Child and Adolescent Mental Health in the UK: Prevalence, risk factors, interventions and recommendations.

Background:

‘There can be no health without mental health’ (WHO, 2004). This statement highlights the increasing emphasis placed on psychiatric disorders and mental ill health as a global public heath concern.
In the UK it is estimated that over 1,000,000 young people suffer from some form of mental illness (Meltzer et al., 2003). Ensuring access to high quality and well coordinated treatment for these young people is a priority as set out in The National Service Framework (NSF; Box 1). To ensure this standard is achieved the NSF encourages multi-agency collaboration and evidence based practice in Children and Adolescent Mental Health Services (CAMHS).

‘All children and young people, from birth to their eighteenth birthday, who have mental health problems and disorders have access to timely, integrated, high quality, multi-disciplinary mental health services to ensure effective assessments, treatment and support, for them and their families.’
Standard 9, NSF for Children Young People and Maternity Services (DHh, 2004). 

Purpose

The purpose of this document is to provide an overview of the existing literature relevant to CAMHS in the UK. Prevalence data on common mental health problems in young people is provided followed by a discussion of specific risk factors for developing mental health problems. The role of other factors such as learning difficulties, ethnicity and other social factors is considered in a section on vulnerable groups. Finally a brief summary of current policy documents and national guidelines from the National Institute for Clinical Excellence (NICE) are described.

Summary Conclusions

This document has provided information related to the mental health of children and young people in the UK. Similar prevalence rates across the ONS surveys between 1999 and 2007. These studies provide good data on the various risk factors which can influence the likelihood of mental ill health in children and young people. It seems apparent that an earlier on-set is associated with a less favourable trajectory from childhood to adolescence. Furthermore a number of studies highlight the impact of a diagnosis in childhood/adolescence on future adult service use.

The National Institute of Clinical Excellence provide a series of recommendations for the treatment of mental health problems in young people. In general these focus on the role of psychological therapies and the inclusion of families in the therapeutic process. A very limited number of pharmacological treatments have received endorsements from NICE for use in children and adolescents.

Together with the good practice guidelines from NICE the Government has attempted to improve service delivery, and service user’s experiences, by commissioning an independent review of CAMHS in the UK. This review highlighted 20 areas for improvement. The DFSC/DH have recently responded to this review and commit to addressing 14 of these recommendations in the immediate to medium short term. It seems apparent from both the CAMHS review and the Governmental response that a homogenous, accessible and effective CAMHS provision is achieved in the long term.