Children and young people’s mental health – we all have a part to play
by Kirsten Morgan
In recent months, the mental health of children and young people has hit the headlines. It is well established that most mental health problems begin during adolescence, with 1 in 10 young people (aged 11-16) thought to experience a diagnosable mental health problem. Such problems have profound effects on young people’s social development and educational attainment – effects that often extend into adulthood. In this respect, mental health problems during these crucial years are a major public health issue. So, whilst growing concern for the mental health of our future generations has seen renewed political commitment to challenging stigma and improving services, what does it mean for research in this area?
The official national data we have on children and young people’s mental health is now over ten years old; a point made by the House of Commons Health Committee in its 2014 report into children and adolescent mental health services. The first national child and adolescent mental health survey was conducted in 1999 and was repeated in 2004. A follow-up survey in 2007 found the prevalence was stable at 10%. These surveys had robust methodologies and collected data from large, community based samples. In this respect, they are reliable indicators of prevalence at the local level. However, a lot has happened since 2004. How can we reliably commission services on this basis? There have been notable social and economic changes in the intervening years that may have a marked impact on the prevalence of mental health problems among young people. For instance, we do not know how economic recession and prolonged austerity, or the explosion in the use of social media and digital technologies, has impacted on children and young people’s mental health. Though we can speculate.
It was encouraging therefore that in a recent speech, Alistair Burt, Minister for Community and Social Care, announced that with the Health and Social Care Information Centre, the government are commissioning the first national survey of child and young people’s mental health since 2004. The survey, conducted by a consortium of NatCen and the Office for National Statistics, will be much wider in scope than in previous years – involving up to 10,000 young people aged between 2-19 years old, their families, carers, and teachers. It will also examine some of the issues linked to mental ill health, like bullying and other social pressures. This data will allow us to estimate how many children and young people in the population are currently living with a mental disorder. It is also hoped it will allow us to improve community based services, so that young people are helped earlier, and are therefore less likely to need to go into hospital.
So, arguably, better data is a positive first step. But does it go far enough? Large cohort studies are extremely important in improving our understanding of the epidemiology of mental health problems in children and young people. We need to know a lot more about why people develop mental health problems, and the resources in people’s lives that can help and hinder good mental health. However, if we are missing important data – or particularly groups are underrepresented – we may not have the full picture. Here we need to understand the social factors involved; we need to ensure the active involvement of young people and their communities, to ensure that data is representative and serves the population it aims to. We must engage communities in the design, delivery and dissemination of mental health research, in order to gather representative data on the most important factors. Increasingly, the voice of young people themselves is being recognised in these conversations. The Clinical Research Network Young People’s Mental Health Advisory Group, for example, have been supporting academics to develop new studies over the past few years, and lobbying for change at a national level to improve mental health research. Likewise, earlier this month the Youth Select Committee, part of the British Youth Council, published its report on ‘Young People’s Mental Health’ today, with recommendations across three key areas: funding and the state of service, the role of education; awareness, stigma and digital culture. This inquiry came in response to more than 90,540 young people voting specifically for mental health services as their number one issue of concern in the 2014 UK-wide ‘Make Your Mark’ ballot.
So, how is McPin involved in exploring these issues? The public involvement team is currently supporting the development of an exciting new research study, led by researchers from the Society and Mental Health Research Group at King’s College London. The five-year REACH (Resilience, Ethnicity and AdolesCent Mental) study, funded by the European Union, will look at risk and resilience factors among young people. The REACH study is being conducted in schools in South London, and over 2,700 young people aged 11-14 will be invited to take part. The study will use questionnaires to tracks cohorts of young people, in terms of both their positive and negative life experiences, over a four-year period. It is hoped that REACH will help us to understand the best ways to promote good mental health in young people from a range of backgrounds. Cohort studies like REACH can collect data sets which when combined with other information are extremely helpful in taking our knowledge forward. This knowledge can help us in shaping innovations to improve responses to distress in a range of settings, from mental health services to schools and the community, and in identifying preventative strategies. To date, we have been consulting with young people aged 11-25 to help develop the study protocol and materials. This preliminary work will support the development of a stakeholder engagement programme to underpin the study, involving young people, parents and local communities. The stakeholder engagement programme aspires to leave its mark locally, using the research study as a community development project to leave a legacy of positive involvement in research and engagement with research experiences, as well as increasing awareness of mental health.
So what next for children and young people’s mental health? It is clear that young people are best placed to understand the issues that affect their mental wellbeing: bullying, exam stress, relationships, issues of unemployment, and more recently, the impact of social media. Community development approaches may have a key role to play in sustaining this dialogue. Large cohort studies involving children and young people are important, but they need to be part of a wider conversation. Only a collaborative approach, with young people, teachers, parents, mental health professionals, community groups and the government working together can this progress be maintained. So while it is clear that children and young people’s mental health is now on the agenda, we still have a lot to learn.
Kirsten Morgan, Senior Involvement Officer, The McPin Foundation
 Meltzer, H. et al. (2000) The mental health of children and young people in Great Britain. London: The Stationery Office.
 Green, H., et al. (2005). Mental Health of Children and Young people in Great Britain 2004. London: Palgrave.
 Parry-Langdon, N. (eds) (2008) Three years on: survey of the development and emotional well-being of children and young people. London: Office for National Statistics.