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Government, NHS, schools and local authorities should do more to support children with persistent behavioural problems

7 November 2018

One child in every twelve in the UK risks having behavioural problems from a young age into their teenage years, putting them at risk of a lifetime of disadvantage and poor health, according to a major new study published today by Centre for Mental Health and University College London Institute of Education.

Children of the millennium is the report of an analysis of the Millennium Cohort Study, which follows the lives of a large sample of children born in 2000 and 2001, funded by the Economic and Social Research Council.

The report finds that 8% of children have severe behavioural problems throughout childhood and early adolescence. The same proportion also have multiple mental health difficulties such as emotional difficulties and hyperactivity which also persist over time. Children with persistent problems are much more likely to have a multitude of risks early in life, including poverty and housing insecurity, parental mental illness and developmental delay. These risks are linked to behavioural problems early in life but are also faced by children with behavioural problems that start later.

Report lead author Dr Leslie Gutman, now at the University College London Centre for Behaviour Change, said: “Our findings confirm that there are diverse pathways leading into and out of childhood conduct problems. The emergence of these behaviours can be seen in children as early as 2 years old. Early risk factors are present no matter whether onset occurs in childhood or adolescence, highlighting the potential for early intervention. Although not shown to be a causal link, most prominent is the association of high levels of conduct problems with maternal smoking in pregnancy. Children with conduct problems also tend to have higher levels of other childhood difficulties, indicating that these behaviours are rarely isolated. This suggests that intervention strategies should take a more systemic view, targeting not only the behaviours themselves, but also children’s internalising problems as well as relationships with parents and peers.”

Children of the millennium calls for concerted action across government to reduce the risk of severe and persistent behavioural problems. It says the Government should seek to reduce child poverty and housing insecurity, the NHS should continue to boost mental health support to parents, and local authorities should get the funding they need to boost early years services such as Sure Start and to offer evidence-based parenting programmes to families with the greatest needs.

No other common childhood condition is associated with such far-reaching and pervasive consequences.

The report also calls for action to support the two children in every classroom who have persistent behavioural problems. The Government should invest in classroom-based programmes to boost healthy behaviour and wellbeing, and the NHS should ensure that the new ‘mental health support teams’ in schools prioritise children with the most serious behavioural problems.

Report co-author Lorraine Khan said: “We have known for some time that children with severe behavioural problems have some of the poorest life chances of all. No other common childhood condition is associated with such far-reaching and pervasive consequences. Our research now shows that persistent behavioural problems are closely associated with a wide range of risks that begin early in life.

Nowhere is there a more compelling case for cross-government action to prevent poor health than in supporting the families of children with the biggest risks for severe and persistent behavioural problems.

“Earlier this week, the Secretary of State for Health and Social Care talked about the importance of prevention. Nowhere is there a more compelling case for cross-government action to prevent poor health than in supporting the families of children with the biggest risks for severe and persistent behavioural problems. Preventing conduct disorder could reduce the prevalence of mental illness among adults by between a quarter and a half according to one study.

“It is time to take behavioural problems as seriously as other mental and physical health issues. They have been overlooked for too long despite their importance to a child’s future. We must take action now to support families facing multiple disadvantages, and we need to do more for children who are struggling because of behavioural problems to have a better future.”

It is time to take behavioural problems as seriously as other mental and physical health issues. They have been overlooked for too long

Download the report for free here

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