The state of children and young people’s mental health in 2023

27 November 2023
By Zainab Shafan-Azhar and Nick Treloar

As the cost-of-living crisis continues to shape children and young people’s lives and Covid casts its long shadow over society, the mental health of children and young people is facing unprecedented challenges. Since 2017 NHS Digital have been monitoring young people’s mental health and we have regularly analysed this data to highlight the ongoing urgent need for effective mental health services and support for children and young people.

Where NHS Digital have used the phrase ‘probable mental disorder’, we have chosen to use ‘mental health difficulty’ and referred to ‘those unlikely to have a mental health difficulty’ as ‘those without’.

What does the data tell us?

Overall prevalence rates 

In 2023, around one in every five children and young people aged 8-25 had a mental health difficulty (20.3% of 8-16 year olds and 23.3% of 17-19 year olds). This compares to 18% of 7-16 year olds having a mental health difficulty in 2022, demonstrating a small rise in prevalence.

Poverty

Poverty is indelibly linked to mental health difficulty. These figures demonstrate that 26.8% of children aged 8-16 years old with a mental health difficulty, compared to 10.3% of those without, had a parent who could not afford for their child to take part in extracurricular activities. 

Children aged 6-18 with a mental health difficulty were also more likely to have parents who were unable to afford the right clothes, shoes, and school equipment them (17% vs. 4% without a mental health difficulty) and not have access to transport to take their child where they needed to go (13% vs. 3%).

Living in poverty compounds poor mental health for children and young people and prevents them from accessing the essential activities that all children deserve.

Differences in prevalence by sex

The report showed ongoing similarities and differences between the sexes. The rates of mental health difficulty were similar for all those aged 8-16; however, for 17-25 year olds, rates of mental health difficulty were twice as high for young women than young men.

Given this, it is important that the differential impact of certain issues on young men and women are explored and more gender-informed approaches are utilised.

Bullying and social media

This was the second year that the survey asked about online bullying and social media safety.

Children aged 11-16 years and those aged 17-24 years old with a mental health difficulty were significantly more likely to have been bullied online compared to those without.

Furthermore, 55% of 11-16 year olds with a mental health difficulty felt safe using social media compared with 64% of those without.

This highlights the dangers of online harm and the need to safeguard those with mental health difficulties appropriately.

Education

Children with a mental health difficulty were less likely than those without to feel safe (56% vs 85%), to be themselves (49% vs 84%) and to enjoy learning (35% vs 70%) at school.

Furthermore, 11% of 8-16 year olds with a mental health difficulty had missed more than 15 days of school in one term, compared to 1.5% of those without, demonstrating the links between school attendance issues and mental health.

Eating disorders

Eating disorders are also presenting more frequently in children and young people, with the pressures of modern daily life manifesting in these forms.

In 2023, eating disorders were identified in 2.6% of 11-16 year olds and 12.5% of 17-19 year olds. For those aged 17-19, these rates were four times higher in young women (20.8%) than young men (5.1%).

The role of climate change and the future

Increasingly, children and young people are concerned about their futures, with over half (54.8%) of 17-25 year olds reporting being worried about the impact of climate change.

This is more evidence of the real impact that eco-anxiety is having on children and young people, highlighting an urgent need for climate restoration, including more nature-based and outdoor solutions for children and young people’s mental health.

What needs to change?

While there has not been a significant change in the data from last year’s survey, rates of mental health problems in children and young people remain alarmingly high and the high levels of distress observed since the pandemic have not yet fallen away.

Despite this, the Government has abandoned the ten-year mental health plan and plans to reform the Mental Health Act. Radical change is required by the Government to invest in and prioritise, children and young people’s mental health.

Tackling risk factors

Mental health does not exist in a vacuum, and the data clearly evidences the extent of wider influences on children and young people’s mental health. While the evidence is clear that risk factors such as poverty and inequality have a deeply negative impact on mental health, little action has been taken at a national level to address these and prevention remains a neglected area by the Government. We need action to address the social and economic determinants for poor mental health, alongside investment in powerful public health initiatives for children and young people.

Poverty is toxic to children and young people’s mental health as the data clearly demonstrates. This is significant given that 4.2 million children now live in poverty. Taking steps to eradicate poverty is a crucial action for the Government and this should include a new Child Poverty Act to eradicate child poverty by 2030.

Whole educational approaches to mental health and wellbeing

Educational settings have significant influence on children and young people and are well-placed to support their mental health. The data highlights how often education settings are a source of support for both children and their families. That’s why it’s crucial there is comprehensive mental health support in schools including national roll out of Mental Health Support Teams, and the full implementation of whole education approaches to mental health and wellbeing across all educational settings.

Invest in national roll out of early support hubs

Intervening early provides the opportunity to support children and tackle the root cause of issues, preventing problems developing and avoiding later more costly interventions. However, there is currently patchy provision of early support services across the country and needs do often escalate before support is accessed.

As partners in the Fund the Hubs campaign, Centre for Mental Health and the Children and Young People’s Mental Health Coalition have long been calling for the roll out of early support hubs to increase the availability of early support in every community. These hubs offer easy-to-access, drop-in support on a self-referral basis for young people with emerging mental health needs, up to age 25. The Government’s current investment in early support hubs is welcome, but commitment to a full national roll out in every local area is required.

Strengthen specialist services

The recent King’s Speech abandoned long-held plans to reform the Mental Health Act. This was a missed opportunity to transform the care provided to children and young people in mental health hospitals and to strengthen rights and safeguards. Work to reform the Act must be brought forward at the earliest opportunity. Outside of legislation, work to address the current shortfalls in support must occur and urgent investment is required. However, the tide will only begin to change once we see action to support children and young people’s mental health through greater investment in preventative and protective factors, early support and specialist services.

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