Address poverty to reduce mental health problems among children, says BMABMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7556.1471-b (Published 22 June 2006) Cite this as: BMJ 2006;332:1471
Governments in the United Kingdom must tackle poverty and deprivation to stem the increase in mental health problems among children, says a report from the BMA.
One in 10 children between the ages of 1 and 15 years has a clinically recognisable mental health disorder, a survey in 2004 by the Office for National Statistics found. In real terms this indicates that 1.1 million children under the age of 18 in England would benefit from specialty services. And there is evidence that childhood mental health problems are “gradually increasing,” says the report.
Children from poor backgrounds, children in care, children of asylum seekers, and children who have witnessed domestic violence are at higher risk of developing mental health problems, says the BMA. Reforms aimed at ending deprivation among children and that therefore reduce risk factors for mental illness must be fully implemented, said Vivienne Nathanson, head of ethics and science at the BMA.
She said, “Children from deprived backgrounds have a poorer start in life on many levels, but without good mental health they may not have a chance to develop emotionally and reach their full potential in life. For example, 45% of children in the care of local authorities suffer from mental health problems. These children may have come from socially and economically deprived backgrounds and are more likely to underperform at school. There are a number of government policies currently being rolled out that are aimed at tackling these problems; it is essential that they deliver what they promise.”
But despite the fact that doctors are seeing more mental health problems among children, variation in services or even a lack or provision in some areas means that many young people are not being referred. This is particularly true of children and adolescents from ethnic minority groups, as disorders are sometimes unrecognised and staff are insensitive to cultural issues, said Dr Nathanson.
Many 16 and 17 year olds end up falling through the gap between child and adolescent mental health services, which do not cover people aged over 16, and services for adults, the report notes. It cites a 2005 study by the charity Young Minds that found that ethnic minority people aged 16 and 17 who had experienced treatment in adult services found it “daunting and uncomfortable.”
The governments in England, Scotland, and Wales have all set out policies to make mental health in young people a key priority. Northern Ireland, however, lags behind. The report states: “Accessibility of services [in Northern Ireland] was inadequate, and there was a severe shortfall in investment in services. Very little appears to have happened since the 1998 policy statement.”
The BMA calls on all policies implemented in the four nations to be “fully monitored” for effectiveness and for current recruitment issues in mental health services to be addressed. It wants to see more money put into mental health services for children and adolescents and more child friendly services being run in different styles and from different venues to appeal to a broad range of young people.
David Skuse, a professor of behavioural and brain sciences at the Institute of Child Health and Great Ormond Street Children's Hospital, said that the Royal College of Psychiatrists and the Royal College of Paediatrics and Child Health are planning to establish joint training schemes on child mental health. “And there is a move to create a behavioural paediatric specialty. This is a big area of practice in the US but has not existed until recently in this country,” he said.
Child and Adolescent Mental Health: A Guide for Healthcare Professionals is available at www.bma.org.uk.
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