There is a mental health crisis developing among our children and young people.
Last month, the Prime Minister announced new measures to support children's mental health, noting that "mental illness too often starts in childhood and ... when left untreated, it can blight lives, and become entrenched".
As a child and adolescent psychiatrist on an inpatient psychiatric unit for children and young people, I work with pupils and teachers to prevent just that. Schools are key to children's mental health but currently health and education are too disconnected - often leaving young people without support.
In our health services and classrooms, poor mental health is on the increase. Instances of children going to A&E with mental health problems have almost doubled since 2012. 79% of schools have seen an increase in self-harm. The NHS and schools are struggling to support the rising numbers of children with mental health difficulties. Despite one in ten children having a mental health condition, only 0.7% of the NHS budget is spent on child and adolescent mental health services (CAMHS). These services turn away more than a quarter of children referred, often because of a lack of capacity.
Meanwhile, cuts to schools' budgets have led to reduced mental health support in some schools. 64% of schools don't have a counsellor, in three quarters of cases due to financial constraints. Schools are the most commonly contacted service about mental health, yet teachers I meet often feel concerned and ill-equipped to support children with mental health difficulties. Awareness weeks such as the current Children's Mental Health Week (6th - 12th February) go some way towards encouraging discussions in classrooms across the country, but so much more has to be done to make those conversations more prevalent.
The Prime Minister has promised trials to better link schools and CAMHS to support pupil wellbeing and provide help before a child reaches crisis point. The most important goal is supporting children and young people with mental health problems, but improved relationships will mutually benefit teachers and mental health professionals who sometimes struggle to direct children through poorly connected services. Schools can better support pupils when they know what CAMHS can provide - especially when a pupil doesn't meet CAMHS referral criteria and needs to be signposted to other sources of support.
The RCPsych works with young advisors who have experienced mental health difficulties. Their experiences highlight confusion and frustration at the lack of information shared between CAMHS and their school. On my ward, as inpatients prepare to return to the classroom, we encourage teachers to attend review meetings prior to discharge wherever possible so there is a good understanding between our service and the home school. We understand teachers are very busy, so if this is not possible we ensure communications in other ways such as telephone or email. Returning to school after a long period of mental health absence is daunting for young people. We need a more holistic approach where teachers see supporting pupil mental health as being equally important as teaching literacy or numeracy. Coming from the Government, this message would empower Headteachers to make this an important part of their remit in schools.
Teachers have a wealth of experience of working with and supporting children. Their ability to provide a trusted, thoughtful listening ear should never be underestimated. There are multiple pressures on teachers' time, but their skills are invaluable in supporting children - especially children with mental health problems. Mental health first aid shows the Prime Minister's recognition that schools need more help addressing mental health issues - but this is far from 'case solved'.
These announcements represent progress but given the scale of the problem it's essential that her pledge to "transform the way we deal with mental health problems... in our classrooms" is fully realised. When the Prime Minister says "parity means just that: parity", we need a clear outline of how this will be achieved for our children and young people, with well-qualified independent counsellors in every school and better links between CAMHS and schools.