The Prevalence Review, published today, led by Peter Fonagy is an opportunity to shift the dial on the overwhelming mental health crisis faced by children and young people. The interim review told us that mental health difficulties that were once commonly associated with mid-life are now acutely experienced by the very youngest in our society and will impact future generations.
The number of children and young people aged 16-24 with common mental illness rose in prevalence from one in six in 1993 to one in four in 2024. Without adequate support, nearly 40% of the 957,000 of young people are not in education, employment or training is due to mental illness – with a cost to the state over a lifetime around £244,000 per person. It’s clear that without action, we will be failing future generations. We can no longer say the challenge is too complex or there is insufficient evidence, the next step is action.
We welcome the recommendations and the overarching point that diagnosis cannot be the only route to accessing support. It aligns with what the sector has been saying for years; singular routes to accessing support cause long waiting lists and distress to increase. It’s imperative that we move towards open-access mental health support in every community. Every child should have access to early and expert support they need in their school or community, without the need for a referral.
We hope this review can put narratives around overdiagnosis to rest. Today has confirmed that the rise in distress and mental health is real and we can only move forward by recognising the scale of challenge, and that the government’s current response is inadequate to meet it.
The report also highlights the complex relationship between neurodivergent children and young people and mental health problems. Whilst these are separate conditions, among young people with a common mental disorder, 57% also screened positive for ADHD traits, 61% for autistic traits. As such, mental health provision should be adapted to the needs of neurodivergent young people with co-occurring mental health needs.
We also welcome the recognition of the social drivers of mental ill-health, that mental ill-health can be experienced differently across race, household income, gender and other markers. Therefore, this requires concerted government action alongside a workforce that is diverse, flexible and has access to evidence-based training and resources. We want to see concerted government action that allows for this flexibility across the workforce.
On neurodivergence, a great deal of the mental health distress in autistic young people is not intrinsic to being autistic. It is the predictable result of unmet need and environments that were never designed for them, school above all. Any discussion of prevalence that separates ‘mental health’ from ‘neurodivergence’ and then counts them as competing categories will miss that.
We recognise the concerns raised around private providers. However, it is important to note The Coalition’s member Ambitious about Autism’s research with University of Birmingham found that almost a third of families paid for private assessments due to long delays, not being believed by professionals or difficulties navigating the system. This decision is not taken lightly and often involves significant financial sacrifices, but many autistic people and families feel they have no choice.
Overall, the messaging and priorities outlined in this review have given us optimism and confidence that the government now has foundational evidence and framework to embed children and young people’s mental health as a national priority. We expect this review informs the reforms set to be announced in The Milburn Review, The Timms Review and Mental Health Strategy. Next year’s Spending Review is an opportunity to put adequate investment behind these recommendations to ensure adequate preventative services, and support that is universally accessible whilst meeting those with the highest needs.
We look forward to working with the government on actioning the recommendations outlined in this review by the end of this parliament. This review must be a catalyst for decisive, transformative action to tackle this urgent crisis and protect the health and wellbeing of generations to come.
