26th February 2016

We must be mindful of children’s mental health support

Anne Longfield, Children’s Commissioner for England, writes about developing a better understanding of mental health support needs for children.

The recent BBC In the Mind series has played its part in cementing mental health as one of the biggest issues of today, with increasing recognition that children’s mental health is as important as children’s physical health.

The rise in levels of anxiety among children is undeniable, with an increasingly strong case being made for accessible help. We await the results of the first phase of the Future in Mind programme which has seen local assessments and plans drawn up and submitted over recent months. These are important steps which begin to develop the kind of help that so many children clearly need. However, the recent report of the NHS Taskforce chaired by Paul Farmer reminds us of the dangers of being lulled into a false sense of security, a feeling that all will soon be well. He tells us that three quarters of people with mental health problems never get help, and some of these are children.

Also, whilst we are starting to better understand the scale of children with mental health issues, there remains a stubborn reticence to join the dots between children who experience poor mental health and those who are vulnerable to risky behaviour in teenage years – those who are involved in violence, in gangs and in custody.

At a recent London Mayor’s MOPAC conference on mental health and gangs, a 27 year old stood up and silenced the room with his story. His account of his young life was as disturbing as it was transfixing. His early years were characterised by disorder and neglect; he had had low self-esteem and believed that he had no worth in anyone’s eyes. He was a member of several gangs; a victim of more kinds of violence than most people would recognise; he dispensed violence and harm on others and became a serial youth in custody.  His ‘turnaround’ came as a result of his own resilience and having someone who believed in him. As he stood before us – an articulate and charismatic young man – there wasn’t a person in the room who didn’t understand how humbling it was to hear how he had overcome such challenges.

The audience will also never need to be convinced again that there is a link between poor mental health and gangs. A third of all gang members self-harm and a quarter have a diagnosable mental health condition. Some gang members will have had prolonged exposure to dangerous, high-risk environments, as they have grown up with their brains developing a highly tuned ‘fight or flight’ mechanism more common in war zones around the world. Girls in gangs are three times more likely than other children to have a parent with mental health issues – boys in gangs are five times more likely to have eating or sleeping disorders. Getting to the point where we can identify mental health issues and act on them at the earliest possible moment cannot be a rosy aspiration – it must be what we set ourselves determined to do.

Over the next few weeks I will be investigating two particular aspects of mental health support – the level of severity children must face before they can access Children and Adolescent Mental Health Services (CAMHS), and what happens to children who don’t turn up for their appointments – something we know is all too common.  By undertaking this lightning review of thresholds and support, I aim to better understand why so many children appear not to be getting the help they need. The findings will be published in May with recommendations for improvement where needed, and I am determined to ensure that they are acted on.

We need to acknowledge that poor mental health is not inevitable, and that we have the knowledge and means of change at our disposal. The prize is the positive transformation of the lives of literally millions of children.

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