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Child and adolescent mental health

Mental health problems in childhood and adolescence can have tragic consequences, including suicide, substance misuse, inability to live independently, involvement in the criminal justice system, failure to complete school, lack of vocational success and other health problems.

Children from the poorest fifth of areas in England are three times more likely to suffer from mental health problems than those from the most affluent fifth. Also, looked-after children (LAC) and children with learning disabilities are more likely to suffer mental health problems than other children. National statistics estimate that nationally around 68% of LAC in residential care have a mental health problem.

What do we know?

Some of the more common mental health problems affecting children and young people are depression, anxiety, behaviour disorders and attention deficit and hyperactivity disorder (ADHD). Increasing children and young people’s self-esteem is important, as those with poor self-esteem are more likely to develop mental health problems. In Shropshire it is estimated that there are around 4,000 children and young people with a diagnosed mental health problem. The conditions with the highest prevalence rate in Shropshire are conduct disorders, followed by emotional disorders and then hyperkinetic disorders.

Most mental illnesses begin before adulthood and often continue throughout life. Half of all lifetime cases of diagnosable mental illness begin by age 14, and three-quarters by mid-20s, therefore early intervention and prevention are important. In terms of the burden of disease, mental illness is the single largest cause in the UK, and its extent has a huge impact on society overall.

Mental health has a considerable impact on other areas of the public health agenda, as lifestyle risk factors such as smoking and hazardous alcohol consumption are significantly greater in people with mental health problems than the general population. Also those with long term conditions are significantly more at risk from mental health problems than people that don’t suffer from long term conditions. In Shropshire with our ageing population this could be a significant issue as many people in this age group have a long-term condition.

What are we doing?

In Shropshire there are services for child and adolescent mental health. Targeted Mental Health in Schools (TaMHS) is a whole school and targeted approach to raise awareness in staff, pupils and parents about the importance of supporting our emotional and mental health.

Reducing the stigma of mental health so children, young people and parents are not afraid to ask for support is key to early intervention. Training is provided to whole school staff to increase confidence, knowledge and skills to recognise early signs, symptoms and behaviours associated with emotional needs.

Key staff within schools are also trained to enable them to deliver targeted intervention programmes offering additional support to vulnerable children in groups or on a one-to-one basis. Supporting these needs whilst developing and promoting the four key psychological factors will build the young person’s resilience to enable them to deal with issues now and in the future, reducing this risk of developing negative coping strategies such as alcohol abuse or self-harming. Referring and consulting appropriately with specialist services and developing staff’s own emotional resilience to supporting the emotional needs of children are also important aspects of TaMHS.

In Shropshire there is also the Child and Adolescent Mental Health Service (CAMHS), which is a specialist mental health service for children and young people. Many children and young people are referred to CAMHS for conditions such as anxiety disorders, depression, family relationships and ADHD. Recently a review of the CAMHS service was undertaken, and some gaps were identified. These were poor access to the service and that many referrals were not accepted, confusion around referral pathways and poor communication from specialist CAMHS service, eg slow response times and no acknowledgement of referrals. The recommendations from this review are now being implemented.

What can we do?

NICE has issued three guidance documents relating to children and young people’s emotional wellbeing.

Public Health Guidance (PH28), promotes the quality of life of looked after children and young people and encourages educational achievement, supporting transition to independent living, meeting particular needs of LAC (eg BME, disabilities) and putting the LAC at the heart of decision making.

PH12 and PH20 offer guidance on social and emotional well-being in primary and secondary education settings. Recommendations for primary settings include providing secure environments that prevent bullying and promote support for children and families, programmes to develop children’s social and emotional wellbeing, planning activities to develop children’s social and emotional skills and to train staff to identify signs of social and emotional problems in children.

The guidance on secondary education recommends that establishments should have access to specialist skills required, that practitioners have knowledge and skills to develop young people’s social and emotional wellbeing, that a safe environment is provided which encourages self-worth and reduces the threat of bullying and promotes positive behaviour and that social and emotional skills education is tailored to the young person’s needs.

Last updated: 13 November 2014 Print this page

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