Striking increase in mental health conditions in children and young people

The proportion of children and young people saying they have a mental health condition has grown six fold in England over two decades and has increased significantly across the whole of Britain in recent years, new research reveals.

In 1995, just 0.8% of 4-24 year olds in England reported a long-standing mental health condition. By 2014 this had increased to 4.8%. Looking across England, Scotland and Wales using data between 2008 and 2014, reports of a mental health condition in England and Scotland, and reports of treatment for one in Wales, grew by 60%, 75% and 41% respectively.

That’s according to the first national-level study in over a decade to investigate trends in mental health problems in children and young people in the UK. Published today in the Psychological Medicine journal, the study is a collaboration between academics at University College London, Imperial College London, Exeter University and the Nuffield Trust. Researchers analysed data from 140,830 participants aged between 4 and 24 years, in 36 national surveys in England, Scotland and Wales over time.

Professor Tamsin Ford, of the University of Exeter Medical School, who was involved in the research, said: “This huge increase in child mental health problems reported over two decades is very concerning. We need to understand how much of this increase is down to a rise in the number of cases, and how much is the result of greater awareness and less stigma, meaning people are more willing to report it and seek help. Both have a part to play, and more awareness could be a good thing as it would mean young people are less likely to experience problems later in life. We have effective treatments including cognitive behavioural therapy and family therapy – we need to get much better at getting them to the young people who need them, as we know that many do not receive the support they need.”

The researchers analysed responses to questions asking children and young people (or parents for the 4-12 year age group) for a yes/no answer on whether they had any ‘long-standing mental health condition’ (any ‘currently treated mental health problem’ in Wales) and compared this to general long-standing health conditions (both physical and mental). They also looked at questions where responses indicated emotional or psychological distress.

In an accompanying blog on the Nuffield Trust website, research lead Dr Dougal Hargreaves says these findings could point to a widening gap between the mental health needs of children and young people and the services available. However, he also argues that the increase in prevalence tracked in this study suggests a greater willingness among children and young people to open up about mental health issues and a better awareness of mental health.

Key findings include:

Between 1995 and 2014 the proportion of children and young people aged 4-24 in England reporting a long-standing mental health condition increased six fold, meaning that by 2014 almost one in twenty children and young people in England reported having a mental health condition.

In 2008, when comparable data from the other two countries was available, 3% of 4-24 year olds in England and 3.7% in Scotland said they had a long-standing mental health condition, with 2.9% of 4-24 year olds in Wales saying they had received treatment. By 2014 these figures had grown to 4.8% in England, 6.5% in Scotland and 4.1% in Wales.

The age group with the biggest increases were young people aged 16-24, with young people in England almost 10 times more likely to report a long-standing mental health condition in 2014 than in 1995 (0.6 vs. 5.9%).

Young boys aged 4-12 were consistently more likely to report a long-standing mental health condition than young girls. This was true across all countries. There was less of a consistent gender pattern in the 12-15 and 16-24 age groups.

Over the corresponding time period, the prevalence of total long standing conditions (both physical and mental) decreased slightly in England (20.3 to 19.5%,), increased slightly in Scotland (17.6% to 22.0%) and was broadly unchanged in Wales (13.1% vs. 13.5%).

Long-term trends in reported symptoms of mental health problems (as opposed to reports of a long-standing condition) showed no consistent evidence of an increase in emotional distress. However, the most recent evidence (from 2011-2014) showed concerning early signs of worsening emotional or psychological distress among young adults. For example, the odds of reporting above-threshold symptoms of emotional distress increased by 15% per year among young adults in Scotland.

Commenting on the findings, Dr Dougal Hargreaves of Imperial College London and a Visiting Research Analyst at the Nuffield Trust said:

“We know that there is already a growing crisis in the availability of Child and Adolescent Mental Health Services, with many more children and young people needing treatment than there are services to provide it. Our study suggests that this need is likely to continue to grow in future. Without more radical action to improve access to and funding for CAMHS services, as well as a wider strategy to promote positive mental health and wellbeing, we may be letting down some of the most vulnerable in society.

“But it’s not all bad news. The increase in reports of long-standing mental health conditions may also mean that children and young people are more willing to open up about their mental health, suggesting that we have made some progress in reducing the stigma associated with mental ill health.”