Emotional wellbeing and mental health
Introduction
One in 10 young people have a mental health problem. That’s the equivalent of three in every classroom. CentreForum analysis suggests that there has also been a significant rise in children’s mental health problems over the last five years. However, a national review in 2015 found that whilst three quarters of parents whose children are experiencing mental ill-health seek help, only one quarter receive support. Unmet needs lead to problems multiplying, getting progressively worse which can then escalate into crisis creating a heavy burden on mental health services and significantly reducing outcomes in later life.
Mental health problems are linked to premature mortality and can also be life-limiting. Young people with an emotional disorder are more likely to smoke, drink and use drugs than other children; more likely to have time off school and fall behind in their education; and are more likely to earn less money as adults or to experience unemployment. As well as the personal cost, the estimated long term cost to the economy of mental health problems is £105bn a year.
Despite this significant impact, children and young people face substantial difficulties in getting help. In response to these issues, the government set out clear direction on how to make it easier for children and young people to access high quality mental health care when they need it in its strategy document Future in Mind (April 2015). In Bracknell Forest, there is a focus on addressing children and young people’s emotional and mental health concerns at an early stage so they do not escalate into more serious mental health conditions. More information is set out in the Transformation Plan for Children and Young People in Bracknell Forest which is a separate section on the JSNA website.
Key inequalities and risk factors
For many children and young people, emotional and mental health difficulties are a natural response to difficult life circumstances. Not all children are equally vulnerable to mental health problems. A range of protective factors in the child, the family and in the community (such as experiencing consistent positive support from a trusted adult) influence whether a child or young person will experience problems or be significantly affected by them.
During childhood and early adolscence, poor mental health most commonly presents through behavioural problems (mainly affecting boys). Later on, emotional conditions such as depression and anxiety are more common (mostly affecting young women).
The National Children’s Bureau 2016 report sets out how children and young people’s also have different coping strategies and help-seeking behaviours depending on gender, which is an important learning point for designing support and messages.
However, some groups are more vulnerable to mental issues than others. These include those children who have one or a number of risk factors related to:
- disability (including learning disabilities)
- ethnicity
- sexual orientation
- those in the criminal justice system
- those who misuse substances
- looked after children
Children of a parent with a mental health problem (including young carers) or who live in low-income households and those who experience domestic abuse are also at greater risk of experiencing poor mental health as are teenage mothers.
Facts, figures and trends
Children and young people population
According to Office for National Statistics 2014 mid-year estimates (Stats.Share [Population]), the number of children and young people in Bracknell Forest are:
Between 2012 and 2022, the Office for National Statistics estimates the largest percentage increase in population is to be amongst 10‑14 year olds. In addition, 10‑14 year olds can experience particular emotional pressures associated with the transition between primary and secondary school. This is a significan observation as around 50% of adults with a long-term mental condition will have experienced their first symptoms before the age of 14. Around 75% of mental health problems in adult life (not including dementia) start by the age of 18. Preventive services will need to respond by supporting children and young people at this life stage to build resilience – the capacity to ‘bounce back’ from adversity – and develop good emotional and mental wellbeing behaviours that will support them through to adulthood.
Source: Office for National Statistics
Emotional wellbeing
The Research in Practice report “Understanding Adolescence” (2016) was summarised by a young person and adds a different perspective on what becoming and being an adolescent is like. The blog post reminds professionals that “young people, even troubled ones, have lots of skills that can be improved so they get better chances and better health” and that focussing first on negative behaviours, rather than on their antecedants, can be unhelpful.
The December 2015 WAY report from the 2014 national “What About YOUth” study reported on the health of young people aged 15 years, including their feelings and satisfaction with life. It reported that negative health behaviours in young people, such as smoking, drinking and substance misuse is associated with poor mental health. In addition to bullying, 15 per cent of young people said they were impacted socially or behaviourally or their mental health was affected was impacted by a long-term illness, disability or medical condition with girls being more affected than boys.
According to the Missed Opportunities report (Centre for Mental Health) bullying is significant because it is a major risk factor for poor mental health which has significant negative lifelong effects on mental health as well as on a range of other different areas of adult life. Children who are both bullied and bully others face higher risks of poor outcomes in adult life, including alcohol and drug misuse, offending behaviour, imprisonment and suicide.
The Bracknell Forest survey of children and young people (Children’s Society, 2013) found that while most children in Bracknell Forest aged 8-15 are relatively happy with their lives, around 8% have a low overall wellbeing. This is similar to the national average. It is important to stress, however, that the number of respondents is unknown and so figures may not be an entirely accurate reflection of the true number of young people. Of the young people who responded:
- Average well-being – decreases with age between year 6 and year 11. Children in year 6 scored 16.2 out of 20 (on a life satisfaction score) compared to 13.6 out of 20 in year 11.
- Appearance (responses by age) – Responses to questions from the Good Childhood Index (Children’s Society, 2013) suggest that children from year 5 to year 11 were least satisfied with their appearance. Compared to males, females of all ages seemed particularly dissatisfied with their appearance, with an overall score of 6.5 out of 10 for appearance (0=very unhappy and 10=very happy). The 2016 report indicates the proportion of males unhappy with the way they look has remained stable, it has increased for girls
- Appearance (responses by gender) – Satisfaction with appearance seems to not only be influenced by gender but also by age. 8% of females in year 5 reported being unhappy with their appearance, compared to 5% for males of the same age. By the age of 15, 26% of females reported being unhappy with their appearance, whilst for males this was only 7%.
- Bullying (prevalence) – Children and young people in years 5 to 11 were asked if they had been bullied in the past year (defined as being hit, kicked or pushed, people taking your belongings, being called names or made fun of). Just over half (53%) said they had not been bullied, 23% said they had been bullied.14% answered ‘not sure’ and 10% chose not to answer the question.
- Bullying (by age) – 32% of children in year 6 responded by saying that they had experienced bullying in the last year. This decreased to 16% in year 11.
- Bullying (by gender) – More females appeared to have experienced bullying in the last year than males; 24% compared to 22% respectively. The 2016 Children’s Society report indicated bullying is most likely to take place at school, and emotional bullying – such as name-calling, which girls are more likely to experience – is twice as commonplace as physical bullying, which boys are more likely to experience.
Mental health
A new national Mental Health Services Data Set (MHSDS) dataset is in development. The MHSDS will provide robust and comprehensive data and information about children, young people and adults who are in contact with mental health services. First data collection is due in February 2016. The new data set will be a key tool for commissioners and providers of mental healthcare services to ensure those services meet the needs of the population.
Pre-school children
Good mental health and wellbeing in young children is shaped by a complex interplay of genetics and exposure to risks (e.g. poor maternal mental health, parents with substance misuse problems, negative parenting) and protective factors (e.g. healthy attachment, positive and proactive parenting and good maternal mental health).
The National Child and Maternal Mental Health Network CAMHS Needs Assessment reports that there are relatively little data about prevalence rates for mental health disorders in pre-school age children. A literature review of four studies looking at 1,021 children aged 2 to 5 years inclusive, found that the average prevalence rate of any mental health disorder was 19.6%. Applying this rate to the estimated population in Bracknell Forest gives a figure of 1,335 children aged 2 to 5 years with a mental health disorder.
School-age children
Prevalence estimates for mental health disorders in children aged 5 to 16 years were estimated in the 2004 national survey report. Prevalence varies by age and sex, with boys more likely (11.4%) to have experienced or be experiencing a mental health problem than girls (7.8%). Children aged 11 to 16 years olds are also more likely (11.5%) than 5 to 10 year olds (7.7%) to experience mental health problems.
Using these rates, the table below shows the estimated prevalence of mental health disorder by age group and sex in Bracknell Forest against 2014 mid-year population estimates:
Note that the numbers in the age groups 5-10 years and 11-16 years do not add up to those in the 5-16 year age group as the rates are different within each age group.
Conduct disorders
These prevalence rates of mental health disorders have been further broken down by conduct (e.g. behavioural) , emotional, hyperkinetic (e.g. attention deficit hyperactivity disorder (ADHD)) and less common disorders. Applying these prevalence rates to the 2014 mid-year population estimates, the estimated number of children and young people with mental health disorders in Bracknell Forest is as follows:
Mental health disorders are more common amongst boys and children in secondary school settings. Feedback from school staff is that more support and advice is needed around the complexity of mental health and particularly in managing behaviour resulting from children who have mental health needs. Furthermore, a whole school approach is needed using the the eight principles which also involves parents and young people is essential for helping young people build their resilience.
Neurotic disorders
Singleton et al (2001) estimated prevalence rates for neurotic disorders in young people aged 16 to 19 inclusive living in private households. The number of 16 to 19 year olds estimated to have a neurotic disorder if these prevalence rates were applied to the Office for National Statistics 2014 mid-year population of Bracknell Forest by gender would be as follows:
*Note where prevalence has been used to calculate an estimate of the approximate numbers affected, these estimates have been rounded up to the nearest five.
Children with learning disabilities
The Foundation for People with Learning Disabilities Linking Up report (2005) states that young people with learning disabilities experience the same range of mental health problems as the general population. However, they are far more inclined to develop emotional difficulties such as depression and anxiety. The 2014 Feeling Down report cites prevalence rates for mental health disorders of between 20.1% and 40.9%.
Further information about children with special educational needs (SEN) can be found in our ‘school life’ chapter, however, the Public Health Outcomes Framework (2015) reports:
- the number of Bracknell Forest children in primary, secondary or special schools identified as having a learning disability was 1,043 (5.1% of the school population) which is not statistically different from the 4.97% England average
- the number of children identified as having SEN was 2,830 (13.8% of all school age children in Bracknell Forest) which is significantly lower than the 15.4% England average
- the number of children with a SEN statement in the borough was 500 (2.44% of the school population) which is significantly lower than the 2.80% England average
Children with autism
The National Autistic Society report that more than 7 in 10 children with autism have a co-morbid mental health problem, and that some of these problems are preventable with the right support and improved mental health services.
The number of children with autism known to schools per 1,000 pupils in Bracknell Forest in 2017 is 258 which is similar to the national average.
The Bracknell Forest Health and Wellbeing Board approved (March 2016) the development of an multi-agency evidence-based Autistic Spectrum Disorder strategy to identify a continuum of provision for children and young people in schools and the development of a community resource for other schools in Bracknell Forest and Ascot CCG area, modelling improved in-school support for children and young people pre and post diagnosis.
Lesbian, gay, bisexual and transfender (LGBT) young people
Young LGBT people often experience emotional and mental health problems and often as a result of stigma. Gay and bisexual young men are particularly vulnerable to depression and suicide, compared to heterosexual young men.
Looked after children and care leavers
The Centre for Social Justice (2008) cites evidence that children in care are 4 to 5 times more likely to experience mental health issues than their peers and these issues can be both a cause and effect of other problems such as substance misuse and low level educational attainment.
Many mental health issues arise frequently as a result of mental health issues in the home, abuse, neglect, loss or attachment difficulties prior to coming into care. For those leaving care, mental health problems can persist without sufficient and appropriate support.
Figures from the Public Health Outcomes Framework, 2015 record:
- 105 (37.7 per 10,000) children under the age of 18 were in care in Bracknell Forest (lower than the England rate of 60 per 10,000)
- 60 care leavers under the age of 18 (21.6 per 10,000) similar to the England rate of 26.8 per 10,000 children
The emotional and behavioural health of children in care (aged 4-16) in Bracknell Forest is measured through a strengths and difficulties questionnaire (SDQ) giving rise to a summary figure for each child called the total difficulties score. The score ranges from 0 to 40: a score of 0 to 13 is considered normal, a score of 14 to 16 is considered borderline cause for concern and a score of 17 and over is a cause for concern. Department for Education figures (accessed 19 April 2016) for 2011-2015 are as follows:
Young offenders
The 2012 Young Minds report for the Prison Reform Trust states that 43% of young people aged 10 – 17 in the criminal justice system on community orders have emotional and mental health needs and that the prevalence amongst young people in custody is much higher.
The rate of 10-17 year olds entering the criminal justice system (first reprimand, warning or conviction) per 100,000 population in Bracknell Forest from 2010 is as follows:
More information about the Youth Justice System can be found in our ‘young offenders’ chapter.
Young carers
In addition to the caring role being stressful and anxiety provoking, studies have shown that young carers and young adult carers are at substantial risk of a range of negative outcomes, including poor educational, social, physical and emotional experiences. The mental health of children and adolescents in Great Britain (ONS, 1999) report states young caresrs whose parents have mental health problems are three times more likely than other children to experienc mental health problems themselves.
Prevention, care and support services
See the Mental Healthcare Services page on the JSNA for more information.
Child and Adolescent Mental Health Service (CAMHS) provide a specialist mental health service for children and young people.
The council’s Community Mental Health Team (CMHT) provides a service for individuals, including 16 and 17 year olds who are no longer in full time education, who are suffering from mental illness or severe emotional distress. The CMHT consists of social workers, psychologists, psychiatrists, community psychiatric nurses, occupational therapist, community support workers and administrative staff.
A range of short videos about positive mental health targeted at children and young people are available on the Bracknell Forest YouTube channel:
Costs
Only 0.7 per cent of NHS funding is spent on young people’s mental health, and only 16 per cent of this funding is on early intervention. An independent review of Children and Adolescent Mental Health Services (CAMHS) (NHS England, 2014), indicated that many children and young people with mental health and emotional difficulties do not receive timely, high quality, accessible or evidence-based support.
Want to know more?
Adult Social Care Market Position Statement 2015 – expectations in quality commissioning based on national priorities and local feedback for potential providers of services to adults and young people moving from children’s to adult social care.
Best start in life: promoting good emotional wellbeing and mental health for children and young people (Local Government Association, 2016) – examples of councils that are looking at innovative ways to provide support with a focus on children and families rather than static services, as well as more information about the scale of the problem and what steps can be taken.
Bracknell Forest Child and Maternal Health Profiles (Public Health England) – an topline aggregate of health and wellbeing indicators for children and young people.
Building children and young people’s resilience in schools (Public Health England, 2014) – a summary of evidence about the effect of resilience on health, the unequal distribution of resilience and its contribution to levels of health inequalities. The review outlines the potential actions that can be taken in schools in order to build resilience in children aged five to 18, in primary and secondary school settings, family homes and communities.
Children and Young People’s Emotional and Mental Wellbeing Strategy 2015-2018 (Draft)
The connections between young people’s mental health and sport participation: Scoping the evidence (Association for Young People’s Health, 2016) – A literature review concluding that the use of sport and organised activity to promote better mental health for young people is recommended. This review forms part of a larger programme of research undertaken by Sport England.
Counselling in schools: a blueprint for the future; departmental advice for school leaders and counsellors (Department for Education, 2015updated 2016) – Guidance for schools about setting up and improving counselling services for pupils.
Creating Opportunities 2014-17 (Bracknell Forest Partnership, 2014) – identifies key priorities for improvement, in particular mental as well as physical health and wellbeing, safeguarding, outcomes for vulnerable children through a whole family, multi agency approach.
Foundation for People with Learning Disabilities Linking Up report (2005) – guidance on identifying and support young people with learning disabilities.
Gender and children and young people’s emotional and mental health: manifestations and responses A rapid review of the evidence (National Children’s Bureau, 2016) – sets out how gender impacts on mental health coping strategies and help-seeking behaviours, including children and young people who identify as trans or non-binary.
Local Action on Health Inequalities: Building Children and Young People’s Reslience in Schools (Public Health England, 2014) – a summary of evidence about the role of schools in building the capacity of children and young people to bounce back from adversity and reduce the risk factors that increase vulnerability.
Making Mental Health Services More Effective and Accessible (Department of Health, 2013) – the national policy direction includes reviewing health visiting and school nursing services, checking that staff have the right training to identify and help parents, children and young people with mental health problems.
MindEd – an emotional health and wellbeing programme has started in primary and secondary schools in Bracknell Forest around topics such as e-safety, self-esteem, personal skills, digital risks such as cyberbullying, pornography and radicalisation.
The mental health of children and adolescents in Great Britain (ONS, 1999) – sets out the prevalence of three main categories of mental disorder: conduct disorders, emotional disorders and hypekinetic disorders to determine the impact or burden of children’s mental health on children and young people and others and how health, social, educational and voluntary services among children with mental disorders might respond.
Missed Opportunities: A review of recent evidence into children and young people’s mental health (Centre for Mental Health, 2016) – A comprehensive overview of mental health set out by age group 0-4, 5-10,11-15 and 16-25, the report highlights an average delay of a decade in children receiving help and what interventions might be considered to help prevent problems multiplying and getting progressively worse, eventually escalating into a crisis in adulthood.
No Health Without Mental Health: A cross-Government mental health outcomes strategy for people of all ages (2011) – putting mental health outcomes on a par with physical health outcomes in assessments of the quality of the NHS.
Promoting children and young people’s emotional health and wellbeing: a whole school and college approach (Public Health England, 2015) – for educators and others working children and young people, this document sets out evidence and practitioner feedback about what works, and if applied consistently and comprehensively will contribute towards helping protect and promote student emotional health and wellbeing.
Supporting public health; children, young people and families (PHE, updated 2016) – guidance to support local authorities and providers in the commissioning and delivery of services across the highest impact health and wellbeing outcomes for children and young people through the 0-19 healthy child programme.
The Eight Principles (Public Health England, 2015) – guidance for schools and colleges to promote emotional health and wellbeing in schools and colleges (curriculum teaching and learning; enabling the student voice; staff development; identifying need and monitoring impact of interventions; working with parents and carers; targeted support and referral and an ethos and environment that promotes respect and values diversity).
The Good Childhood Report 2016 (Children’s Society 2015) – the fifth in a series of annual reports published by The Children’s Society about how children in the UK feel about their lives. This report shows a growing gap in happiness between girls and boys, with girls being particularly unhappy with their appearance.
Young Minds – the national charity provides details on a range of mental health and behaviour concerns, symptoms and causes in children and young people aged 0 – 25 years, as well as a Helpline for parents who wish to talk in confidence to someone about their concerns.
This page was created on 27 February 2014 and updated on 27 September 2016. Next review date September 2016.
Cite this page:
Bracknell Forest Council. (2016). JSNA – Children and Young People’s Emotional Wellbeing. Available at: http://jsna.bracknell-forest.gov.uk/developing-well/children-and-young-peoples-wellbeing/emotional-wellbeing-and-mental-health (Accessed: dd Mmmm yyyy)
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