Preventing mental health problems in children and young people

As part of the Mental Health Foundation’s 70th anniversary, three reports have been commissioned, each looking at a different stage in life and the key things that both challenge and support mental health at these stages. This is the first of these three reports, and focuses on children and young people. It is intended both as a review of the recent evidence, and as a guide to anyone wishing to gain a rapid understanding of a preventative approach to mental health.

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Image source: https://www.mentalhealth.org.uk/

Mental health problems, such as anxiety or depression, can happen at any age. However, childhood and young adulthood represents a particularly important time for development and mental health. By understanding the things that can challenge good mental health, as well as the things that can protect and promote it, we can introduce policies and services that support children and young people to reach their full potential, preventing mental health difficulties from progressing to the point where it becomes difficult to cope.

 

Based on the research and the suggestions of our Youth Advisory Panel, to support good mental health and prevent the development of mental health problems, we should:

  1. Provide resources to parents and caregivers (parenting programmes, education, employment and housing resources) that help them to be consistent sources of support for their children.
  2. Ensure that as part of their education, children are equipped with the skills they need to understand, talk about and manage challenging feelings.
  3. Embed the teaching of skills that support good mental health into the curriculum and into youth work and other young-person focused organisations.
  4. Ensure that effective early support is available for young people’s mental health that considers young people’s views on what makes that support acceptable and accessible.
  5. Enable community leaders to bridge the gap between communities and local government and make sure people have a choice and a voice in deciding what their area needs to support good mental health.

Full detail at Mental Health Foundation

Full report: State of a generation: Preventing mental health problems in children and young people

Paediatric critical care and surgery in children review: Summary report

NHS England | November  2019 | Paediatric critical care and surgery in children review: Summary report

NHS England has summary report of the national review into paediatric critical care and specialised surgery in children, which took place in October 2016. The aims of the review were to ensure that services are sustainable and fit for the future, and to reduce any variation in the care being provided.

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Improving children and young people’s mental health and wellbeing

This report, and associated documents, summarises the evidence for the effectiveness of universal approaches to improving children and young people’s mental health and wellbeing | Public Health England

The documents are intended for strategic and operational leads, working on children and young people’s mental health. This includes:

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Image source: https://assets.publishing.service.gov.uk
  • local commissioners
  • public health teams
  • child and adolescent mental health service (CAMHS) providers
  • clinicians
  • leads in educational settings
  • those leading children and young people’s mental health and wellbeing Local Transformation Plans (LTPs)
  • voluntary, community and social enterprise sector leads and researchers

The report of the findings of a Special Interest Group summarises the approach, findings and recommendations.

Full document: Universal Approaches To Improving Children And Young People’s Mental Health And Wellbeing: Short Descriptions Of Interventions Identified From The Synthesis Of Systematic Reviews

See also: Public Health England – publications

Investigation into pre-school vaccinations

This investigation sets out the system for providing vaccinations to pre-school children in England. It is prompted by public concerns about the levels of uptake of pre‑school vaccinations | National Audit Office

Health professionals consider that vaccinations are a crucial tool in protecting the health of individuals and that of the wider population, particularly for people with existing health problems who are more vulnerable to infectious diseases and for those who cannot receive vaccinations themselves. For vaccinations to be most effective, the World Health Organization (WHO) recommends that enough people need to be vaccinated to stop disease spreading across the population. This is called ‘herd immunity’.

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There are seven types of vaccines (which protect against 13 diseases) routinely provided to children by the National Health Service (NHS) before they go to school aged five. In 2017‑18, the Department of Health & Social Care (the Department) set NHS England a performance standard of 95% uptake for pre-school vaccinations (except flu). There has been a general fall in uptake of pre-school vaccinations in England since 2012-13 and, in many cases, uptake of these vaccinations
is below the Department’s performance standard.

This report sets out:

  • the current levels of vaccination uptake and cases of disease across England
  • Public Health England (PHE)’s and NHS England’s understanding of the problem
  • PHE’s and NHS England’s response to the problem.

The report uses the MMR vaccination, the 4-in-1 booster and the Hib/MenC booster to highlight many of the challenges that exist in the system for pre‑school vaccinations and illustrate in more detail how uptake of vaccinations is falling.

 

 

 

Anorexia in younger children may be increasing

Observational surveillance study (305 incident cases) estimates an annual incidence rate for anorexia nervosa of 13.68 per 1000,000 population. Comparison with earlier estimates suggests that the incidence rate in children 12 years and under has increased over the past 10 years | BMJ Open

Abstract

Objectives This study aimed to estimate the incidence of DSM5 anorexia nervosa in young people in contact with child and adolescent mental health services in the UK and Ireland.

Design Observational, surveillance study, using the Child and Adolescent Psychiatry Surveillance System, involving monthly reporting by child and adolescent psychiatrists between 1st February 2015 and 30th September 2015.

Setting The study was based in the UK and Ireland.

Participants Clinician-reported data on young people aged 8–17 in contact with child and adolescent mental health services for a first episode of anorexia nervosa.

Main outcome measures Annual incidence rates (IRs) estimated as confirmed new cases per 100 000 population at risk.

Results 305 incident cases of anorexia nervosa were reported over the 8-month surveillance period and assessed as eligible for inclusion. The majority were young women (91%), from England (70%) and of white ethnicity (92%). Mean age was 14.6 years (±1.66) and mean percentage of median expected body mass index for age and sex was 83.23% (±10.99%). The overall IR, adjusted for missing data, was estimated to be 13.68 per 100 000 population (95% CI 12.88 to 14.52), with rates of 25.66 (95% CI 24.09 to 27.30) for young women and 2.28 (95% CI 1.84 to 2.79) for young men. Incidence increased steadily with age, peaking at 15 (57.77, 95% CI 50.41 to 65.90) for young women and 16 (5.14, 95% CI 3.20 to 7.83) for young men. Comparison with earlier estimates suggests IRs for children aged 12 and under have increased over the last 10 years.

Conclusion These results provide new estimates of the incidence of anorexia nervosa in young people. Service providers and commissioners should consider evidence to suggest an increase in incidence in younger children.

Full study: Petkova H, Simic M, Nicholls D, et al. | Incidence of anorexia nervosa in young people in the UK and Ireland: a national surveillance study | BMJ Open 2019;9:e027339 |  doi: 10.1136/bmjopen-2018-027339

See also: Number of children with anorexia on the rise, study suggests | The Guardian

Young people’s future health

Young people’s future health inquiry: A healthy foundation for the future | The Health Foundation

The Health Foundation has published A healthy foundation for the future – the final report from the Young people’s future health inquiry.  This two-year project explored the influences affecting the future health of today’s young people, and what needs to change to secure a healthy society.

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Image source: https://www.health.org.uk

The report brings together the inquiry’s findings and explores:

  • whether young people currently have the building blocks for a healthy future, such as good quality work and housing, and supportive relationships
  • what support and opportunities young people need to secure these building blocks
  • the main issues that young people face as they become adults
  • what this means for their future health and what policy action is needed.

The inquiry was structured around a mixture of research and engagement, site visits and policy work, led by the views and experiences of young people around the UK.

Alongside the final report, the Health Foundation worked with nine expert partner organisations who have come together to recommend that young people’s needs are put at the centre of government policy making. Detailed policy reports will be published by the expert organisations from across different sectors, throughout autumn 2019.

Full report: Young people’s future health inquiry: A healthy foundation for the future

Time to solve childhood obesity

Time to solve childhood obesity: an independent report by the Chief Medical Officer | The Department of Health and Social Care

The Chief Medical Officer calls for action across industry and the public sector to help the government reach its target of halving childhood obesity by 2030.  It sets out a range of recommendations for the government, which are supported by 10 principles, and builds on the work the government has already done.

Full report: Time to Solve Childhood Obesity. An Independent Report by the Chief  Medical Officer,  Professor Dame Sally Davies | 2019