Children and young people seen by NHS Child and Adolescent Mental Health Services (CAMHS) often experience challenging circumstances in their lives that are directly harmful or can contribute to risks for themselves or others.
Yet until now there has been little understanding of the volume and nature of these adverse experiences as assessed by CAMHS professionals, including how they relate to one another. These adverse experiences may be linked to their mental health need or independent of it.
Exploratory analysis, part of the Living Assessments collaboration between the National Children’s Bureau (NCB) and the University of Cambridge, showed that many of the children and young people assessed by CAMHS professionals had experience of emotional abuse, violence towards others, destructive behaviour and not attending school.
The study has examined data from over 20,000 initial assessments of children and young people carried out by a London mental health service and provides unprecedented detail on the nature, volume and connection between the adverse experiences of young people.
"Our new epidemiological study provides fresh insights about the different types of risks commonly identified in young people's mental health services,” said Barry Coughlan, British Academy Postdoctoral Research Fellow, Department of Public Health and Primary Care at the University of Cambridge. “This approach may facilitate a better understanding of service provision for underserved groups and has the potential to allow for more targeted support."
Last month NCB published analysis of more than 71,000 children’s health and social care records as part of a groundbreaking new research project that showed that despite vulnerable children with social care involvement often suffering higher levels of mental illness, they are often refused access to CAMHS because their lives are considered too unstable.
Around 15-20% of the young people assessed by CAMHS in this latest Living Assessments study were at some point identified as having received protective interventions from children’s services, which indicates that social care experienced young people represent a significant portion of the population assessed by CAMHS.
Together, the findings suggest a dedicated pathway for children with social work involvement to access CAMHS would be a real step forward for a group of children who desperately need more help.
Many of the young people in this study were assessed by CAMHS professionals as being at high risk of not attending school or being excluded from school. This highlights the need to embed wellbeing and mental health provision within the school environment. As proposed by the Children’s Wellbeing Bill, requiring local authorities to maintain “Children Not in School” registers may prevent school absences from going unnoticed.
NCB hopes that the insights that this study provides, alongside increased funding for children’s social care and CAMHS, will enable more children and young people to access the support they need to thrive.
This research analysis is part of the Living Assessments programme funded by the Wellcome Trust and is the product of a collaboration between eight universities (University of Cambridge, University of Kent, King’s College London, Kingston University, Loughborough University, University of Bath, University of Huddersfield and University of Central Lancashire), in conjunction with the Care Leavers Association and NCB.
Three groups of Experts-By-Experience (EbyE), facilitated by NCB, were consulted on the initial interpretations of the findings.
As a parent of disabled children and an expert by experience for the programme, I’m pleased this research identifies the range of risk factors a family may face, and the difficulties in accessing support. It highlights the need to update safeguarding guidance on help for families where children are at risk from behaviours due to a disability or mental health condition (by either themselves or a sibling). More recognition and understanding are needed on managing risks where a child may be 'beyond parental control' as set out in the Children Act 1989. All too often there is a focus on parental blame, rather than the urgent need for help.
A member of the Living Assessments Parents of Disabled Young People’s Experts-by-Experience group facilitated by NCB
This research has shown that parental mental health could, alongside other factors, contribute to poor mental health in children. It goes to show how important supporting the mental health of parents is, to reduce generational trauma and improve outcomes for all children.
A member of the Living Assessments Disabled Young People’s Experts-by-Experience group facilitated by NCB
For further depth and detail on this study, read this journal article in The Association for Child and Adolescent Mental Health.