One in five children and young people in England aged eight to 25 have a probable mental disorder, according to a new survey from NHS England, with large rises in the last few years in the number with eating disorders.
But years of underinvestment in community mental health services means these children and young people are struggling to get access to care, with NHS England data released for the first time showing that over 24,000 are waiting almost two years to receive any help.
This data exposes the shocking state of mental health services in England, which was called a ‘national emergency’ by health leaders back in October, who warned that the continued lack of resourcing for mental health has left services overwhelmed and at breaking point.
The Mental Health of Children and Young People in England 2023 report, published by NHS England, found that 20.3% of eight to 16-year-olds had a probable mental disorder in 2023, among 17 to 19-year-olds, the proportion was 23.3%, and in 20 to 25-year-olds it was 21.7%.
The survey, commissioned by NHS England, and carried out by the Office for National Statistics (ONS), the National Centre for Social Research (NatCen), and University of Cambridge and University of Exeter, is considered to be England’s best data source for trends in children and young people’s mental health and how this has changed since 2017. The survey covers a range of topics, including bullying, substance use, self-harm and feelings about cost of living, education, climate change and the future.
For the first time since 2017, participants were questioned about eating disorders, which showed large increases. In 2023, 12.5% of 17 to 19-year-olds had an eating disorder, up from just 0.8% in 2017. Between 2017 and 2023, rates rose both in young women (from 1.6% to 20.8%) and young men (from 0.0% to 5.1%) in this age group.
Eating disorders rose in 11 to 16-year-olds as well. In 2023 eating disorders were identified in 2.6% of this age group, compared with 0.5% in 2017 – with rates in 2023 four times higher in girls (4.3%) than boys (1.0%).
Although the prevalence of mental health disorders has risen, increases in investment and capacity in services has not kept pace. Recent data released by NHS England on waiting times for community mental health services shows a shockingly high number of children and young people having to wait almost two years before being seen.
HSJ analysis of this data puts the figure at more than 24,000 children and young people waiting almost two years to be seen. With 19,000 adults with a serious mental illness waiting for longer than 18 months for a second contact with community mental health services.
In total, almost 240,000 children and young people were waiting for treatment from community mental health services in August 2023, as well as more than 192,000 adults.
The lack of community mental health services means patients often turn up at A&E in crisis. Here they can wait hours (with some reports of waits of over 80 hours) until they are redirected to more suitable care options. In many cases patients are admitted into inappropriate acute hospital beds meant for physically ill patients. This then delays treatment for patients who need treatment for physical conditions.
One acute trust chief operating officer (COO) in the North of England said:
“We have weekly, often daily, instances where we have mental health patients in our ED awaiting mental health beds. These patients often wait three or more days in our ED.”
Matthew Taylor, chief executive of NHS Confederation said:
“The current focus on the elective recovery, industrial action and GP access has meant that mental health has slipped down the government’s set of priorities and patients and services are being forgotten. This is a national emergency which is now having serious consequences across the board, not least for those patients in crisis.”
As community mental health services are a combination of services, with patients not only needing input from NHS staff, but also from social services and other council services, Taylor added that although “urgent and increased targeted investment in community mental health teams” is needed, “many of the solutions to this problem lie outside of the NHS, not least with the need for more supported housing and social care support.”
Unfortunately, local government has seen its spending power fall steadily since 2009/10, with the amount of money authorities have to spend from government grants, council tax and business rates in 2021/22 now 10.2% below 2009/10 level.
Data compiled by Unison, the trade union, published in September 2023 found councils are facing a record cash shortfall of more than £3.5bn with more cuts to jobs and services being considered by councils.
Such is the worsening situation in mental health social work teams, with high waiting times for patients, worsening practice and chronic staffing issues, that UNISON staff in community mental health services in Barnet, took strike action in October.
Barnet UNISON branch secretary John Burgess. “The waiting lists are extraordinarily high and all the experienced staff have left or are leaving. It’s not safe for staff and it’s not safe for service users, because if you don’t build relationships with social workers, how is that meant to be therapeutic?”
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