One recent report called the problem a “silent catastrophe” while a survey of teachers labelled it an “epidemic”. But, whatever the language deployed to describe the scale of mental health challenges facing Britain’s young people, it has to be addressed immediately.
NHS figures published last month revealed that almost 400,000 children and young people aged 18 and under are in contact with the health service for mental health problems. According to the figures, the number of “active referrals” by GPs in April was a third higher than the same period two years prior. Those seeking help for conditions such as depression and anxiety showed a sharp increase.
Demand for help is up, but services are diminishing. Last month also saw new figures showing a 30% fall since 2009 in the number of hospital beds for people with acute mental health conditions. This follows the revelation in November 2017 that two-thirds of children referred for specialist mental healthcare are not receiving treatment. Last week, the charity Barnardo’s warned that ministers were “sleepwalking” into a deeper crisis in children’s mental health, after the government’s response to a parliamentary select committee report and green paper failed to promise urgent action to plug “gaping holes” in services.
Of course, an increase in referrals over time may be, in part, an indication of more young people self-reporting and GPs being more receptive to it. Nevertheless, the warning flares on children and young people’s mental health have come thick and fast lately. In June, the NHS England boss, Simon Stevens, said a major expansion of serviceswas needed to deal with growing demand. A few days earlier, a report from the Association of Child Psychotherapists warned of “a serious and worsening crisis” following a survey of staff in child and adolescent mental health services (Camhs). Underfunding on top of service reorganisation was an ongoing threat to specialist services, it concluded. “There was never a golden age of funding” for young people’s mental health, as Andy Bell of the Centre for Mental Health explains, but help must include a concerted focus on groups that face additional inequalities, such as LGBTQ youth who are much more likely to experience common mental health problems. Research shows that almost twice as many young LGBTQ people in the UK (44%) have considered suicidecompared with heterosexual non-trans young people (26%).
In the US, concerns about young people’s mental health have come to the fore lately, too, including for common problems like anxiety, depression and suicide. Suicide is the second biggest cause of death for 10- to 24-year-olds in the US and 90% of those who die have a mental health condition. And research shows the proportion of young people treated at children’s hospitals for suicide attempts or suicidal thoughts more than doubled between 2008 and 2015.
The 2018 State of Mental Health in America report tells a story similar to Britain’s. “Rates of youth with severe depression increased from 5.9% in 2012 to 8.2% in 2015,” it reports. And again, access to treatment is a problem as budget cuts put pressure on insurance coverage and services. “Even with severe depression, 76% of youth are left with no or insufficient treatment.”
And, as in Britain, for youngsters from marginalised groups the picture is especially challenging. Amit Paley, chief executive of the Trevor Project, which offers suicide prevention and crisis intervention support for young LGBTQ people in the US, points out that the rate of gay, lesbian and bisexual young people who have seriously contemplated suicide is around three times that of heterosexual young people. The evidence tells us that early identification and intervention can mitigate damage to young people’s mental wellbeing. We know, for example, that if children’s centres and young people’s services and schools are better equipped to promote wellbeing they can make a difference.
When it comes to young people in extreme distress or at risk of suicide, effective crisis services and access to support are utterly essential. But so too is preventing youngsters from reaching a crisis in the first place.
• In the UK the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org.