30/11/2017 16:49 GMT

Girls Aged 16-17 Are Among Highest Users Of NHS Mental Health Services - Here's Why

'I thought I wasn’t normal.'

Young women aged 16 and 17 were the most likely to have had an NHS referral for mental health, learning disability or autism services last year out of all young people, and among the highest service users across the population. 

For the first time, NHS Digital’s annual report on these services has included referral statistics for under 18s. 

According to the figures, 11% of girls aged 16-17 in England are known to have had an open referral for NHS secondary mental health, learning disabilities or autism services last year. 

An “open referral” for secondary services is the term used for when a GP refers a patient to an external specialist service for care. If your health is managed by your GP, this is referred to as “primary care”. 

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In total, more than 2.6 million people are known to have had an open referral with mental health, learning disabilities and autism services at some point during the year. Of these, 560,000 of these were under 18 years of age.

While 11% of females aged 16-17 received a referral, the figure dropped to 8% for males of the same age. 

A total of 2% (1,300) of females in this age group were admitted to hospital as part of their referral.  

A spokesperson from the NHS explained figures around mental health, disability and autism referrals are grouped together because a person with a learning difficulty may also receive support from mental health services. In this instance, a single referral may signify contact with either or both services. 

One possible explanation for the significantly higher referrals among 16-17 year old women, could be explained by mental health.

The Mental Health Foundation told HuffPost UK: “These statistics reflect what we might expect to see, knowing the pressures that young women in this age group in particular are under.”

Commenting on the figures, Tom Madders, director of campaigns at the charity YoungMinds, said “we are facing a mental health crisis for children and young people”.

“We know that teenage girls face a huge range of pressures, including school stress, body image, and early sexualisation,” he told HuffPost UK.

“For girls growing up today, there is also the pressure that comes with the 24 hour online world, like creating a personal ‘brand’ from a young age and comparing yourself to a constant feed of ‘perfect’ bodies and lives.” 

Sadly, this is something Sarah* has experience of. She was referred to NHS secondary mental health services at the age of 16, after struggling with her mental health since starting secondary school and self-harming. 

“I felt sad and it spiralled from there. I got bullied in Year 7, they would call me names, commenting on my weight and laughed at me. I was tired all the time and never found the energy to do school clubs or anything,” Sarah, now 17, told HuffPost UK.

“I didn’t feel the need to socialise with people. I didn’t feel good about myself. I thought I wasn’t normal because I worried about all these things that other people weren’t worrying about.

“I started self-harming, because I didn’t feel like I had a way of talking about or a way of releasing my feelings and I wanted to feel something that wasn’t worry and sad.”

Sarah believes social media is the umbrella cause of a lot of the pressure girls her age feel. 

“Everyone has such easy access to seeing other people’s lives. If I look at celebrities, the beauty standards are so high,” she said.

“Although it’s not specifically said that you have to be size 10, it’s very much implied. I get that when I’m looking through social media. I wish I was as skinny as the people I see on Instagram. It spirals from there.” 

Thankfully, Sarah accessed the help she needed via the NHS and now doesn’t feel pressured to hide her feelings from her family. 

She went to see her GP alongside her parents and was referred onto CAHMS - the NHS-provided Child and Adolescent Mental Health Services - as an emergency case.

“In my head it wasn’t a burden [to talk to the therapist] because it was their job, so I could tell them everything I felt, she said. 

“They gave me some copying strategies and how they could work daily.

“Now, I’m a lot more open with my parents and the rest of my family and that’s because I was taught to talk about it with CAHMS. I’m more confident in asking for help if I’m having a hard time and use some self help strategies such as calming myself through relaxing, turning my phone off and music.”

As well as having the highest referral figures among under 18s (11%), young women like Sarah were also among the most regularly referred across the entire population.  

The only higher referral age groups were women above the age of 80, but the NHS report says this is probably explained by the fact that dementia services are counted among these figures. 


Dr Amy Pollard, from the Mental Health Foundation, said she’s not surprised “there is a spike in mental health issues for girls aged 16-17 years”.

“16 and 17 year olds are going through a big transition period – taking exams, thinking about their futures, preparing to go to university or leaving home – and we know that transition periods are often times when our mental health is most vulnerable,” she told HuffPost UK.

“Sixteen is also the average age that girls lose their virginity, and stepping into sexual relationships for the first time (or feeling that you are being left behind) can be very stressful experience.

“It is critical that this overlooked crisis is urgently put at the top of the agenda.”

But Kate Elliott, a 26-year-old from York, pointed out that the high level of young women accessing referrals for mental health services could be a good thing.

She began struggling with her mental health at the age of 15, but didn’t seek support initially. It wasn’t until she was 19 that was diagnosed with anorexia, depression and anxiety. She’s also since been diagnosed with OCD.

“I think the statistics are really encouraging; perhaps representing the increase in awareness and understanding for mental health difficulties,” she told HuffPost UK.

“Compared to when I began to struggle with my mental health, it feels that mental health is much more part of everyday life. There are more prominent celebrities and influential figures who are speaking more openly about their own mental health and I think it’s really helping young females to seek support and understand how they would do so.”

Kate Elliott

She added that when she was a teenager, she was aware that some of her feelings about herself and her body image “weren’t quite right”, but she didn’t know she could seek help for those feelings.

“Mental health is gradually becoming so much less of a taboo subject, particularly with females,” she said, adding that we still have some way to go in normalising mental illness, so that men feel as able to seek support as women.

The Girlguiding Advocate Panel, which is made up of young women aged 14-25, agreed that the high statistics are not necessarily a bad thing.

“It should never be taboo to seek help for a mental health problem, and it’s vital that girls and young women can access the support they deserve,” they told HuffPost UK.

“These numbers may seem high, but with one in four of us experiencing a mental health condition at some point in our lives, it’s positive that many girls and young women feel able to access support.”

They pointed out previous research from Girlguiding found 34% of girls and young women in 2016 said supporting young people with their mental health is the most important way to improve their lives.

“We know that amazing work is being done by so many people to break the mental health stigma. Our own data from our Girls’ Attitudes Survey shows that 65% of girls aged 11-21 say their school, college or university has someone they can speak to about mental health,” they said. 

Despite improvements in awareness, Tom Madders from Young Minds believes more needs to be done to ensure all young people can access the mental health support that they need. 

“It takes a lot of courage for a young person to reach out for help, but too often that help is not available,” he said.

“That’s why there needs to be sufficient funding for mental health services, as well a focus on wellbeing in schools to prevent problems developing, and we hope to see Government commitment to this in the upcoming children and young people’s mental health green paper.”

*named changed to protect anonymity of speaker

Useful websites and helplines:

  • Mind, open Monday to Friday, 9am-6pm on 0300 123 3393
  • Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI - this number is FREE to call and will not appear on your phone bill.)
  • Get Connected is a free advice service for people under 25. Call 0808 808 4994 or email:
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