Every child matters: equality for mental health provision

Current research presents a stark landscape across the country in light of the pandemic and the impact on mental ill-heath. Children are at disadvantage because of where they live. Equality in outcome and provision is disproportionate and dramatically underfunded.

“The prevalence of mental health difficulties in children and young people has risen significantly over the last 30 years in the UK and, consequently, mental health services aimed at supporting children and young people have also changed. Demographics, family context and socioeconomic factors play a substantial role in whether a child or young person will develop a mental health problem.”¹

This statement highlighted by the Centre for Mental Health – Time for Action report is of no surprise to us but brings into strong focus a crucial and loud shout to the responsibility we have as a society and a nation to challenge the commitments outlined by governments to make the world of mental health provision and outcomes better for all.

Equality for mental health provision North

There is concerning evidence that services for children and young people’s mental health are dramatically underfunded and there has been a quiet but steady reduction in universal and targeted services the fallout in terms of fiscal spend is greatly higher than if there was significant investment at scale.

We have a moral imperative to change this and continue campaigning to embed a strategic national approach to support early intervention within not only the NHS and CAMHS, but schools. Schools are often best placed to offer consistent relationships with trusted adults who, with the right resources and support, can offer early intervention programmes and provision to protect against, and change the long-term trajectory of mental ill-health.

Central to the community, schools and ‘Hubs’ are places where services, professionals, and supported staff can offer a range of provision, signposting and evidence-based programmes to children and families to protect against and buffer adversity and mental ill-health. We need to offer a robust, multi-layered approach from the earliest years throughout education and to explore innovative approaches to equip society with the right to wellbeing and good mental health. This can only be done with sufficient funding and investment.

There is a need for real investment, to ensure equality of mental health provision as well as quality that is equitable at a national, regional and local level as the report highlights:

“A postcode lottery also persists, which is exacerbated by the roll-out of new programmes and initiatives that do not provide nationwide coverage. Some areas receive new resources, others do not.”

Children’s mental health is a vital investment, yet funding has lagged behind and provision of support is highly variable.

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Research into the effects of the pandemic and the impact across UK regions show a stark and clear picture that particularly in the North impact for long term mental health is of serious concern.

A report published by the Royal College of Physicians ‘COVID-19 and the north-south health divide’² highlights regional variations in health inequalities between the North and South, exacerbated by COVID-19, and makes recommendations to tackle regional health inequalities.

“Adverse trends in poverty, education, employment and mental health for children and young people have clearly been exacerbated over the pandemic, particularly in the north.”

Looking at factors that may have contributed to this inequity, the report found austerity measures had disproportionately affected the North – particularly in areas of high deprivation. The report continued:

“A brutal truth emerged: economic and health inequalities between the north of England and the rest of the country are, without significant intervention, likely to worsen for subsequent generations.”

The recent report ‘Child of the North: Building a fairer future after Covid-19³ produced by Northern Health Science Alliance and N8 Research Partnership, written by over 40 leading academics from across the North of England corroborates this, presenting the stark reality of inequality and co-author Kate Pickett Professor of Epidemiology at the University of York wrote:

“Levelling up for the North must be as much about building resilience and opportunities for the Covid generation and for future children as it is about building roads, railways and bridges…. Investment in children creates high returns and benefits for society as a whole.”

Poverty is the lead driver of the inequalities between children in the North and their peers in the South, leading to worse physical and mental health outcomes, educational attainment, and lower lifelong economic productivity.

The report sets out 18 clear recommendations which include:

  • Increase government investment in welfare, health and social care systems that support children’s health, particularly in deprived areas and areas most affected by the COVID-19 pandemic.

  • Tackle the negative impacts of the pandemic in the North through rapid, focussed investment in early years services, such as the Health Improvement Fund. This should include health visiting, family hubs, and children’s centres
  • We must feed our children. Introduce universal free school meals, make the Holiday Activities and Food Programme scheme permanent, and extend it to support all low-income families. Promote the provision of Healthy Start vouchers to all children under five and make current government food standards mandatory in all early years settings.

  • Government should prioritise support to deprived localities by increasing the spending available to schools serving the most disadvantaged pupils in England.

  • Support educational settings to initiate earlier interventions. Teachers and early years professionals see many of the first indicators of children’s risk and vulnerabilities. Prioritising strong pupil and staff relationships and collaboration with parents/carers will ensure a firm foundation for meeting children’s needs, and for a return to learning.

These recommendations are synonymous with the Centre for Mental Health report: Time for Action and provide a pathway forward. It is now more important than ever that we need a comprehensive national approach and investment is made into a mental health system that supports all children from 0 to 25 years old – whatever their postcode.

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