quarter of members (24%) were somewhat confident in the vision set out in the NHS Long-Term Plan.

1.3 When we asked members to tell us what areas of provision needed greater investment, they reported education settings, from early years to higher education (30%). 

1.4 Notably, our members have stressed that infants have been largely overlooked in policy initiatives to date, including a lack of mental health support in early years settings. The NHS Long Term Plan commits to improving access to specialist services for all children from 0-25, this therefore should include services for children aged 0-2.[2]

1.5 However, no explicit information has yet been published about improving services for the youngest children aged 0-5. The Government has not made any subsequent statements about the need to improve provision for the youngest children and, as far as we are aware, there are no comprehensive plans in place to improve mental health services for this age group nor is there monitoring of progress towards this goal.

1.6 While the increased policy focus on children and young people’s mental health is welcome, findings from our members indicate that we still have a long way to go to ensure the needs of all infants, children and young people are effectively met. Members have expressed concern that reforms are not ambitious enough in creating the change that is needed within the mental health system. For example, only one fifth of the country’s children will benefit from a mental health support team, as set out in the green paper, by 2022/23.[3]

1.7 The 2020 Spending Review included a much welcome commitment to invest additional funding in the nation’s mental health, including a £500m pledge to address waiting times for mental health services, give more people the mental health support they need, and invest in the NHS workforce.[4] This investment is in addition to funding for the NHS Long-Term plan and should specifically help to deal with some of the emerging effects of the Covid-19 pandemic. A significant proportion of this investment should go towards expanding children and young people’s access to support to help them recover from the impact of the pandemic. It is important to note, however, that this funding is for one year only and is not re-current. It is likely that future investment will be needed to respond effectively to the growing needs children and young people are experiencing.

1.1 Provision of mental health support in education

1.11 Schools and colleges play a crucial role in preventing and identifying mental ill-health and providing targeted interventions. Our members have long been advocating for mental health and wellbeing to be prioritised within education settings. We strongly believe that the promotion of mental health and wellbeing in schools is not an objective that conflicts with academic attainment, but instead should boost children’s learning and development.

1.12 There have been some welcome changes in recent years such as the mandatory rollout of the new Relationships and Sex Education (RSE) and Health Education curricula into the school curriculum, the revised Ofsted framework, and the implementation of mental health support teams and designated senior leads for mental health as set out in the green paper.

1.13 However, there is still more progress that needs to be made to ensure that mental health and wellbeing support is fully embedded within education settings. As we recover from the Covid-19 pandemic, our members have emphasised the importance of educational providers being well prepared and well supported so they can respond effectively to student’s needs.

1.14 A whole school and college approach across all education settings is critical. This refers to a universal, school-wide, and multi-component approach to the promotion of wellbeing and mental health of the whole school community. The approach is widely used and promoted across primary and secondary schools and further and higher educational establishments in the UK. The Coalition has worked with Public Health England to develop a guide for education settings on implementing such an approach.[5]

1.15 An independent review of whole education approaches by the Schools Wellbeing Partnership found clear evidence demonstrating the value and benefits of implementing such programmes.[6] This included positive impacts on academic learning, staff wellbeing, pupil wellbeing, the prevention of mental health difficulties and improving school behaviour. In addition to this, the Department for Education[7] and Ofsted[8] both recognise the importance of embedding a whole school approach to mental health and wellbeing in guidance and research.

1.16 The Coalition has been calling for the full implementation of a whole education approach across all schools and colleges to ensure that wellbeing is fully embedded in the school curriculum. Alongside the rollout of Mental Health Support Teams and Designated Senior Leads, we believe that the government should require every school, college, and university to have a well-resourced whole-education approach to mental health and wellbeing.

Recommendation: The Department for Education should provide wellbeing support funding for every pre-school, school, college, and university to adopt a whole-education approach to mental health and wellbeing.

1.17 In response to the impact of the Covid-19 pandemic on children and young people, the Department for Education’s Wellbeing for Education Return programme, and the attached £8m to help deliver its objectives, has been welcomed by our members.[9] However, this programme is only a short-term intervention, due to end in March 2021. Considering the second closure of education settings and the enduring impact on mental health and wellbeing, we would welcome an extension of the programme to help settings, staff and children respond to the continued disruption.

1.18 It is also crucial that mental health and wellbeing is made a priority in catch-up planning. In comparison to the money dedicated to academic catch-up, the £8 million made available for wellbeing support appears to be relatively small. In the recent announcement on catch-up funding for schools, no mention was made about how much of this money should be dedicated to mental health and wellbeing support, nor was there mention of specific funding being made available to support this. Whilst the Department for Education set clear expectations on the number of hours of remote learning that schools should provide during school closures, no similar framework for the provision of wellbeing support or pastoral care was put in place. Mental health and wellbeing needs to be an integral part of the catch-up plans to ensure that children and young people are supported in dealing with the impacts of the pandemic.

1.19 We also welcome the establishment of the new Mental Health in Education Action Group, which will look specifically at how young people are supported with their wellbeing as they return to school, college, and university. Further details of the remit of the action group are yet to be published, but it is crucial that the taskforce listen to the voices of children and young people as a priority.

Recommendation: The Department for Education should extend the Wellbeing for Education Return package beyond March 2021 and make available additional funding to support mental health and wellbeing within catch-up planning.

1.10 Whilst the introduction of the green paper proposals to invest in more mental health support within education settings is welcome, there have been concerns about the slow progress of the rollout of these proposals. A robust plan is needed that sets out how mental health support teams in schools and colleges will be delivered at scale to ensure that every child and young person can benefit from the support they offer. This plan must be underpinned by learning from areas already taking part in the trailblazer programme.

Recommendation: The Department for Education and Department of Health and Social Care should fully fund and scale up the rollout of Mental Health Support Teams and other Green Paper reforms so that every child and young person in England can benefit from the approach and support they offer.

1.11 We know that many children and young people will have experienced grief and trauma through-out the pandemic and therefore may require more intensive school-based support. Research suggests that counselling in schools can reduce psychological distress, help manage emotions, and improve relationships.[10] In addition to the Mental Health Support Teams, which is in early stages of implementation, school counselling should be made available to every child who needs it.

Recommendation: The Department for Education should make school counselling available in every school, which should be rolled out alongside Mental Health Support Teams.

1.12 The Higher Education (HE) sector has developed a University Mental Health Charter which has been co-produced with students, HE organisations and experts. The Charter outlines a set of principles to support universities across the UK in making mental health a university-wide priority. This Charter was created in response to there being limited guidance on how universities should support the mental health and wellbeing of members of the university community.[11] All universities should be encouraged to sign up to this Charter to ensure that there is mental health and wellbeing provision within their settings.

1.2 Provision of support for young people with eating disorders

1.21 There have been concerns about the increasing numbers of young people experiencing problems with conditions such as anorexia during the isolation of lockdown. Recent findings from Ofsted reported that several secondary school leaders had observed an increase in eating disorders among both girls and boys as students returned to school last September.[12]

1.23 Data published recently also show there has been an increase in waiting times for children and young people, with a 128% increase in the number waiting for routine treatment in 2020, compared with the previous year.[13] There has been a fourfold increase in the number of children and young people waiting for urgent treatment from October, November and December 2020 compared with the same months a year earlier.[14]

1.24 The introduction of an access and waiting time standard for children and young people has set clear expectations around access to evidence-based treatment within maximum waiting times, and funding to support this has been a major step forward.[15] However, it needs to be ensured that there is comprehensive implementation of the access and waiting time standard across every region, and that additional resources are provided to address this increase in the need for treatment.

1.25 Evidence also states that early intervention is crucial to a rapid, sustained, and full recovery. We believe that a clear and comprehensive early intervention strategy should be created, that is based upon a cross-government approach and accompanied by dedicated funding to support the delivery of the strategy.

1.3 Addressing capacity and training issues in the mental health workforce

1.31 We see the workforce as comprising all professionals who work to improve the mental health of infants, children, and young people.[16] Transforming the mental health workforce is crucial in creating sufficient capacity within the system, but NHS England has consistently citied an insufficient workforce as the greatest challenge to improving access to services.[17]

1.32 The Royal College of Psychiatrists has reported that the number of consultant child and adolescent psychiatrists fell 4.5% from October 2013 to October 2018.[18] The Health Education England mental health workforce strategy committed to 100 extra consultant child and adolescent psychiatrists by 2020/21, but it has been noted that they are not on track to hit their target.[19]

1.33 What is more, the NHS Long Term Plan requires 1,040 consultant psychiatrists by 2023/24, yet recent workforce forecasts from Health Education England indicate that only 71 additional consultant psychiatrists will be added to the NHS mental health workforce by that date if action is not taken. Similarly, only 257 mental health nurses will be added to the NHS workforce by 2023/24 against a requirement of 7,000 needed to deliver the Long Term Plan. 

1.34 There is also a shortage of parent-infant specialists. Specialised parent-infant teams are crucial in providing therapeutic support where babies’ development is most at risk due to severe, complex and/or enduring difficulties in the parent-infant relationship. However, there are fewer than 40 specialised parent-infant relationship teams in the UK.

1.35 Working with babies requires specialist expertise, but very few professionals are routinely trained in parent-infant relationships as part of their core training. NHS and Health Education England need to clarify the skills and competencies required to deliver this specialised work and set out a plan for how enough appropriately qualified and skilled staff will be trained to deliver the planned service provision.

1.36 Members have also pointed to the importance of a diverse workforce that span across counselling, youth work, advice, and guidance. The recognition of these diverse professional skills will be vital to any workforce strategy that can meet the needs of all infants, children, and young people, and that can be responsive to the range of social and economic factors that come hand-in-hand with their wellbeing.

1.37 In order to deliver the NHS Long Term Plan commitments of expanding access to specialist services, there must be a rapid growth in the workforce. Health Education England is advancing plans to develop and expand the workforce, with mental health identified as a key priority area,[20] and the NHS Long Term Plan will develop a workforce strategy. However, we need urgent action to expand and upskill the children and young people’s mental health workforce at the pace required.

Recommendation: Health Education England and the Department of Health and Social Care should develop an overarching infants, children and young people’s mental health and wellbeing workforce plan to expand the workforce and enhance the skills of the wider workforce. This plan should go beyond staff working in NHS and statutory services and tap into the potential of the diverse professions including counselling, youth work and advice.

1.38 It has been identified that young people want to see their diverse lived experiences reflected in the mental health workforce. [21] This means creating more opportunities for training and career development for young people and other groups who are typically underserved by the mental health system and underrepresented in the mental health workforce.

1.39 Research presented in our Overshadowed report, young people and their families highlighted concerns about the mental health workforce’s training in learning disabilities and the impact this has on the identification of mental health difficulties.[22] This has also been noted in relation to mental health training among learning disabilities specialists.

1.4 Improving access to mental health services

1.41 The difficulties in accessing support from NHS children and young people’s mental health services has been well publicised, with access to specialist mental health services often described as a ‘postcode lottery.’ Infants, children, and young people do not consistently receive the mental health support they need, and experiences of the system vary depending on their level of need and where they live. [23]

1.42 Despite the ongoing transformation of NHS Children and Young People’s Mental Health Services, waiting times continue to be unacceptably long, and children are often not seen until they reach crisis point. Recent findings from the Office of the Children’s Commissioner (OCC) found that access to children’s mental health services is still inadequate, and that change is not happening as quickly as anticipated. [24] The report finds that in 2019/2020, just 4% of children accessed NHS mental health services - based on 2020 estimates of need, this is equivalent to about 1 in 4 children who needed mental health services.

1.43 There is also very little mental health provision in place for children aged 3 and under. In its report Rare Jewels, the Parent-Infant Foundation found that 42% of clinical commissioning groups in England did not accept referrals to NHS CYPMHS of 0-2 year olds, even though the service by definition covers 0-18 year olds.[25] We are concerned that the mental health system fails to recognise or respond to the needs of babies, despite the vital importance of early emotional wellbeing for good mental health and positive social relationships.

1.44 Access to mental health services has now become more important than ever as we deal with the fallout from the Covid-19 crisis. Data published by NHS England has shown that the number of children and young people being referred to mental health services is at its highest ever level and has increased by 20%.

1.45 The NHS Long Term Plan is the latest policy initiative that proposes to improve access to specialist services to all children and young people aged 0-25 who need them.[26] This presents the opportunity to seriously expand access to services, and it is crucial that a delivery plan is put in place to ensure this target is met.

1.46 There have also been longstanding concerns about transitions to adult mental health services at the age of 18. It is widely recognised that young people often struggle to move between services and are poorly supported with the transition, meaning that young people can fall between the gaps in support. In order to mitigate the issues with transitions, the NHS Long Term Plan sets out an ambition to extend current service models to create a comprehensive offer for 0-25 year olds that reaches across mental health services for children, young people and adults.[27]

Recommendation: The ambition for NHS Children and Young People’s Mental Health Services to have a comprehensive offer for young people up to the age of 25 should be progressed with urgency across the country. The Government should also set out a plan of how it aims to meet the target in the NHS Long Term Plan to support 100% of young people who need specialist mental health care over the coming decade.

2.0 Improving inpatient care

2.1 A report from Article 39 on the rights of children in mental health inpatient care estimates that over 3,500 children are admitted to hospital each year because of mental health difficulties.[28] The report highlights longstanding concerns about inpatient care including children and young people being kept in hospital for too long without sufficient understanding of plans for their care and treatment, too many children being placed miles from home, and a lack of a child-centred, rights-based approaches in some units.[29]

2.2 The report also raised concerns around access to advocacy for informal patients. Advocates have a fundamental role in supporting children in mental health hospitals and can ensure their voices are heard within the care and treatment process. However, advocates are not automatically made available to informal patients, and as a result, many informal patients do not understand their rights.[30] The Mental Health Act White Paper proposes reforms to expand access to advocacy to informal patients, but this change is dependent on future funding decisions.[31] It is important that funding be made available for this, and that advocacy services should be culturally competent.

2.3 There is evidence of unnecessary and excessive use of restraint for children and young people in institutional settings, including the use of medical restraint (i.e. unnecessary medication and sedatives). There are particular concerns about the ability of children and young people with multiple needs to access adequate community-based support, particularly for young people with learning disabilities and/or autism and mental health needs and those with behaviour that is perceived as challenging, who are over-represented in all institutional settings.

2.4 Evidence has found that people with behavioural challenges are three times more likely to be prescribed anti-psychotics. Children and young people have reported feeling traumatised by restraint, which they feel was too often heavy handed, though they also recognised the need for restraint under specific circumstances.[32]

2.5 The Government has committed to restricting the use of seclusion, long-term segregation and restraint for all patients in inpatient settings, particularly children and young people. Guidance has been issued by the government on restrictive intervention, but it needs to be made clearer that restraint should be the last-resort response to behaviour that challenges and this needs to be implemented consistently across the UK. Restraint should be based on consent where possible and an understanding that all children can and do communicate. Staff working within inpatient settings also need to be supported to work proactively in order to contribute to the reduction in restrictive intervention.

2.6 The NHS Long Term Plan includes commitments to reduce the number of children and young people with a learning disability and/or autism cared for in an inpatient facility. However, there continues to be a high number of children and young people in inpatient settings, and the number of recorded instances of restrictive interventions used against children, young people and adults is high.

Recommendation: The Government should commit to increased community-based provision to ensure that young people with the most complex needs receive good quality care in a setting that is right for them, and when young people access inpatient care they should be assured of minimum standards of rights and protections.[33] A preventative and early intervention approach is key in ensuring those with the most complex needs are properly supported, with community responses to mental health support always being prioritised.

3.0 Prioritising early intervention in the mental health system

3.1 Improving the mental health of infants, children and young people means that people and systems need to work well together at every level. Currently, systematic barriers such as inconsistent funding, patchy data, and workforce shortages have all prevented the improvement of mental health support for these groups.

3.2 The reforms that have been proposed by the government, such as the green paper and the NHS Long Term Plan, should likely result in significant expansion in access to mental health services, and in workforce capacity across England. However, whilst these reforms recognise the importance of acting early to prevent escalation of need, they do not provide detail on how access to early intervention support will be expanded beyond schools and the NHS, and there is a lack of exploration as to what support can be put in place within community settings.

3.3 The Coalition and its members believe that we need a step-change in the mental health system to ensure that all infants, children, and young people can receive early support with their mental health. That is why our strategic priorities for improving infants’, children’s and young people’s mental health across the 0-25 age group are focused on promotion and prevention, and early intervention.

3.4 We see that this requires a dedicated and comprehensive expansion of early intervention support in communities.[34] The emotional needs of infants, children, young people, and their families can often be effectively met in the community by wider local support services. Many of these services seek to destigmatise mental health difficulties and normalise help-seeking behaviour, identify needs early and provide preventative and low-level mental health support and advice. Services of this kind can help reduce referrals to more costly, specialist services.

3.5 Members have found success in delivering interventions within the community. For example, Our Time delivers low-cost, community-based, multi-family interventions known as ‘KidsTime Workshops’. These are for families where a parent has a mental illness and are non-treatment sessions, offering a fun protected space, where young people can express themselves, build their confidence and resilience, and learn about mental illness; while their parents can share experiences and discuss their role as parents, rather than patients, in an informal and intimate space.

3.6 An effective way of delivering these services is through the delivery of open access, drop-in hubs. These hubs are designed to provide additional capacity and are not designed to replace the vital support provided by statutory services.

3.7 Open access, drop-in hubs offer easy-to-access, drop-in support on a self-referral basis for young people with low-level mental health needs, up to age 25. These hubs can be delivered through the NHS, in partnership with local authorities, the voluntary sector and with digital providers. A mix of clinical staff, counsellors, youth workers and volunteers provide a range of support on issues related to wellbeing, while a variety of services can be co-located under one roof; offering wrap-around support across, for example, psychological therapies, housing advice, youth services and sexual health.[35]

3.8 This model has been established in the UK through Youth Information Advice and Counselling services (YIAC).[36] These services are rooted in the community and provide accessible support to those aged 11-25, providing holistic support on a range of emotional and social needs under one roof. The government has recognised the importance of services of this kind, with the Future in Mind (2015) strategy making a commitment to deliver “…every area having ‘one-stop-shop’ services, which provide mental health support and advice to children and young people in the community, in an accessible and welcoming environment.[37] However, this is an ambition that is yet to be realised.

3.9 Whilst our members agree on the importance of early intervention, they recognise the many barriers that make it difficult for it to be prioritised. A lack of national oversight on early intervention services has also translated to a local level. For example, evidence has highlighted that there is a significant lack of accountability and transparency across CCGs and local authorities in local areas as to who is responsible for ensuring that early intervention mental health provision is available for children and young people.[38] As a result, the provision of early support services is patchy.

3.10 This is further confused by a lack of dedicated funding for local areas to provide services of this kind.[39] In their 2019 report on early access to mental health support, the Office of the Children’s Commissioner for England estimated that around £226 million was spent on low-level mental health services in the financial year 2018/19 but found that there was wide variation in local areas on the amount spent.[40]

3.11 Members have noted that there needs to be a more defined role in local decision-making structures. While the NHS Long Term Plan makes some recommendations for the involvement of the Voluntary and Community Sector in decision-making (VCS), this should be formalised to ensure they can play an equitable role and ensure that decisions about service provision considers the needs of VCS services, as well as, crucially, the young people they serve.

3.12 Early intervention should also include a focus on infant mental health. There is overwhelming evidence that parent-infant relationships are a very influential factor in child development, including mental health and wellbeing. Supporting early relationships requires a coordinated system of services and support to be available, ranging from universal support for all families, to targeted and specialist services for those who need extra help.

Recommendation: The Government should develop a clear and comprehensive overarching early intervention strategy for all infants, children, and young people. This should be based upon a long-term vision and cross-government approach and should be accompanied by dedicated funding to support the delivery of the strategy. A strategy of this kind should be an addition to any support that is already in place.

Recommendation: The Government should fund a range of prevention and early intervention services as part of this strategy, such as open access services, in order to improve access to early support in the community.

3.13 Mental health support of this kind must also be accompanied by a range of social and practical support to help address social determinants of mental health, such as financial insecurity, discrimination, and poor living conditions.[41] This is even more important when seeking to address socioeconomic inequalities, many of which have been exacerbated by the Covid-19 pandemic.

4.0   Learning from best practice

4.1 The Voluntary and Community Sector (VCS) is an importance resource that provides much mental health and wellbeing support to children and young people, with many charities and social enterprises providing innovative approaches to support. We believe it is crucial that the power of the VCS is harnessed, that we learn from the work it is doing, and that the VCS are well-resourced to provide this support.

4.2 However, our members have expressed concern that the role of the VCS has not been fully considered within government policy proposals. During our evidence gathering process for our annual report, we asked members if they believed policy initiatives such as Future in Mind, the Green Paper and the NHS Long-Term Plan empowered the voluntary and community sector to play a role in protecting the mental health of children and young people. Unfortunately, few of our members agreed that these reforms achieved this.

4.3 There have been wide-ranging concerns about the impact of the Covid-19 pandemic on the sustainability of VCS organisations. We have heard reports from professionals that their organisations have been relying on reserves and existing contracts for the past few months and are concerned that contracts may not be renewed due to the impact of the pandemic.

Recommendation: In order to support the important work of the Voluntary and Community Sector, the Government should make available sustainable recovery funding to help organisations deal with the impact of the pandemic in their work.

4.4 Our members have also pointed towards learning from best practice examples from abroad. For example, members have pointed to the Headspace in model in Australia which provides a network of one-stop-shop centres across the country. [42] Headspace is now accessed by over 100,000 young people each year.[43] This model has also been established in the UK through YIAC services. These services provide early intervention mental health support and

4.5 What is more, members have expressed the need for more research and promotion of evidence-based approaches in the children and young people’s mental health sector.

5.0 Measures needed to tackle increasing rates of self-harm and suicide among children and young people

5.1 Research conducted by the National Children’s Bureau and UCL used data collected from the Millennium Cohort Study to look at mental ill-health at age 17. The research found an increase in the prevalence of self-harming between ages 14 and 17, and that 1 in 4 teenagers reported self-harming in the past 12 months.[44] What is more, by age 17 approximately 10% of females and 4% of males said they had self-harmed with suicidal intent.

5.2 The research also highlighted large inequalities in mental health, with stark inequalities by sexuality. The study found that that over half (55.8%) of LGB+ young peopled reported self-harming in the last year and 21.7% of LGB+ young people having attempted suicide.[45] Research from Stonewall has also shown that more than 2 in 5 of trans young people have tried to take their own life, and 84% of trans young people have self-harmed. [46] Trans young people’s access to gender-affirmative care and support for mental ill health at an early age is a crucial factor in reducing the hight levels of mental ill health amongst this group.

5.3 Our members have been calling for the need for preventative and early intervention support to prevent young people reaching crisis point. The recent APPG on self-harm and suicide inquiry stated that the single most impactful change to improve the support available to young people who self-harm would be a systematic shift away from the current reliance on crisis intervention towards a preventative model of support.[47] The Inquiry recommended that the Government should focus long-term investment on early intervention provided by wider community-based services, as well as alternative third sector support specifically for self-harm.

Recommendation: The Government should ensure continued cross-departmental responsibility and delivery for the National Strategy for Suicide Prevention and the important focus given to the needs of children and young people.

Recommendation: The Department of Health and Social Care should ensure that national and local self-harm and suicide prevention plans include measures to reduce the risks faced by children and young people, including those with special educational needs and disabilities, those who identify as LGBTQ+ and young people from racialised backgrounds. These plans should also include an emphasis on early intervention.

February 2021

References