In a typical classroom of 30 children you are likely to find that:
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• 15 children (52%) report having been bullied at some point
• 3 children (11%) are living with limiting long-term conditions
• 8 children (25%) have a parent with mental health problems
• 1 child (2%) is living with two parents with serious mental health problems
• 1 child (2%) is caring for their parents or siblings
• 3 children (10%) have special education needs
• 2 children (7%) are living in homes with domestic violence and abuse
• 1 child (4%) is living in material deprivation and severe low income
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As you can see, some children are affected by more than one vulnerability. Some classrooms may not have any children with these vulnerabilities; other classrooms may have far more. In practice levels of risk are clustered by area and will be higher in areas of greater deprivation. To put this into context, Waltham Forest is the 7th most deprived London borough and the 35th most deprived Local Authority in the country.
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In addition, one in eight children in England have at least one mental health disorder3. That is around four children in every classroom. Many of these children will have developed their mental health disorder because of one or more of the above. Further, many young people do not have a clinical diagnosis yet experience a period of mental ill-health or emotional distress during their childhood or adolescence, with almost one in four showing some evidence of mental ill-health, including anxiety and depression.
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A Freedom of Information (FOI) request by the NSPCC to NHS Trusts in England found that the number of referrals by schools seeking mental health treatment for pupils has risen by over a third in the last 3 years. 56% of referrals came from primary schools and on average 183 referrals were made per school day in 2017/185. The Key, the national information service for school leaders, found that 78% of primary, and 87% of secondary school head teachers were more concerned about their pupils’ mental health than they were two years ago. In addition, they felt 61% of primary children and 65% of secondary pupils were less resilient over that period.
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On average, 21% of referrals to specialist CAMHS in 2017/18 were rejected or deemed inappropriate at the point of referral, as eligibility thresholds are now very high. Many referrals where children are experiencing problems, such as those described above, are routinely turned down. In Waltham Forest all referrals were rejected during eight months in 2018, except for the most severe cases.
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Once children are deemed to meet the threshold for specialist treatment, it may be a long time before treatment starts. The average median waiting time to treatment in 2017-18 was 60 days, with young people in London waiting the longest for treatment. It typically takes ten years for a young person to get any help, from the time they first show the signs of a mental health difficulty to the time they get support. And in those ten years, for many young people problems escalate, accumulate and too often come to a head in a crisis. Once assessed, only one in four children and young people currently receive treatment.
