Children playing outsideChildren and young people are often not being prioritised by joint strategic needs assessments (JSNAs) or Joint Health and Wellbeing Strategies (JHWS), according to the Children & Young People’s Mental Health Coalition.

The Coalition’s report, Overlooked and Forgotten, found that 2 in 3 JSNAs do not specifically address children and young people’s mental health, 1 in 3 JHWS do not prioritise children and young people’s mental health and data most commonly used to estimate the prevalence of mental health need is almost a decade old.

Other key findings include:
• 1 out of 3 of JSNAs do not include an estimated or actual level of need for children and young people’s mental health services in their area
• Data commonly used to estimate prevalence of need is almost a decade out of date or does not provide a full picture of need
• Data about the mental health needs of 16-25 year olds is especially limited in JSNAs
• 1 out of 5 JSNAs highlight the link between risk factors and their effect on children and young people’s mental health
• 1 out of 3 JHSWs do not prioritise children and young people’s mental health.

Research suggests that 75% of adult mental health issues develop before the age of 18, so investing in mental health services for children and young people to stop problems beginning or developing could bring significant cost benefits.
The report makes numerous recommendations, including:

To Health and Wellbeing Boards:
• All JSNAs should include a section specifically about children and young people’s mental health needs that uses a comprehensive range of data to estimate local levels and types of need. This should include a focus on infant mental health
• All JHWSs should include children and young people’s mental health as a priority, address mental health needs based on evidence in the JSNA and include outcomes to measure impact.

To the Department of Health:
• Commission a national survey of child and adolescent mental health to establish the prevalence of mental health needs in this group
• Divide data from this survey, along with all other data about children and young people’s mental health, into five-year age bands to allow services to be commissioned based on their distinct developmental needs
• ‘Adapt and extend the existing outcomes within the NHS Outcomes Framework,’ as recommended in the Report of the Children and Young People’s Health Outcomes Forum, to ensure outcomes adequately cover mental health.

To Public Health England:
• Update existing guidance and tools on how to assess children and young people’s mental health needs and ensure it is in line with current government guidance
• Make guidance tools easily accessible to health and wellbeing boards and commissioners through Public Health England’s Child and Maternal Health Intelligence Network
• Commission an evidence review into existing research on risk factors related to children and young people’s mental health.

Professor Dame Sally Davies, chief medical officer, Department of Health, welcomed the report, adding: “I believe it is important that the Department of Health commissions a new survey of the prevalence of mental health problems in children and young people, to ensure they get the right support and treatment they need as early as possible.”

Barbara Rayment, chair of the Children & Young People’s Mental Health Coalition, said: “Local authorities have difficult decisions to make about how to allocate dwindling health budgets. While it is very welcome that two-thirds of JHWSs are prioritising children and young people’s mental health, too many are not giving this the priority it needs in order to help them develop the resilience and self-esteem necessary for making healthy choices and to deal with the challenges they face.”

“A recent study shows voluntary sector providers feel their data has been excluded from JSNAs, thus further excluding the issues that matter most to their local young people, therefore it is vital that the Coalition’s evidence of good practice is shared. Reliable data must also be made available, as a basis from which the services that need to be funded as a priority can be identified.”