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

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

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

Young children, especially those under the age of 11, were also less likely to get help – which hampered earlier intervention efforts.

More worryingly, there were limited improvements in clinical outcomes one year after referral to CAMHS (61% continued to meet criteria requiring mental health input).

The prevalence of mental health problems in children and young people has increased significantly in recent years and far exceeds service capacity, meaning that many children and young people with significant needs are unable to access specialist support, requiring processes to screen and prioritize when, where and how care can be provided to them.

With this data, we wanted to examine the factors that influence access to and receipt of mental health services, the care provided, and outcomes following referral.”

Professor Kapil Syal, School of Medicine, University of Nottingham, and principal investigator of the study

The mental health of children and youth, especially emotional disorders such as anxiety and depression, is a very important public health concern. In recent years, and particularly since the pandemic, there has been international concern regarding the prevalence, severity and reported increase in help-seeking. This research is particularly timely, given that the DHSC’s independent review into mental health conditions is underway

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

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

Professor Syal said: “As a large nationally representative study, these new analyzes of STADIA data enable investigation of referral acceptance, receipt of care and clinical diagnosis and clinical outcomes. This addresses important questions for families, referrers, clinicians and policy makers: who is seen? Who is offered help? Who gets better?

“Our findings identify significant inequalities in access to care and underline the urgent need to rethink the current model of CAMHS service provision.”