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‘How far does it have to get? Sometimes to you sit there and you think what do I have to actually do to get the support, how far do I have to go?’ – Girl, 15, in focus group. 

England’s children told me in The Big Ask, the largest ever survey of children with over 550,000 responses, how important good mental and physical health are to them. They see living healthy lives as one of the key elements of happy childhood and a successful adulthood.  

While most children who responded were happy, a significant proportion of children said in The Big Ask that they were unhappy or worried about their mental health. It was one of the biggest worries for children, especially for teenage girls. That’s why I made understanding children’s worries about their mental health my priority this year. I spoke to hundreds of children where mental health emerged as a recurring theme. 

Earlier this year, I published my annual mental health report. Using my unique statutory data gathering powers, this report tracked performance and spending on children’s mental health across Clinical Commissioning Groups (CCGs) in England. The report showed that nationally, spending on specialist NHS mental health services for children has increased for the fourth consecutive year, and by 4.4% since 2019/2020 in real terms. But, the data showed that demand is rising. There has been an increase in underlying mental health need, with 1 in 6 children now experiencing mental health problems. And there is still a significant ‘treatment gap’ where children cannot get the help they need. The next annual mental health report is being collated, and will be published early next year.  

Then in July, I published ‘A Head Start’ report, where I spoke to children about the type of early support they would like to receive when they begin to struggle with their mental health. Based on what children told me, I created six comprehensive ambitions for early mental health support. I want to see all families able to receive support for their mental health  – whether that’s in pregnancy and the early years through family hubs, or for older children to have plentiful access to safe and fun spaces to play with their friends. You can find the six ambitions and the full report here. 

Good mental and physical health lays the foundation for children to thrive in all areas of their lives. That’s why, alongside this, I made sure health was a focus in all areas of our work across the office this year. 

As part my of my work on attendance, I spoke to 300 children who were struggling to attend school, many because of mental health problems.  

The Office conducted further focus groups with children and families as part of the Family Review and in response to the Government’s SEND Green Paper, many of whom described finding it challenging to get the right support for their mental health.  

The Office has also delivered a programme of work exploring the impact of the online world on children – in particular, on the harmful impact of online abuse. This followed a joint commission from the Department of Culture Media Sport (DCMS) and DfE Secretaries of State. In fulfilment of this, the Office spoke to 120 children and young people aged 8-21 in focus groups and at a workshop of young adults, to understand and inform the role of parents in tackling sexual violence online. Mental health arose as a key theme threading through these conversations. Young people – particularly girls – spoke powerfully to us about the harmful impacts of sexualised and highly-edited and filtered online content on their mental health, self-esteem, and body-image. 

Since the publication of The Big Ask, I have worked across government to raise the profile of children’s mental health. This includes attending a roundtable at Number 10 Downing Street alongside other cross-Government meetings on the issue. The Office has held regular discussions with senior leads in the Department of Health and Social Care (DHSC), the Department for Education (DfE), and NHS England. The Commissioner has also discussed children’s views and solutions on this issue at conferences and roundtables with the Royal Society of Medicine and the Royal College of Paediatrics and Child Health, the NHS Assembly and the Institute of Psychiatry, Psychology & Neuroscience at King’s College London. Alongside this the Children’s Commissioner continues to visit children’s hospitals around the country to speak to clinicians delivering care. 

Next year, I look forward to looking at children’s health more widely. I learnt from The Big Ask that children see physical and mental health as closely interlinked. That is why alongside an updated analysis of children’s access to mental health support early next year, I will be exploring some of the pressures on other children’s health services. Families tell me that delays in accessing specialist care for their children can place serious strain on family life, as well as children’s education. 

The healthcare system is undergoing transformation with the introduction of Integrated Care Boards. This is happening at the same time as the implementation of the Independent Review of Children’s Social Care, and the Government’s SEND review. I believe that there is a real opportunity to be grasped to place children and families front and centre of all these reforms, and make sure that no child ‘falls through the gaps’ of care. I want to make sure that all these reforms work together to ensure the needs of children are prioritised. 

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