The mental wellbeing of children has been a subject of concern over recent years, even more so since the start of the Covid-19 pandemic. Between 2017 and 2021, rates of probable mental disorder in childhood rose dramatically; for 6-16 year olds the rise was from one in nine to one in six children (NHS digital 2021). This reinforces the need for sustained efforts to promote good mental wellbeing and reduce inequalities.

Around half of children who will go on to have a mental health difficulty as adults have already begun to experience symptoms by the age of 14. Getting the right help to children early can limit or prevent pain and distress, as well as reducing the need for costly mental health support later in their lives.

However, supporting the mental wellbeing of younger children is often overlooked and under-resourced. Government policies designed to promote and protect mental health are predominantly aimed at older children and young people, missing this important opportunity to prevent problems from starting or escalating.

One response is coming from A Million & Me, a three-year programme funded by BBC Children in Need and evaluated by Centre for Mental Health. The programme identifies and scales mental wellbeing support which is “scaffolded” around children aged 8-13 and their families.

The importance of relationships and good conversation

At the development and design stages many of the projects learned that children highly valued relationships and interaction as ends in themselves. In our evaluation, we saw the projects’ focus shifted from improving adults’ knowledge about mental health, to instead working to enable adults to have helpful conversations with children.

We have found that A Million & Me is facilitating better relationships, driven by these conversations that directly address important mental health concepts. This equips both children and adults with language about mental health and teaches children and adults to respond positively to the whole spectrum of mental health experience.

Several projects developed tools to help in these conversations, such as story content, avatars, carefully curated language and help to value the ‘everyday magic’ of communication and interaction.

“Scaffolding” around children

Enhancing the community’s capacity around each child can help to protect them from worsening mental wellbeing. A Million & Me is helping parents, carers and communities to create emotionally supportive and uplifting environments around children as well as helping adults to react appropriately to children’s mental distress. We are learning about the crucial role positive activities like dance, sport, play, stories and time outdoors have in underpinning good mental health for children.

Growing and developing in partnership

In the evaluation we recorded how A Million & Me projects are proactively recruited by BBC Children in Need and offered substantial levels of support by the funder to codesign a project that fits coherently within the wider programme. We heard that A Million & Me projects valued being given time and space to think, and to listen and learn from the wider programme, enabling them to innovate through every stage of their projects.

Ongoing sharing of successes and challenges at learning events, targeted at emerging themes, have enabled each project to feel part of a learning journey.

Sustaining and scaling projects

A Million & Me seeks to have a legacy well beyond the life of the programme. It aims to make sustained and large-scale changes to the capacity that communities have to support the mental wellbeing of their children.

This is being achieved by:

  • Piloting and exploring new income models
  • Developing digital resources that can be rolled out across the UK
  • Building confidence and skill in the children and young people’s workforce
  • Promoting the learning of the programme through BBC platforms.

Learning from the coronavirus pandemic

With a wide range of ways to reach children, A Million & Me was well placed to adapt to the challenges posed by the coronavirus pandemic. The growing understanding that children’s mental health was vulnerable during lockdowns accelerated some projects and prompted them to act quickly to make digital assets more widely available.

In common with mental health services across the country, A Million & Me projects found that the pandemic highlighted existing inequalities, with families with less digital access disproportionately affected. However, reach to some communities improved. For example, A Million & Me noticed that projects working remotely (via text or website) tended to have better reach to disabled children. This learning about improving access can now be taken into future projects, offering children and their families more choice about how to engage with help.

Inequalities facing children’s mental health

Our evaluation once again highlights that children with the biggest risks to their mental health are often the least well supported with their wellbeing. We began the programme with an understanding of the impact that poverty, marginalisation and disability have on children’s mental health. As the programme has gone on, however, we have also learned more about the needs and risks facing children who live in rural, coastal or island communities, and children with behavioural needs. It is vital that programmes aiming to promote the mental health of 8-13 year olds address these inequalities.

Taking the learning forward

It is clear from our evaluation of A Million & Me that investing in relatable and age-appropriate support and information about mental health for both children and trusted adults will produce significant benefits.

Positive, rewarding relationships can help children to make sense of their own mental health. Everyday conversations about mental health, within these relationships, equip children to learn about their mental health, develop healthy habits, and reach out for help when they need it.

Author: Juliet Snell

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About the author: Juliet Snell

Juliet has worked in the community sector for almost 30 years, with front-line, leadership, policy and research roles in mental health, learning disability, housing, and children and young people’s services. She is a trained group facilitator. She has extensive experience of understanding and evidencing needs and developing policy responses from a foundation of proactive community engagement and sound evidence of what works.