Socio-economic gaps hinder mental health care for children and teens

Children and young people from deprived areas with mental health conditions are less likely to access mental health services, according to a new study led by experts from the University of Nottingham.

In a new study, published in the British Journal of Psychiatry, experts identified significant socio-economic inequalities in access to care and clinical outcomes, with children and young people living in the most deprived neighbourhoods more likely to have their referral to child and adolescent mental health services (CAMHS), rejected, and to have worse clinical outcomes at 12 months follow-up from their referral.

Younger children, particularly those aged under 11, were also less likely to receive help – hampering earlier intervention efforts.

More concerningly, there were limited improvements in clinical outcomes one year after being referred to CAMHS (with 61% continuing to meet criteria for needing mental health input).

The prevalence of mental health problems in children and young people has increased considerably over recent years and far exceeds service capacity, meaning that many children and young people with significant needs are unable to access specialist help, requiring processes for triage and prioritization of when, where and how care might be delivered.

With this data, we wanted to investigate the factors which influence access to and receipt of mental health services, care offered and the outcomes following referral."

Professor Kapil Sayal, School of Medicine, University of Nottingham, and Chief Investigator of the study

The mental health of children and young people, particularly emotional disorders such as anxiety and depression, is a public health concern of huge importance. Over recent years, and particularly since the pandemic, there has been international concern in relation to reported increases in prevalence, severity and help-seeking. This research is particularly timely, given that there is an ongoing DHSC independent review into mental health conditions

Despite this, access to services and evidence-based interventions remains limited, impacting clinical outcomes and recovery.

The data come from the STADIA study, which was funded by the National Institute for Health and Care Research (NIHR). STADIA was a multi-center randomized controlled trial set in eight large NHS Trusts across England involving children and young people with emotional difficulties who were referred to CAMHS. This large study followed up 1,225 children and young people for 18 months to collect service-related and participant-reported outcomes.

Professor Sayal said: "As a large nationally representative study, these new analyses of the STADIA data enable an investigation of referral acceptance, receipt of care and clinical diagnoses, and clinical outcomes. It addresses crucial questions for families, referrers, clinicians, and policymakers: Who gets seen? Who gets offered help? Who gets better?

"Our findings identify significant inequalities in accessing care and underline the urgent need to reconsider current models of CAMHS service provision."