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More than one in five 8 to 16-year-olds have a probable mental health condition, NHS says

NHS research shows that around 16% have a probable mental health condition at late primary age, rising to almost 23% in secondary – notably higher than when the annual research began in 2017

More than 1 in 5 children and young people in England aged 8 to 16 had a probable mental health disorder in 2023.

Annual figures published by the NHS show that prevalence in 2023 has increased slightly when compared to 2022 (20.3% compared to 18%), but is notably higher than in 2017 when 12.1% of 7 to 16-year-olds were judged to have probable mental health conditions.

Breaking down secondary and primary age groups, the figures show that 22.6% of 11 to 16-year-olds are considered to have a probable mental health condition compared to 15.7% of 8, 9 and 10-year-olds.

At ages 17 to 19, 23.3% have a probable mental health condition. This is down from 25.7% in 2022 but still notably higher than in 2017 (10.1%).

The Mental Health of Children and Young People in England 2023 report has been published this week by NHS England. The annual study first began in 2017 and this year's iteration involved responses from 2 370 children and young people who also took part in the 2017 research.

It uses the Strengths and Difficulties Questionnaire which assesses different aspects of mental health including problems with emotions, behaviour, relationships, hyperactivity, and concentration. It then concludes whether the young person has a possible or probable mental health disorder or is unlikely to have one.

The study comes as NHS England has rolled out 398 Mental Health Support Teams (MHSTs) within schools and colleges to provide early support to young people with mild to moderate mental health issues.

MHSTs support the mental health needs of children and young people in primary, secondary and further education (ages 5 to 18), providing early intervention on issues such as mild to moderate anxiety. Delivery is led by the NHS with support from the DfE.

Each MHST covers an average of 8 500 learners in 17 schools or colleges and are also intended to support education settings in promoting good mental health and wellbeing.

This support now covers an estimated 35% of students and a further 200 teams are currently in training and due to be operational by spring 2025. This will expand coverage to 50% of students.

Despite the slow roll-out, the NHS research found that around 80% of 11 to 16-year-olds were positive about their access to mental health support at school, stating that they knew how to get to support; around 60% said they felt comfortable talking to adults about their mental health while 65% said the support at their school was ‘helpful’.

As ever, the research looks at pupils' experiences across a number of specific issues:

• Eating disorders: The 2023 research raises specific concerns about the prevalence of eating disorders, including anorexia and bulimia. Eating disorders were identified in 12.5% of 17 to 19-year-olds and 2.6% of 11 to 16-year-olds this year. Rates were four times higher in girls across both age categories and are higher than in 2017.
• Self-harm: The report warns that 30.4% of children aged 8 to 16 with a probable mental health disorder had ever tried to harm themselves, including 5.9% who had done so within the past 4 weeks. These figures for young people (aged 17 to 24) rise to 36.8% and 4.8% respectively.
• Climate change: For the first time, the research asked the older cohorts about their concerns with regards to the impact of climate change. It found that 54.8% of 17 to 25-year-olds said they were worried about it.
• Poverty: The survey highlights a link between mental health and disadvantage. Among 8 to 16-year-olds 26.8% of those with a probable mental disorder had a parent who could not afford for their child to take part in activities outside school or college, compared with 10.3% of those unlikely to have a mental health disorder. Among 17 to 25-year-olds, those with a probable mental health disorder were three times more likely not to be able to afford to take part in activities such as sports or socialising.
• Loneliness: Of those respondents aged 11 to 16, 5.5% said they were often or always lonely – this figure rises to 16.6% among those with a probable mental health condition. At ages 17 to 24, 12% say they are often or always lonely, rising to 29.5% among those with a probable mental health condition.
• Sleep: In 2023, 37.8% of children aged 8 to 16 had a problem with sleep three or more times over the previous week. Of those with a probable mental health disorder, this rises to 76.5%. At age 17 to 23, these figures shoot up to 64.9% and 91.4% respectively.
• Attendance: In the autumn term of 2022, 3.8% of children aged 8 to 16 missed more than 15 days of school. However, children with a probable mental health disorder were seven times more likely to have missed more than 15 days of school (11.2% compared with 1.5%).

NHS mental health director Claire Murdoch said the research shows the ‘continued unprecedented pressures’ faced by young people and ‘reflects the increased demand for NHS children's mental health services.

She said: ‘The NHS is providing support for more children and young people than ever before – we have already supported over 700 000 children and young people with their mental health this year and seen a 47% increase in young people being treated for eating disorders compared to pre-pandemic.

‘NHS staff are working harder than ever to meet the increased demand and we have fast-tracked mental health support for millions of pupils in schools and colleges, as well as significantly expanding the children's mental health workforce.

‘Our partners, especially in the education, voluntary and social care sectors, also have a critical role to play in supporting this effort.’

Commenting on the research, Laura Bunt, chief executive at mental health charity YoungMinds, added: ‘The data confirms that the crisis in young people's mental health is deepening, and the government is not taking enough action on what is now an emergency.

‘We know that more young people than ever have been referred to mental health services and that too many are reaching crisis and facing agonising waiting times.

‘We need the government to turn the tide on this emergency – they must commit to reducing prevalence and tackle the reasons why so many young people are struggling with their mental health. Right now, they can make a difference by making sure every community has an early support hub so that young people can get help as soon as they need it.

‘Beyond that, we need an ambitious plan that matches the scale of need focusing on prevention, investment and improving services.’

• Newlove-Delgado et al: NHS: Mental health of children and young people in England, 2023: Wave 4 follow up to the 2017 survey, NHS England, November 2023: https://tinyurl.com/44tn76hv

Mental health: Anxiety, stress and low mood top list of reasons for Childline calls

Anxiety and stress, low mood and unhappiness, depression, and loneliness – these are among the most common mental health-related reasons why children are contacting Childline.

Mental and emotional health and wellbeing is the top reason children contact Childline, with the charity carrying out more than 105 000 counselling sessions where this was the main concern between April 2022 and March 2023.

Of these sessions, more than 31 000 were specifically related to stress and anxiety, while more than 14 000 related to low mood and unhappiness.

A further 6 400 sessions focused on depression, while more than 5 100 were with children suffering with feelings of loneliness.

The figures were published to mark World Mental Health Day on Tuesday (October 10) and have come alongside a call from the NSPCC for the government to step up its delivery of Mental Health Support Teams. The initiative was first announced in 2018 but the NSPCC says that the current target of access for 50% of pupils by April 2025 ‘lacks the sense of urgency needed’.

The NSPCC said: ‘Children being able to access this early intervention support can prevent young people's mental health problems from getting worse and reaching crisis point.’

Shaun Friel, director of Childline, added: ‘Young people may struggle with a range of mental health issues throughout their childhood and adolescence. This can be a time of turbulence, and so it's important that children feel supported and uplifted.

‘Ensuring that young people have a network of support, whether that's in school, with their peers, at home or through organisations such as Childline, helps young people take the first step to tackling these struggles. Childline is here for any child that may be struggling with their mental and emotional wellbeing.’

Childline is a safe space for anyone aged under-19 who is seeking help and support. They have the option to speak to a counsellor over the phone, by online chat, or by email. Last year, Childline delivered almost 200 000 counselling sessions to children and young people, with about 75% of these taking place online.

• All children can speak to a trained Childline counsellor over the phone on 0800 1111 or via one-to-one chat. Children can visit the Childline website for more information and advice on mental health and how to cope. Visit www.childline.org.uk

Mental health crisis: A quarter of year 13 students seeking support

A quarter of year 13 students have sought mental health support in the last year – with a third of these young people still to receive the help they need.

Findings from the COVID Social Mobility and Opportunities Study (COSMO) show that 44% of year 13 students are classified as ‘experiencing high psychological distress’ post-pandemic.

The ongoing cohort study involves more than 11 500 year 13 students, who are now aged 17 and 18.

Of these young people, 25% said they have sought some form of mental health support in the previous 12 months. However, of this number 35% were either on a waiting list or had yet to receive support.

The situation is worse for those young people living in the most deprived areas of the country. Of this cohort, 39% said they were still on waiting lists or waiting for support to materialise.

The most common source of support sought by young people in the study was school counselling (12%) as well as GPs (10%) and CAMHS (9%).

When it came to accessing CAMHS, of the 9% who sought help in the last year, 10% said they did not get any support, while 18% are still waiting. For students in deprived areas, these figures rise to 15% and 25% respectively.

The study lends weight to the suggestion that mental health problems are worse for this generation of young people. While 44% of the year 13 students were considered to be experiencing high psychological distress (between November 2022 and April 2023), this figure in previous studies was much lower – 35% in 2017 and 23% in 2007. Previous COSMO studies have highlighted that psychological distress is an important predictor of persistent school absence.

When it comes to specific issues, the young people reported:

• Self-harm: 15% had self-harmed in the past year (compared to 18% a year ago). Of those students considered to be experiencing high psychological distress, 28% had self-harmed.
• Bullying: 25% of the cohort experienced some kind of bullying in the past 12 months, including verbal and emotional abuse.
• Harassment: 27% said they had experienced harassment in the last 12 months, including bullying based on their appearance, gender, ethnicity or sexual orientation.
• Pandemic: 31% said they felt the pandemic was still having a negative impact on their wellbeing.
• Long COVID: 13% said they had or had recovered from Long COVID.

COSMO is being led by UCL Centre for Education Policy and Equalising Opportunities, the Sutton Trust and the UCL Centre for Longitudinal Studies and has been established to examine the short- and long-term impacts of the pandemic and cost of living crisis on educational inequality, wellbeing and social mobility.

The report's authors have called for sustainable and well-funded support for young people experiencing mental health issues, with a focus on improving services in the most deprived areas.

Dr Jake Anders, associate professor and deputy director of the UCL Centre for Education Policy and Equalising Opportunities and COSMO's principal investigator, said: ‘The scale of the crisis in young people's mental health is already well known. But these new findings show that we are simply not doing enough to tackle it. It is vital that we properly resource mental health services across the country. There is no quick, cheap fix to achieving that.

‘We must also ensure that these services are targeted to where there is the most need. If more young people living in worse-off areas are not receiving the support that they need, this will widen existing gaps in life chances.’

• Holt-White et al: COVID Social Mobility and Opportunities Study (COSMO): Wave 2: Initial Findings – Briefing No 1: Mental and Physical Health, November 2023: https://tinyurl.com/bd9sc9js

MPs identify key barriers to good attendance, and suggest some solutions

A mental health absence code, better resources for SEND support, breakfast clubs and enrichment activities, and a national mentoring programme – all could be key to tackling the school attendance crisis.

These are among the recommendations from an inquiry by the Education Select Committee into the troubling rates of persistent absence in schools post-pandemic.

The cross-party inquiry has concluded that growing demand for mental health services and SEND support, as well as increasing cost-of-living pressures and other issues, are compounding the already worsening attendance problems since the COVID outbreak.

Cross-party MPs on the committee have made several recommendations that they say could address attendance problems caused by the mental health crisis as well as better support SEND students to attend in mainstream schools.

The report also praises the DfE's current attendance mentors pilot and urges progress towards a national roll-out.

And MPs want to see ‘food-based interventions’ prioritised, including breakfast clubs, among a wider focus on enrichment activities as part of attendance strategies.

The report also calls for a national framework and new statutory guidance to end the ‘postcode lottery’ of approaches to parental fines and prosecution and ‘ensure consistency across the country’.

The absence rate in England's schools during the 2021/22 academic year was 7.6% – 2.1% of these missed sessions were unauthorised (DfE, 2023). This absence rate is up from around 4–5% before the pandemic.

In addition, 22.5% of pupils in 2021/22 were persistently absent, meaning they missed 10% or more of school sessions – around double the pre-pandemic rate. And 1.7% were severely absent, meaning they missed more than half of sessions, compared to less than 1% pre-pandemic.

Committee chair Robin Walker MP said the reasons behind the absence figures are ‘complex and varied’, but raised his concerns about ‘worrying changes in parental attitudes’ as a result of the pandemic. However, the problems are being compounded by other issues.

• Unmet mental health needs: MPs point to research by charity Mind showing that only one in four children absent due to a mental health-related problem were able to get authorisation from their school. As such, the report calls for the introduction of a new mental health absence code with clear thresholds to ‘ensure only serious cases of mental health problems necessitate absence, as the consensus remains that the vast majority of children will be better off in school being able to socialise and progress their education alongside their peers’.
• SEND: Absence rates are ‘significantly higher’ among pupils with SEND and many witnesses told the inquiry that a ‘failure to meet the needs of children with SEND is the main cause of their absence’ – with a lack of resources in mainstream schools a particular concern.
• Cost of living: The report says the DfE must consider measures to tackle child poverty as part of its approach to improving attendance, including making ‘an assessment of the eligibility criteria for free school meals and adjusting if necessary, ensuring all children in poverty are in receipt’. Also, rising costs of transport and uniform can be barriers to attendance for disadvantaged families.

The report supports the DfE's attendance hubs plan and the roll-out of attendance mentors. Launched earlier this year after a successful pilot in the North-East, the DfE is designating schools to lead nine new Attendance Hubs. It is hoped the hubs will be able to support up to 600 schools, sharing effective practice and practical resources.

The attendance mentoring scheme, meanwhile, is funded by the DfE and run by Barnardo's. It is entering its second phase following a pilot in Middlesbrough. The scheme involves one-to-one mentoring of persistently and severely absent students.

The DfE does plan to expand the mentoring programmes, but the MPs want to see a national roll-out and particularly noted the importance of placing whole-family support at the heart of the programme.

The report states: ‘We heard that the expansion does not go far enough, and we are persuaded that measures need to be rolled out nationally to support persistent and severely absent pupils effectively. Given the success of the pilots of the Attendance Mentors Programme, the DfE should start by implementing a national roll-out of attendance mentors, with whole-family support at the forefront of the programme for effectual support.’

MPs heard ‘strong evidence’ that sports and enrichment activities drive attendance by helping children to develop positive relationships and improving their wellbeing. The report supports the idea of an ‘enrichment guarantee’ to ensure more pupils benefit from extra-curricular activities.

Finally, on parental fines, MPs highlight a ‘lack of consistency’ between local authorities in their approach to issuing fines. The DfE told the inquiry that fines can be suitable ‘if families are not prepared to engage’ with support. However, many witnesses said that fining families ‘lacks support and compassion and should only be a last resort’. The report urges the DfE to produce a national framework and new statutory guidance for the use of fines and prosecution ‘to ensure consistency across the country’.

• DfE: Academic year 2021/22: Pupil absence in schools in England, 2023: https://tinyurl.com/5n8kvyxj
• Education Select Committee: Persistent absence and support for disadvantaged pupils, 2023: https://tinyurl.com/mtkjh4j7

Food poverty warning: Schools braced as families face a difficult winter ahead

Schools are bracing for the knock-on impact of increasing rates of food poverty this winter with 600 000 people and more than 220 000 children expected to access food banks between December and February

The Trussell Trust, which runs a network of food banks across the UK, is forecasting that 600 000 people will need support between December and February.

During the same period last winter, the charity supported more than 220 000 children, with 225 000 people using food banks for the first time – these figures are also expected to be higher this winter.

The charity is expecting to provide more than one million emergency food parcels – which would be up from 904 000 last winter.

The Trussell Trust has reached its estimates by looking at the average increase in need seen from April to September 2023 and comparing this to the same period in 2022.

Official figures state that 4.2 million children are now living in relative poverty (household income below 60% of the median after housing costs). This is 29% of all UK children. Of these, 2.7 million are living in ‘deep poverty’ – families below 50% of the median income. Furthermore, 21% of children who live in relative poverty are now also living in food-insecure households.

Meanwhile, the Institute of Fiscal Studies has reported that despite 30% of families on Universal Credit being considered ‘food insecure’, 69% of families on Universal Credit are not eligible for free school meals (FSMs) – this equates to 1.7 million children.

In September, research from the Child Poverty Action Group reported that 68% of school staff say there are more pupils coming to school without money for enough food at lunch, compared with two years ago.

And in May, the ongoing COVID Social Mobility and Opportunities (COSMO) study found that 1 in 10 young people were living in food-insecure households during COVID, while a third of young people in families using food banks during the pandemic were not eligible for FSMs.

The National Education Union said the Trussell Trust's warning was yet another reason to introduce universal free school meals – or at least to ensure that FSMs are offered to all families on Universal Credit.

General secretary Daniel Kebede said: ‘Introducing FSMs for all children, starting with those in primary, is the best way to ensure that no child goes hungry while in school, and lifting the two-child limit (for the payment of social security benefits) would take 250 000 children out of poverty overnight.’

Meanwhile, the Trussell Trust has launched a campaign encouraging donations of food to help meet increased need. It says that 93% of food banks are having to purchase stock to meet demand. As a result, one in three food banks are concerned about being able to maintain current levels of service in the coming months.

Emma Revie, chief executive of the Trussell Trust, said: ‘We don't want to spend every winter saying things at food banks are getting worse, but they are. Food banks are not the answer in the long term, but while we continue to fight for the change that could mean they can be closed for good your local food bank urgently needs your support.

‘They need donations of food for emergency parcels, and money to fund costs such as the purchasing of food to meet the shortfall in donations they are currently experiencing.

‘One in seven people in the UK faces hunger because they don't have enough money to live on. That's not the kind of society we want to live in, and we won't stand by and let this continue. Every year we are seeing more and more people needing food banks, and that is just not right.’

• Find out how you can support a food bank at www.trusselltrust.org/get-involved/ways-to-give/donate-food/
• You can find your local food bank via www.trusselltrust.org/get-help/find-a-foodbank/