Ministers accused of neglecting ‘tidal wave’ of child mental ill health in England

Ministers have been accused of failing to grasp the “tidal wave” of mental ill health blighting children’s lives, after research found that only a quarter of English primaries will be able to offer vital school-based support by the end of next year.

With almost one in five pupils aged seven to 16 now thought to have a mental health disorder, specialist support teams were set up to work with children in schools, addressing early symptoms and reducing pressure on overstretched NHS services.

According to new figures shared exclusively with the Guardian, however, pupils in almost three-quarters (73.4%) of primary schools in England will have had no access to the new mental health support teams (MHSTs) by the end of 2024.

Older pupils fare slightly better, with MHSTs expected to be in place in about half (53.5%) of secondary schools by the end of 2024, according to figures obtained by the Liberal Democrats. The government is yet to confirm future funding plans.

The research follows reports that a quarter of a million children in the UK with mental health problems have been denied help by the NHS, with some trusts failing to offer treatment to 60% of those referred by GPs.

The former children’s commissioner for England Anne Longfield said: “These shocking figures show the scale of the crisis in unmet mental health need that our children are now facing.

“Poor mental health, self-harm and in some cases suicide attempts have become part and parcel of growing up for many children, yet children’s mental health services are unable to meet the overwhelming demand.”

MHSTs were widely welcomed when first announced by the government in 2018, promising early intervention in a school-based setting for children aged five to 18 with mild to moderate mental health problems, before they develop into a crisis.

School leaders say the MHSTS are having a positive effect, but the rollout has not gone fast enough or far enough, leaving tens of thousands of children without adequate support either in school or from child and adolescent mental health services (CAMHS).

There are also concerns that the teams are struggling to meet the needs of children with more complex conditions, who do not reach the high threshold set for a CAMHS referral but need more support than MHSTs can offer.

The Lib Dems sent freedom of information requests to every NHS integrated care board (ICB) in England, asking for details about MHSTs already operating in their area, or due to be operational by the end of 2024. Thirty-one of the 42 ICBs responded with data.

The responses revealed “a huge postcode lottery” in the rollout and wide geographical variation in spending per pupil on MHSTs, ranging from £87 in the area covered by NHS Surrey Heartlands ICB, down to £24 in North East and North Cumbria ICB and £34 in Hertfordshire and West Essex.

The Liberal Democrats’ education spokesperson, Munira Wilson, said: “The government is letting down our children and young people. Our children’s mental health services were in crisis before the pandemic, but Conservative ministers have failed completely to grasp the scale of the tidal wave in mental ill health that has emerged since.

“Under the Tories, a school that sees an NHS mental health professional for a day a week is one of the lucky ones. Meanwhile, tens of thousands of children are left waiting to see if mental health support will be rolled out at their school or sacrificed to pay for the government’s economic incompetence. Yet failing to roll out the programme will simply make waiting times for acute CAMHS even worse.”

In some areas, the Lib Dem data shows, MHSTs do not cover secondary schools at all. Data for Cornwall and the Isles of Scilly show that the MHSTs cover only primary schools, with a remit to prioritise pupils “in reception year and [in] the transition into year 7”, but even then only 47% of primary schools in the area are covered.

Surrey Heartlands ICB, which covers most of the county, operates MHSTs in four out of 10 secondary schools but in fewer than one in 10 primaries. Four more MHSTs are due to become operational by the end of next year.

The Lib Dems say Buckinghamshire, Oxfordshire and West Berkshire ICB have seen the slowest rollouts, with existing or planned teams covering just one in five secondary schools and one in 10 primaries.

According to the government, the rollout of MHSTs is ahead of schedule, and it has promised to increase the number from nearly 400 in April 2023, covering 35% of pupils and learners in England, to more than 500 covering about 44% by the same time next year.

Barnardo’s, which delivers 12 MHSTs across England, launched a petition earlier this year calling on the government to roll out MHSTs to cover every school and college throughout England. The charity’s senior policy adviser, Becky Rice, said: “Children of all ages across both primary and secondary schools are struggling with their mental health – it’s not just something which is impacting those in their teenage years.

“We need to ensure children of all ages struggling with issues such as low mood, anxiety or emotional regulation get the help and support to manage so they are able to happily progress through the rest of their childhood years without reaching crisis point.”

Schools are dealing with growing numbers of children with special educational needs. Government data published on Thursday showed that the number of children with education, health and care plans in 2023 rose to 517,000, 9% more than last year.

Margaret Mulholland, a special needs and inclusion specialist at the Association of School and College Leaders, said: “There is a growing mental health crisis among children and young people. MHSTs can have a really positive impact in tackling this, but not all schools are currently able to access these services. The scheme must be rolled out to all parts of the country as soon as possible to ensure all children and young people are able to benefit from it.”

A government spokesperson said: “These teams represent just one of the ways we are supporting schoolchildren’s mental health, and come on top of our annual £2.3bn investment into mental health services. This means an additional 345,000 children and young people will be able to access the NHS-funded mental health support they need.”

‘It is an ongoing challenge’

Hannah Savory works for Barnardo’s mental health support teams in schools across Swindon

“It’s a challenging, diverse and rewarding role, but an increasing number of children need support. The first quarter of this year’s referrals are up by 185% compared with 2021. I see the positive difference mental health support teams are making and I just wish there were more teams like us throughout the country to meet the level of need.

“My day starts with a session with a 14-year-old boy. When I first met him, he was feeling very low – withdrawing from school, hobbies and friends. We have spent our sessions together building up his motivation and reintroducing activities back into his routine that will support his mental health. As he’s talking to me, it’s the first time I’ve seen the light come back on in his eyes. He describes a time with his friends and the joy it made him feel. This moment makes me so grateful for the role I have with Barnardo’s – without these sessions, he wouldn’t be in the good place he is now.

“My next session is with a girl in year 11 experiencing anxiety. Her GCSEs have started, and she tells me her panic attacks have increased. She says she doesn’t feel “good enough”, which is something that unfortunately a lot of young people can relate to. We use the session to challenge these thoughts and practise mindfulness exercises, so she can go into her exams feeling calmer and more confident. When our sessions end, I know she is someone who would benefit from further specialist counselling for low self-esteem. Barnardo’s is calling for an MHST+ model which will include a school counsellor to help children with more specific needs, which would be a dream to have for children like her.

“My role includes working closely with teachers, so, in the afternoon, I am training staff on how they can support students’ mental health. As a mental health professional, I can help school staff to offer more effective support to promote the wellbeing of their students. They tell me the session leaves them with a better understanding of mental health and some good practical strategies. We all agree that children’s academic success must be built on a strong sense of wellbeing.

“My day finishes with a meeting to discuss waiting list management. Our service has seen a huge increase in demand and it is an ongoing challenge for me and the team to make sure children and young people get help in a timely manner.”