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Children and young people needing support with their mental health feature significantly in the work of Help at Hand, my advice and advocacy service for children in care, leaving care, working with children’s services or living away from home. This could be children who are living with their families but struggling on a daily basis, children who are looked after by local authorities but not having their mental health needs met, and care leavers dealing with past trauma. 

These children and young people often face obstacles to accessing the right therapy from the NHS, and for some it leads to acute mental health issues, self-harm, or hospitalisation. The team has worked with a number of children who are detained in wards, despite this being the wrong environment for them, simply because there is no suitable setting available from either the NHS or Children’s Social Care.  Below are some examples of where Help at Hand has intervened for children and been able to make a difference.

Susie* was detained in hospital under the Mental Health Act when she was 13, due to serious self-harm. The local authority issued care proceedings and she became a looked after child, but she remained on an acute mental health ward for two years. She was extremely unhappy and there were several safeguarding incidents, but she was unable to move on because Children’s Social Care could not find a specialist children’s home able to meet her needs in the community and there were no places available in suitable therapeutic NHS settings. 

With the help of Susie’s Independent Mental Health Advocate (IMHA), Help at Hand spoke to her directly about her wishes and wrote to the health and social care professionals involved in her care to raise concerns about her situation and request a plan to move her on as soon as possible. This took time, due to the shortage of placements for children with her needs and differences of opinion between professionals, although everyone agreed she needed to leave the ward. Susie finally moved to a secure therapeutic health setting, with the aim of transitioning to a specialist children’s home when she is ready and the right place can be found. 

Lily* was 8 when her children’s home manager contacted Help at Hand to raise concerns about the lack of support she was receiving with her mental health. Lily was showing signs of trauma and her behaviour was causing difficulties at school and leaving her isolated from other children. Following an assessment with the NHS Child and Adolescent Mental Health Service (CAMHS), specialist therapy had been recommended, but the local authority had not arranged this. Help at Hand contacted her social care professionals to raise concerns about Lily’s mental health needs not being met and the potential impact on her, asking for all options to be explored urgently.

The team also asked for Lily to have access to an independent advocate, to support her in expressing her views about her care plan, so that these would be kept central to all decision-making. As the therapy Lily needed was not available from CAMHS, the local authority ultimately agreed to fund a private therapist to work with her and also advise her professionals, to ensure she would receive the right support going forwards. 

Susie and Lily’s immense resilience is inspiring, and successfully helping them to get the support they need is what motivates the Help at Hand team to keep advocating for children’s rights to safety and care.   

Sadly, for many children with the most acute mental health needs, the summer holidays will be just like any other day of the year. Help at Hand will continue to provide support for children and young people over this time. The team can be contacted by children, parents or advocates by calling 0800 528 0731, emailing [email protected], or using our online form:  

Get in touch | Children’s Commissioner for England ( 

*Names and certain details have been changed to protect children’s anonymity.  

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