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Crisis in child mental health care combined with rising poverty is devastating for vulnerable children


4 min read

There aren’t many good news stories around at the moment, but England’s academic performance is a rare shaft of light in the gloom.

In international pupil assessments that compare countries we are going up the league tables: fourth in the world in the recently published Progress In International Reading Literacy Study (PIRLS). Parents seem content too, education is well down the list of voters’ priorities, which are dominated by concern over the NHS and cost of living.

Yet this positive picture on attainment is hiding some extremely worrying negative trends around the most vulnerable children, all of which were getting worse before the pandemic caused a further deterioration. 

Local authorities are turning away parents whose children need support

Take mental health. In April 2016 there were just over 37,000 referrals to the child and adolescent mental health service (CAMHS), which was already a big rise from a decade earlier. But this March there were an astonishing 129,000 referrals. Naturally the system cannot cope, leaving schools and families to pick up the pieces. A recent FOI investigation by The House in April uncovered a postcode lottery in CAMHS, with some vulnerable young people having to wait up to four years for help.

According to government figures, the number of children on education and health plans for serious special needs has more than doubled since 2015 – with a particularly large increase in plans for autism. This is despite heavy suppression of demand by local authorities who have run out of money. And we know local authorities are turning away parents whose children need support because nearly all parent appeals to tribunals are successful.

There are now 2.7 million young people living in “deep poverty” (their families have less than 50 per cent of median income after housing costs). This is half a million higher than 2010, and the effects of recent inflation have been devastating for these families. In particular there has been a huge increase in the number of parents who say they don’t have enough food. All of this is exacerbated because local authority budgets have been severely cut and so can no longer provide many of the discretionary support services to families that they used to.

These trends are happening for different reasons. The increase in poverty is easy to understand as it’s a result of deliberate government policy combined with high inflation. The rise in mental health and SEND are more complex and have several contributory factors which are heavily debated. For instance, on the former the rise of social media is often blamed. A growing willingness to talk about mental health may also be a factor and clearly the pandemic didn’t help either.

But the combination of all these trends happening at once is toxic, especially as the groups affected often overlap. We are seeing the impact in deteriorating attendance figures – 22 per cent of pupils have missed more than 10 per cent of sessions this year, double the pre-pandemic number. And there is worsening behaviour in schools, with teachers reporting more disruption. All this seems likely to put the academic successes of recent years at risk.

Dealing with the collective crisis of vulnerable children will first require wider acknowledgement and discussion of these trends, alongside proper analysis of why they are getting so much worse. It will also likely involve creating new connections between schools and other services like CAMHS and social services. The shift to having schools run by academy trusts has arguably helped on the academic side but has made integration harder. 

One measure the government could do straight away to relieve some of this pressure would be to lift families out of poverty by providing enough money for them to cope. This is particularly true for larger families which have been doubly hit by the two child penalty and the overall benefits cap. If we let these trends drift then one of few success stories of recent years will be rapidly undermined. 


Sam Freedman, former senior policy adviser at the Department for Education 

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