The Big Ask: Mental health
This World Mental Health Day is an excellent time to reflect on children’s views about their mental health as identified in The Big Ask – the largest ever survey of children in England.
Over half a million children responded to the survey and it is really good news that despite everything they have gone through over the last 18 months – the vast majority of children are happy with their lives.
Children are also united in their clear understanding of the importance of looking after their mental health. They see good mental health and wellbeing as a key element that they will need for a successful adult life. Among 9-17 year olds, just over half (52%) said that having good mental health was one of their most important future aspirations, as one 14 year old said: ‘Maintaining good mental health is important for success and achieving new heights.’
It is a big concern for children – one in five children are worried about their mental health. And this rises to 2 in 5 girls aged 16-17. What children mean by mental health is clearly a wide spectrum, encompassing everyday emotions like sadness and worries all the way through to fully diagnosed conditions like eating disorders.
We heard a lot about the impact of the pandemic on children’s wellbeing. As one girl said: ‘I didn’t learn anything in lockdown and I’m really struggling. I also think children’s/teenagers mental health needs to be talked about more, this pandemic has been so draining for us.’ – Girl, 15.
Children talked about the impact of loneliness, as they had to stay apart from friends and family and their social lives shrank down to the size of a laptop or phone screen. They talked about missing school and sports and all the things that brighten childhood, like birthday parties and school trips: “At the moment you can’t go out to many places which makes children lonely and upset.” – Girl, 9.
We heard about how children’s and parents’ lives were more entwined than ever, with offices and schools and living rooms all collapsing in on one another. This was not just felt by older children – we also spoke with parents of babies and toddlers about the impact of being born in lockdown: “You just can’t just help but have that stress filter down to the children. I think they saw more than we would ever like to admit.” – A, mum of 3-year-old and 6-month-old.
We also saw children happy to spend more time with their parents, and we saw a survivor generation, a sleeves-up, pragmatic generation, with civic-minded aspirations. They are happy to be back in school, and they are relishing the opportunity to get outside and play – to be part of their communities once more: ‘We are very lucky to come back to school cause that has helped me a lot.’ – Girl, 9.
All these things are essential building blocks for strong mental health. That’s why we are calling for more Family Hubs to help families create the right environment for their children to thrive, right from the earliest years. We are proposing ways to help children play safely on and offline, and to have the chance to take part in sports and cultural activities – to bring the fun back after Covid.
Some children were already struggling more with their mental health before the pandemic. They spoke about the stress of exams, bullying and the impact of social media all piling up. One boy told us: ‘Bullying/cyber bullying because you can never forget something that someone has said to you and it can effect your mental health.’ – Boy, 12.
Nevertheless, we know from Government figures that the numbers of children with a mental health problem have risen from 1 in 9 to 1 in 6 since Covid.
In The Big Ask, children talked about wanting someone to talk to when they start to struggle, particularly in school, and not having to wait until things get ‘bad enough’ before they can get the help they need: “I didn’t really get more help until it was too late. I was on a waiting list for CAMHS and then when you do get in, they only see you like one time, unless you’re at breaking point”. – Girl, 18.
Children talked about the importance of getting help if mental health problems emerge so that they can succeed in life: ‘The lack of help with mental health has been the biggest thing that has stopped me and my friends from achieving what we want. It is difficult to access as we are not taken seriously, and when we are, waiting lists are so long.’ – Girl, 17.
We have a series of ideas on how to get this help in place around the country. Starting with support in school. As one girl explained: ‘Mental health is important and it should be supported more in schools. For a lot of people, school is their safe place!’ – Girl, 15. Every school should be adopting a ‘Whole School Approach’ to mental health, with the right leadership in place and an understanding of the importance of wellbeing running through everything from assemblies to the curriculum. We also want to see Mental Health Support Teams available in every school, rolling this excellent new initiative out much more quickly. As one child told us: ‘I personally struggle with self-harm. I’ve never even considered reaching out to school because I know they do not have the facilities to help.’ – Girl, 16.
A national offer of digital counselling should also be made so that every child who wants it can find help easily online or offline and Community Mental Health Hubs should be available in every area so that children can drop in for support in a relaxed environment, rather than waiting for an appointment in a very clinical setting.
These ideas would help stem the tide of rising referrals to NHS specialist services, but it is also important that NHS England sets clear targets to further increase access to these services. Currently just over a third of children who need this treatment can get it. The NHS has an aim to treat all children who need it by 2028 but we need a clear action plan to get there.
For those who hit crisis point, intensive support is needed closer to home to avoid children having to go to A&E or be admitted into a mental health hospital. The quality of inpatient care must also be improved.
These ideas are not impractical. They are the next steps in a journey which has already seen so much progress made to improve care for children in recent years. They are what we owe this generation for their sacrifices during the pandemic. And putting this support in place will pay dividends in years to come, as this heroic generation comes of age.
There is lots of information on where to find support and advice on the NHS website.