Mental health equality in Great Britain

Today, the Equality and Human Rights Commission published a pre-publication draft of their report ‘Is Britain Fairer’ – a review on the state of equality and human rights in Britain. The current blog post will focus on the mental health sub-theme.

Key findings

Mental health and wellbeing

  • Across England, Wales and Scotland, women reported poorer mental health and wellbeing compared to men, disabled people reported poorer mental health wellbeing compared to non-disabled individuals, and those that  identified as Lesbian, Gay, Bisexual, Trans (LGBT) reported poorer mental health and wellbeing compared to those that identified as heterosexual (for LGBT – England only).
  • People who experience homelessness are more likely to have mental health conditions, compared to the general population.
  • There are no official/robust figures for the number or prevalence of people in prison who have a mental health condition in England, Wales or Scotland.

Access and quality of services/therapies

Immigration

  • Mental health provision for those in immigration detention is variable – from excellent in Scotland (e.g., Dungavel) to significant barriers reported in England and Wales.

Looked after children

Deaths by suicide

Restraint

Legislation

Conclusions

The Governments of England, Wales and Scotland have highlighted their commitment to establishing a parity of esteem between physical and mental health, and have implemented policies which represent steps towards this.

However, further work (including collection of reliable data collection and evaluation) needs to be conducted to ensure that all individuals, including those under protected characteristics (e.g., sexual orientation, ethnicity etc.) can access specialist treatment. Moreover, that the healthcare experiences of those under protected characteristics improves, as well as their mental health outcomes.

The full ‘Is Britain Fairer’ report can be accessed here, whilst the executive summary (shortened, concise version) can be accessed here. The report has been published in pre-publication form, and will be finalised following presentation to Parliament.

 

Blog post written by Dr Rachel Moss (Twitter: @DrRMoss), Research Associate on the PGR Wellbeing project at the University of Portsmouth (School of Education and Sociology).

 

Access to mental health services for children and young people

Background

Improving access to and engagement with mental health services is a central tenant of the Children and Young People’s Improving Access to Psychological Therapies (CYP IAPT) programme, which commenced in 2011. The Education Policy Institute (EPI) published their third report on mental health services for CYP on the 7th October, with the current report focussing on access to services. The report is timely, as the CYP IAPT programme will become self-sustaining from 2019.

Which methods were used to obtain data for the report?

The EPI sent Freedom of Information requests to service providers (Child and Adolescent Mental Health Services; CAMHS) across England. In 2018, 90% of services and 73% of local authorities (e.g., county councils) returned information requested (Service: 54/60 providers contacted; Local authorities: 111/152). However, the data returned varied in terms of quality and extent (e.g., missing data points). The Institute also analysed data from the Mental Health Forward View Dashboard, which highlights performance against targets for Clinical Commissioning Groups (e.g., responsible for planning and funding health services for the local area that they look after).

What did the report find?

 

 

 

 

Access to mental health services for CYP

  • The number of referrals have increased in the last five years by 26%.
  • 2% of referrals were rejected or were described as inappropriate – common reasons including the CYP did not meet the thresholds for treatment (i.e. the condition was not serious enough), or the condition was not suitable for intervention.
    • Of the referrals rejected, most services signposted CYP to a more appropriate service.
    • However, there was limited, or no follow-up after a referral was not accepted into CAMHS.
    • 27/111 local authorities reported no longer providing services based on supporting early help (e.g., support for CYP with mild-moderate mental health problems), or support in schools.

Waiting times (2017-18)

  • The average median waiting time (maximum number of days in brackets) was 34 days (267) to assessment and 60 days (345) to treatment.

What were the limitations of the report?

The Education Policy Institute highlights that the quality of the data received, as well as official published data, should be treated with caution, due to the lack of standards for reporting data and missing data from CAMHS providers. The report also emphasised that it is also unclear how the Government is currently progressing on its commitment to increasing the CAMHS workforce, which is an important foundation to consider when analysing access to treatment for CYP.

In sum, the report highlights that CYP continue to experience difficulties in accessing treatment (e.g., referrals accepted, waiting times) and emphasise that greater attention needs to be paid to early intervention and prevention – to take ‘demand out of the system’ (p.30). To do so, policy makers could focus on a child poverty reduction strategy and ‘whole school’ (p. 31) approach.

Blog post written by Dr Rachel Moss (Twitter: @DrRMoss), Research Associate on the PGR Wellbeing project at the University of Portsmouth (School of Education and Sociology). 

The Good Childhood Report 2018

Since 2005, The Children’s Society has been working in partnership with the University of York to build up a picture of children’s wellbeing in the UK. The work aims to understand the factors that contribute to how children feel about their lives, and provide recommendations for policy makers to improve the wellbeing of children. Now in its seventh year, The Good Childhood Report describes the findings of research conducted by The Children’s Society and the University of York, with the most recent report, based on longitudinal data, published in August.

An overview of the findings from the sixth wave of the Millennium Cohort Study (MSC), with data collected when children were around the age of 14 years, is presented below. The MSC is a survey of children born in the UK between 2000-2001, and follows the lives of roughly 19,000 children. The overview will focus on the relationship between wellbeing and mental health.

Key findings

Relationship between life satisfaction, depressive symptoms, and emotional and behavioural difficulties

  • A proportion of children with a low happiness in life (happiness with life as a whole), also had high levels of depression (47%), and vice-versa.
  • A small number of children who had low life satisfaction (19%), and those who had high depressive symptoms (19%), also had a high score for emotional and behavioural difficulties.
  • Boys had greater emotional and behavioural difficulties compared to girls, but girls had lower levels of wellbeing and higher symptoms of depression compared to boys.

Physical activity and truancy

  • Children with lower life satisfaction, those with higher depressive symptoms and those with higher emotional and behavioural difficulties, were less likely, compared to other children, to be physically active and were more likely to have truanted.

Self-harm

  • Of the 15% of children who responded that had self-harmed in the past year, girls were more likely than boys (22% vs. 9%) to have self-harmed.
  • Children from White, Mixed and Other ethnic groups were more likely to have self-harmed compared to children from Indian, Pakistani/Bangladeshi and Black/Black British ethnic groups.
  • Children who were attracted to the same gender, or both, were more likely to self- harm. Just under half of children surveyed (46%) had self-harmed.
  • A higher than average risk of self-harm was observed for children who were from lower-income households.
  • Children with higher levels of depressive symptoms (60%), those with low life satisfaction (48%), and those with high emotional and behavioural difficulties (30%) were more likely to self-harm, compared to children with lower levels of symptoms/difficulties.

Policy recommendations

The Children’s Society emphasised that the insights gained from the report should be used by policy makers to inform decisions about children and young people. A key recommendation included using shorter, subjective measures of wellbeing as a tool for identifying children who may need more support (e.g., in schools, in monitoring the wellbeing of looked after children).

Please click on the links to access the full and summary versions of The Good Childhood Report 2018.

About the author

Blog post written by Dr Rachel Moss, Research Assistant for the Office for Students postgraduate research student wellbeing project. Dr Moss is based within the School of Education and Sociology at the University of Portsmouth.