Is children’s mental health being sufficiently supported by the government? Charlotte Foster, IF student volunteer, investigates as part of Children’s Mental Health Week.
It’s Children’s Mental Health Week
Children’s Mental Health Week is an awareness week which runs from 6–12 February 2023. The lack of government funding for children and young people has been a long-running concern for those advocating on behalf of the young and those calling for greater intergenerational fairness in government spending decisions. So, are government policies changing to better support children and young adults suffering from mental health disorders?
As part of recent 2022 policy reforms, the government amended the 1983 Mental Health Act. While the proposed changes are welcome and generally a step in the right direction in terms of improving the access to urgent mental health care there is concern that too little has been done to address the needs of children under the age of 18, before urgent medical intervention is required. Often it seems that government policy continues to be reactive rather than preventative.
A growing number of young people are battling mental health
Approximately half of all mental health disorders start at the age of 14. In 2019/20 hospitals admitted 508 children as a result of self-harm. Early intervention is vital to avoid such high levels of emergency care. Unless treated mental health disorders can lead to profound and adverse effects on younger people later in life, costing careers, and increasing the cost of out-of-work welfare suppport which ultimately falls on the taxpayer to fund. As IF has outlined in the past, early intervention makes fiscal, moral and societal sense. Yet, the government still significantly underfunds this aspect of health care by, for example, limiting access to free therapy which has led to extensive waiting lists and insufficient resources. Even in cases where children are referred to specialist children’s mental health services, at least 26% were rejected (2018/19). Children and young adults diagnosed with mental health disorders are still not receiving sufficient support until emergency medical intervention is required.
The 1983 Mental Health Act
The Mental Health Act 1983 allows for those considered to have a mental health concern to be sectioned without consent and treated against their will. While people detained under the Mental Health Act have the right to appeal, it is often a long, arduous and uncertain process.
The current government reforms to the Act aim to improve not only the transparency and accountability of the clinical decision-making process but also to give patients more opportunity to appeal against detention. One of the ways patients will gain more autonomy over their detention is by being allowed to choose a “nominated person” who may be more supportive than an assigned “nearest relative”.
Many of the proposed amendments are a step in the right direction. However, there is little clarity or acknowledgment of how these changes will apply to children under the age of 18. In the case of the “Nominated Persons” amendment the Children & Young People’s Mental Health Coalition argues that the Bill fails to address the process of what happens when there are complications. For example, if a young person nominates someone who is a security risk should that child instead be placed under the care of the local authority?
Knowing their rights
Most children understandably do not know their mental health rights, let alone their rights when it comes to detention. While there is little data on the number of under–18s who are detained, what data there is tells us that most children have been: informally detain; have been placed in “out of area” wards, far from family; placed in adult wards; and/or “sanctioned” for “breaking rules” they may not understand.
How the government can save money through preventative measures
The government pledged to increase spending to £500 million in 2021, with eligible local authorities able to receive £500,000 “to fund: prevention activities like debt advice; carers support; outreach to people facing loneliness and isolation; youth projects; and community groups for those most affected by Covid-19 including minority ethnic communities”.
The government has gone some way to addressing the “cliff edge” that young people find themselves on when turning 18 years of age. With a further £13 millions of funding announced for mental health services for young adults aged 18 to 25, with supportive tailored health services to “reduce the likelihood of needing hospital treatment in the future”.
Earlier intervention makes fiscal sense
While more government funding is welcome, further earlier intervention can reduce the fiscal cost in decades to come. IF’s “Costing Young Minds” research report investigated the fiscal cost of a lack of spending on earlier intervention in depression and found that each person diagnosed with depression costs the government £37,770 because of the loss of tax revenues, increased health service use and excess mortality between the ages of 16 to 40 years-old. Applying this to a birth cohort could mean a fiscal cost of £2.9 billion between the ages 16 to 40 for each birth cohort. Instead, IF argues, the government could fund 35 ten-session courses of cognitive behavioural therapy (CBT) for every depressed person using the amount of money it is losing in net tax contributions.
Sometimes it makes sense to spend more in the here and now.
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