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The urgent need to support children and young people with their mental health

10 February 2022

Rebecca Burgess-Dawson, National Clinical Lead (Mental Health) at HEE reflects on the impact of education, training and workforce for Children's Mental Health Week

As an NHS Ambassador, I explain to the younger schoolchildren I visit that I work as a mental health nurse consultant ‘mainly helping grown-ups’. I’m always acutely aware however that my patients are part of their own wider family and community, but also that they too themselves were children. In fact, 50% of the mental illness diagnosed in adulthood is present before the age of 14[1].

In 2020, research showed that 1 in 6 of today’s children aged 5-16 report having a diagnosable mental health problem. These problems can then be pervasive and lifelong, affecting children’s relationships with other people, their achievements in life, and their capacity to experience a quality of life overall. The effects of the stresses of modern life, not least a global pandemic and the social restrictions and worry about COVID-19 have all meant that our children and young people have greater need for mental health support than ever.

As health and social care professionals, seeing this massive increase in need to access help brings a great challenge for ensuring NHS services to meet that need. Pivotal to providing safe, effective quality services is workforce; to ensure the right support is available at the right time and in the right place. The NHS Long-Term Plan made this commitment, stating that by 2024, 345,000 additional children and young people aged 0-25 would have access to specialist support.

The good news is the mental health workforce supporting children and young people in England is growing to meet that commitment, with a 34% increase in headcount since 2019. Significant progress has been made in expanding and supporting new and existing staff through education and training. Training targets set out in Stepping forward to 2020-21: The mental health workforce plan for England have been exceeded (by 116%, one year early), resulting in additional upskilling of the existing workforce.

At Health Education England (HEE), we are not only transforming the capacity for people to have education and training to support children and young people, we are thinking about the specific skills, knowledge and abilities they need to work with the complexity of need that our most vulnerable children can have.

Developing us to meet the needs of our children and young people

First and foremost we need to listen to and understand the needs of children and young people today. As adults, remembering what it felt like to be a child is of limited value; we were not children in these times, and with these experiences. The direct, current voice of children and young people can help HEE to build skills, knowledge and abilities in our workforce, with renewed focus on using their lived experiences to create learning programmes for the people who work with them, so their needs inform everything that we do.

Sources of support

Firstly, we want our children to feel confident and safe to talk to us all about how they feel. When things reach crisis point, children and young people with complex mental health needs sometimes come to seek help in locations that have little or no immediate specialist mental health expertise. When things reach crisis point and staying safe is difficult, this can mean A&E is the only option.

Since 2017, HEE has commissioned Healthy Teen Minds to deliver ‘We Can Talk’ training to acute hospital staff to support them to feel confident in having crisis mental health conversations with young people and making them aware of where further help is available. The training is co-designed and co-delivered with young people and hospital staff. To date this award-winning programme has trained over 2000 workers in more than 50 hospitals nationally.

COVID-19 has seen a particular rise in cases of young people with eating disorders[2], putting increased pressure on specialist services and staff to offer treatment themselves, and advice and support to other areas who don’t feel as if they have enough specialist knowledge. We are addressing this from several angles.

As well as commissioning specific learning in partnership with the specialist eating disorder charity BEAT, the Royal College of Psychiatrists, a number of healthcare education providers and Maudsley Centre for Child and Adolescent Eating Disorders, we are also working closely with our seven regional teams to review the feedback from services and how it can inform further education and training to manage the rising caseload.

Increase in services

We are working with our partners at NHSE/I to address the increasing overall intense pressures caused by rising demands, and tackle workforce challenges wherever mental health care is provided to children and young people at some of the most difficult times in their lives.

Children and young people sometimes require intensive support in an inpatient setting, whether that be a mental health unit, or whether a concurrent physical health problem means they are on a paediatric ward. We need to attract, develop and retain a workforce who deserve to have a rewarding, meaningful and successful career.

In specialist mental health units, a National Quality Improvement Taskforce for children and young people’s mental health inpatient services was set up to develop training and support for this workforce to address these needs at all levels, and ensure staff are supported to provide the best quality of care in this setting. Several training packages where people can learn to provide care as a whole team have been created.

For our colleagues in physical healthcare, we are working with partners and key stakeholders to make sure mental health knowledge and skills learning packages are easily accessible in the right place at the right time, and we are examining how our specialist mental health colleagues can best be present to add to that learning whilst we support patients and their families together.

Everyone together

The success of providing safe, effective quality mental healthcare for our children and young people depends on a wide range of groups and networks. We know that health and social care professionals are included, but this group also this includes families and friends, schools and education providers and all the people who care, whether that is a paid role or not.

An old proverb attributed to a variety of African cultures is that it ‘takes a village to raise a child’, and as we’re trying to raise awareness and skill, it follows that providing knowledge, information and support to the ‘whole village’ is important. Members of our community who are children now will be working in our NHS later, and the attitudes and approaches we show them to managing emotional distress and mental health problems now are the way in which they themselves will approach the provision of care in years to come.

As we’re still processing the events of the last two years, this is an opportunity to consider how all of us can be educated, supported, listened to and truly valued for what we have experienced. We all have experience of what we need to feel safe, and this is what will drive service transformation for the best care of our children and young people.

I am inspired by the feedback from our Healthy Teen Minds Young Advisors, Nadia, Kenya and Jo who said: “We are so thrilled to see change in action; it gives us hope that young people in crisis in the future will be safer.” As a representative of the NHS I am aware of my responsibility to our children when they recognise my NHS badge, and that they should always know the person wearing it is someone who has the knowledge, skills and abilities to make them feel safe, supported and listened to.

Footnotes

[1] Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. (2005). Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62 (6) pp. 593-602. doi:10.1001/archpsyc.62.6.593. https://pubmed.ncbi.nlm.nih.gov/15939837/

[2] https://www.england.nhs.uk/statistics/statistical-work-areas/cyped-waiting-times/

HEE is committed to increasing education and training in the children and young people’s mental healthcare (CYP MH) to ensure the workforce has the appropriate knowledge and skills to support early intervention. This is in line with the Long Term Plan priority areas. HEE supports an increase in access to high-quality children and young people’s mental health services, so that by 2023/24 an additional 345,000 children and young people (aged 0-25 years) can access support by NHS-funded mental health services and school-based mental health support teams.

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This Page was last updated on: 10 February 2022