Mental Health

Record 420,000 Children a Month in England Treated For Mental Health Problems

More than 400,000 children and young people a month are being treated for mental health problems – the highest number on record – prompting warnings of an unprecedented crisis in the wellbeing of under-18s. The Guardian has more.

The latest NHS figures show “open referrals” – troubled children and young people in England undergoing treatment or waiting to start care – reached 420,314 in February, the highest number since records began in 2016.

The total has risen by 147,853 since February 2020, a 54% increase, and by 80,096 over the last year alone, a jump of 24%. January’s tally of 411,132 cases was the first time the figure had topped 400,000.

Mental health charities welcomed the fact that an all-time high number of young people are receiving psychological support. But they fear the figures are the tip of the iceberg of the true number of people who need care, and that many more under-18s in distress are being denied help by arbitrary eligibility criteria.

‘Open referrals’ are under-18s who are being cared for by child and adolescent mental health services (CAMHS) or are waiting to see a specialist, having been assessed as needing help against treatment thresholds. GPs, teachers and mental health charities believe the criteria are too strict, exclude many who are deemed not ill enough, and amount to rationing of care.

“There is an unprecedented crisis in young people’s mental health, further evidenced by these record numbers of young people needing help from the NHS,” said Olly Parker, the Head of External Affairs at Young Minds. “The record high number of children and young people receiving care from the NHS tells us that the crisis in young people’s mental health is a wave that’s breaking now.”

While it was positive that more and more under-18s are receiving psychological support, he said, “the rise in the number of young people seeking help from the NHS is relentless and unsustainable. Over the past two years young people have experienced isolation, disruption to their education and reduced access to support, including from counsellors and GPs. All of these things have massively impacted their mental health, but these figures are only the tip of the iceberg and will continue to rise.”

He said many young people were reaching crisis point before could get the treatment they need.

Worth reading in full.

Forget Science – Climate Now Has a Central Role in The Culture Wars

One of my first tasks as a journalist in the late 1970s was to compile a “Major losses and catastrophes” page for a monthly reinsurance magazine. Sources were much scarcer in those days, but the back pages of the daily Lloyd’s List would supply various reports from shipping agents and news agencies. Every month there would be stories of large weather-related disasters including wildfires sweeping Australia, monsoons failing in Asia, droughts continuing in California, hundreds of people dying on a Philippines ferry caught in rough seas. At the time, I was intrigued at how little of this made the headlines in the U.K. Go forward a few years and we have global catastrophes, morning, noon and night. Bad weather has been politicised to spread widespread fear and anxiety as established elites pursue their subsidy-driven, command-and-control Net Zero political project.

Journalist Helen O’Callaghan put it succinctly in the Irish Examiner recently: “Whether it’s watching a David Attenborough interview, or seeing fires raging in California, becoming aware of the climate emergency is leading to anxiety and distress.”

The medical journal the Lancet published a paper in 2020 stating that ecological grief and anxiety were reasonable and functional responses to climate-related losses, and, needless to say, an “urgent response is needed from clinicians, public health practitioners and policy makers”. The American Psychological Association goes on to note that climate change mental health disorders include “trauma and shock, PTSD, anxiety and depression that can lead to suicidal ideation and risky behaviour”. Community-wide impacts are said to include interpersonal violence, including domestic and child abuse.

“I Have No More Tears”: Athletes in Despair Over Covid Quarantine Conditions at Beijing Winter Olympics

Event organisers of the Winter Olympics in China are facing a litany of complaints from athletes and countries on multiple fronts, especially over the COVID-19 isolation arrangements. The Guardian has more.

The Polish speed skater Natalia Maliszewska, who was forced to miss the 500m short track event on Saturday, revealed that she had faced fear and uncertainty in a Beijing isolation ward after testing positive for Covid.

“Since a week I have been living in fear and these changes in mood,” she said. “I cry until I have no more tears and make not only the people around me worry but myself too,” she said.

Those in an isolation ward are allowed out if they are free of symptoms and have two negative Covid tests 24 hours apart and Maliszewska was eventually released back to the Olympic village – before being told there had been a mistake.

“People got me out of my room at 3am,” she said. “This night was a horror, I slept in my clothes in my bed because I was afraid that at any moment someone would take me back to isolation. Then a message that unfortunately they were mistaken, that I am a threat, and should not have been released from isolation.

“I have to get back to the Olympic Village as soon as possible,” she added. “I can’t understand this anymore. I no longer believe in any tests, any Olympics. To me this is a big joke, I hope whoever is managing this has a lot of fun. My heart and my mind can’t take this anymore.”

More than 350 Games participants, including dozens of athletes, have tested positive upon arrival in the Chinese capital since January 23rd. Many are still in isolation, fearing their Games are over.

One of those is the Finnish ice hockey player Marko Anttila, whose team believes he is being kept in COVID-19 isolation for no reason. “From a medical perspective we know that a person like this is no longer infectious, no danger to the other team,” Finnish doctor Maarit Valtonen said. “These isolation decisions are not based on medicine or science, it’s more cultural and political decisions.”

The Finland head coach Jukka Jalonen said that the situation was affecting Anttila’s mental health. “We know that he’s fully healthy and that’s why we think that China, for some reason, won’t respect his human rights and that’s not a great situation,” he added.

The Russian biathlon competitor Valeria Vasnetsova also recently expressed her experiences of being in a quarantine hotel, posting on Instagram: “My stomach hurts, I’m very pale and I have huge black circles around my eyes. I want all this to end. I cry every day. I’m very tired.”

Vasnetsova posted a picture of what she said was “breakfast, lunch and dinner for five days already” – a tray with food including plain pasta, an orange sauce, a piece of meat on a bone, a few potatoes and no greens.

There are also general complaint about the food, with Germany’s coach Christian Schwaiger lamenting there was no hot food available for athletes: “The catering is extremely questionable, because really it’s not catering at all. I would have expected that the Olympic Committee is capable of providing hot meals. There are crisps, some nuts and chocolate and nothing else.”

The IOC said it was working with Beijing 2022 to address the issues, adding about the situation in the Covid hotels: “We feel for every athlete who cannot compete because of a COVID-19 infection. The protocols have been put in place to ensure safe Olympic Games for everyone.”

It’s for your safety so suck it up and stop complaining. Will it ever end?

Worth reading in full.

77% Rise in Children Needing Mental Health Treatment

There has been a 77% rise in the number of children needing specialist treatment for severe mental health crisis, according to BBC News.

Some 409,347 under-18s were referred to the NHS in England for specialist care for issues such as suicidal thoughts and self harm between April and October 2021.

Head teachers also report a huge rise in less severe mental health issues.

The government plans 400 mental health teams to support schools by 2023.

The NHS Digital referrals data analysed by the Royal College of Psychiatrists for the BBC, includes the most serious and urgent cases where the child faces an immediate risk from an eating disorder, self-harm or suicidal thoughts. In the same six month period in 2019, there were 230,591 referrals for under-18s.

There were 349,449 under-18s in touch with NHS child and adolescent psychiatric teams at the end of October 2021, the highest number on record.

I wonder how the teaching unions, headteachers, school governors, local education authorities and the Department for Education, all of whom bear responsibility for the closure of schools and the confinement of children to their homes, feel about these figures?

Worth reading in full.

Canadian Study Shows Online Learning Increases the Risk of Depression and Anxiety in Children

Researchers at the Hospital for Sick Children in Toronto, Canada have found that online learning dramatically increases the likelihood that a child will suffer from psychiatric issues such as anxiety or depression. Their study also found that the more time a child spent in front of a screen and the less time spent with others due to lockdowns has caused an increase in mental and behavioural problems for young people. MailOnline has more.

Learning online, rather than in a classroom, comes with an increased risk of depression and anxiety for older schoolchildren, according to a new study. 

Researchers analysed parent-reported mental health outcomes for more than 2,000 school-age children living in Canada at the time of the Covid outbreak.

For the study, the experts, from the Hospital for Sick Children in Toronto, explored links between different types of screen use and mental health.

They found that there was a clear link between parent-reported anxiety and depression in older children, who were having to use a screen for education. 

“These findings suggest that policy intervention, as well as evidence-informed social supports, may be required to promote healthful screen use and mental health in children and youth during the pandemic and beyond,” the team wrote.

The scientists behind the study also found that increased TV watching and gaming in younger children during the outbreak led to higher levels of depression, anxiety, behavioural problems and hyperactivity. 

There was no increased risk of these conditions in children with Autism Spectrum Disorders, according to the experts.

They say this could be due to their already higher level of screen use, and lower level of social interaction. 

“The Covid pandemic has resulted in major changes in the daily routines of children,” the researchers said.

This was “primarily because of the imposed public health measures related to distancing, isolation, and school closures”, the team explained.

The amount of time children and young people spent on screens increased dramatically, through television, gaming, video chat and online learning. 

To understand what impact this could have had on the mental health of young people, researchers examined a number of cohort studies.   

This study included 2,026 children with an average age of 6 and roughly split evenly between male and female participants.

Higher TV or digital media time, including gaming, was linked to higher levels of behavioural problems and hyperactivity in children aged two to four years-old, they discovered.

In older children and youth, with an average age of 11 years-old, watching more TV and gaming was linked to higher levels of depression, anxiety and inattention. 

Worth reading in full.

Lockdown Restrictions Have Accelerated America’s Youth Mental Health Crisis, Says Surgeon General

The U.S. Surgeon General Vivek Murthy has said that an already existing youth mental health crisis has been amplified over the course of the pandemic. Targeting lockdown restrictions directly, Murphy referred to the “devastating” impact which school closures and a lack of socialisation have had on the mental well-being of America’s children and young adults. The Mail has more.

While youth mental health had been a growing concern before the pandemic with increased rates of depression, anxiety, and suicidal ideation, Covid has exacerbated this trend into a crisis, Murthy said.

For example, during the pandemic, the number of children and teenagers reporting symptoms of depression and anxiety doubled, according to one study of 80,000 youth around the world.

Children from minority communities and those at socioeconomic disadvantages, as well as those who lost a parent or caregiver to Covid, are at higher risk for Covid-related mental health conditions, the Surgeon General’s report found.

The Surgeon General’s advisory provides recommendations for improving mental health through increasing mental health care access, addressing economic and social barriers that contribute to poor mental health, and more.

In the decade prior to Covid, youth mental health has become a growing concern for doctors and public health experts, and the pandemic exacerbated this concern.

A new report from the U.S. Surgeon General’s office (released Tuesday) provides statistics on youth mental health, as well as recommendations for how to address this challenge.

“Mental health challenges in children, adolescents, and young adults are real and widespread,” said Surgeon General Vivek Murthy in a statement about the report.

“Even before the pandemic, an alarming number of young people struggled with feelings of helplessness, depression, and thoughts of suicide, and rates have increased over the past decade.”

For young people, mental health conditions may be caused by both biological factors and environmental factors.

These environmental factors can include relationships with family members, relationships with peers, neighbourhood safety, and social and economic inequalities, according to the Surgeon General’s report.

Prior to Covid, up to one in five children between the ages of three and 17 years-old had a mental, emotional, developmental, or behavioural disorder.

This number has increased sharply over the last 10 years, according to the report.

From 2009 to 2019, the share of high school students who reported feeling sad or hopeless increased by 40%, to more than one in three students.

The share of high school students seriously considering a suicide attempt increased by 36 percent, while the share creating a suicide plan increased by 44%.

The Covid pandemic has added further hardship and stressful experiences for America’s young people.

“The Covid pandemic further altered their experiences at home, school, and in the community, and the effect on their mental health has been devastating,” Murthy said.

Covid caused schools to close across the country, disrupting opportunities for learning and socializing with peers.

In addition, many children who relied upon school for access to healthcare and social services had those services disrupted.

Numerous children also faced housing and food insecurity as their parents and caregivers went through job loss due to the pandemic.

Worth reading in full.

Mental And Physical Health of Young Children Damaged by Lockdown, Welsh Study Shows

A survey conducted in 2020 by Cardiff University has uncovered that primary school age children reported a substantial increase in ‘emotional difficulties’ compared with an identical survey conducted two years prior. In addition, those from disadvantaged backgrounds reported having emotional and behavioural problems at twice the rate of wealthier families, with the research also unveiling that, during this period, children were on unhealthier diets as well as getting less exercise. The Guardian has more.

A biennial survey conducted by investigators at Cardiff University found that primary school-age children reported a sharp increase in ‘elevated or clinically significant emotional difficulties’ in early 2021, compared with the same survey conducted in 2019.

The survey between April and June found that 27% of children in year six showed significant emotional difficulties, compared with just 17% in 2019, while reporting little change in behavioural difficulties. Children from poorer backgrounds were nearly twice as likely to report emotional and behavioural difficulties compared to those from affluent families.

Kelly Morgan, a Social Science Research Fellow at Cardiff, said the impact of the pandemic was likely to leave a “lifelong footprint” on the mental health of children as they grew older, based on evidence from previous international studies.

“From our findings, children and their families were extensively affected over the course of the pandemic”, Morgan said. “We know that it was illegal for children to meet others to play at some points, but also that children were deeply concerned about the health of their family and others”.

The survey highlighted the important role schools have played during and after the pandemic. Of the children surveyed, 90% said they felt cared for by their teachers and 80% said there was at least one adult in school they could talk to.

Professor Graham Moore, who led the study, which was funded by the Welsh Government and examined data from 1,863 children in 76 schools, said it showed that good relationships were maintained between teachers and their pupils. “These connections remained consistently strong among the children we surveyed, demonstrating the vital role education professionals have played for young people during the pandemic”.

“It’s plausible that if teachers and support staff hadn’t done such a good job of connecting with their pupils in this way, we would be dealing with an even greater mental health crisis among our children”, Moore said.

The study revealed that in terms of diet and exercise, the 10 and 11 year-olds surveyed were ‘consistently less healthy’ during the pandemic than in previous years. The proportion of children eating daily portions of vegetables dropped from 52% in 2019 to 41% in 2021, while those eating fruit every day dropped from 59% to 47%.

Worth reading in full.

Cases of Psychosis Soared Over Past Two Years of Lockdowns

Data shows an increasing number of people suffering from hallucinations and delusional thinking over the past two years in England (and across the world) during which time our lives were plagued by the social isolation caused by numerous lockdowns. The Guardian has the story.

There was a 75% increase in the number of people referred to mental health services for their first suspected episode of psychosis between April 2019 and April 2021, NHS data shows.

The rise continued throughout the summer, with 12,655 referred in July 2021, up 53% from 8,252 in July 2019.

Much of the increase has been seen over the last year, after the first national lockdown, according to data analysed by the charity Rethink Mental Illness. More than 13,000 referrals were made in May 2021, a 70% rise on the May before when there were 7,813 referrals. …

A study earlier this month found that anxiety and depression around the world increased dramatically in 2020, with an estimated 76 million extra cases of anxiety and 53 million extra cases of major depressive disorder than would have been expected had Covid not struck. Women and young people were disproportionately affected, the researchers said.

Psychosis can involve seeing or hearing things that other people do not (hallucinations) and developing beliefs that are not based on reality (delusions), which can be highly distressing. It can be a symptom of mental illness such as schizophrenia, bipolar disorder or severe depression, but psychosis can also be a one-off, potentially triggered by a traumatic experience, extreme stress or drug and alcohol misuse.

Despite the continued pressure on mental health services, Rethink Mental Illness is highlighting the importance of rapid access to treatment to prevent further episodes of psychosis and reduce people’s risk of developing severe mental illness. …

Brian Dow, the Deputy Chief Executive of Rethink Mental Illness, said: “Psychosis can have a devastating impact on people’s lives. Swift access to treatment is vital to prevent further deterioration in people’s mental health which could take them years to recover from.

“These soaring numbers of suspected first episodes of psychosis are cause for alarm. We are now well beyond the first profound shocks of this crisis, and it’s deeply concerning that the number of referrals remains so high. As first presentations of psychosis typically occur in young adults, this steep rise raises additional concerns about the pressures the younger generation have faced during the pandemic.”

Worth reading in full.

300 People a Day Go to A&E with Depression

As patients struggle to access face-to-face appointments with their GPs, figures show that more than 300 people a day are attending A&E departments complaining of depression – a sign both of the deepening mental health crisis and the inability of the NHS to cope with it. The Telegraph has the story.

NHS Digital data show that, in the year to March, “feeling depressed” was a patient’s main complaint in 114,000 attendances at NHS emergency departments in England – an average of 312 a day.

Mind, the mental health charity, said it was “deeply concerning” that so many people across the country needed emergency care for this reason.

The data refers to chief complaints, which a clinician views during a patient’s first assessment as the main reason that led them to seek emergency care. It is not an official diagnosis.

Feeling depressed was the 28th most common reason of nearly 150 recorded for attending an emergency department nationally in the last year, coming above puncture wounds, back injuries, coughs and sore throats. …

Pennine Acute Hospitals NHS Trust, in the North West, saw the highest number of A&E attendances for people presenting with feeling depressed as their main symptom (4,785), followed by University Hospitals Birmingham NHS Foundation Trust, which recorded 3,950, and Manchester University NHS Foundation Trust, with 2,525.

Different figures show “depressive disorder” was listed as the first suspected or confirmed diagnosis in 83,500 A&E attendances at NHS trusts across the country in 2020 to this year, making it the 25th most common diagnosis of hundreds recorded.

A patient with this diagnosis may not necessarily have been listed as “feeling depressed” in their initial assessment.

Leila Reyburn, the policy and campaigns manager at Mind, said: “It is deeply concerning to see so many people feeling so mentally unwell that they need to go to A&E. This is supported by data which shows an increasing number of people, including children, being treated by the NHS in a mental health crisis.”

Worth reading in full.

Record Numbers of Children Seeking Access to Mental Health Services

A new analysis by the Royal College of Psychiatrists has underlined the damaging impact of long months of school closures and general lockdowns on children’s mental health, showing that record numbers of young people are seeking – and are having to wait for – access to mental health services. The Guardian has the story.

In just three months, nearly 200,000 young people have been referred to mental health services – almost double pre-pandemic levels, according to the report by the Royal College of Psychiatrists.

Experts say the figures show the true scale of the impact of the last 18 months on children and young people across the country.

“These alarming figures reflect what I and many other frontline psychiatrists are seeing in our clinics on a daily basis,” said Dr. Elaine Lockhart, the college’s Child and Adolescent Faculty Chair. “The pandemic has had a devastating effect on the nation’s mental health, but it’s becoming increasingly clear that children and young people are suffering terribly.”

The college analysed NHS Digital data on mental health referrals for children and young people aged 18 and under. It found that between April and June this year, 190,271 children aged 18 and under were referred to children and young people’s mental health services – almost twice the number (97,342) referred during the same period in 2019.

Urgent referrals had also risen steeply. From April to June in 2019, 5,219 children and young people were referred for urgent care. This rose to 8,552 in 2021, the college said.

At the end of June, 340,694 people were in contact with children and young people’s mental health services, up from 225,480 in June 2019. …

Eating disorder treatment services were seeing more patients than ever, the college said, but it also warned of an “unprecedented” number of children still waiting for care.

Worth reading in full.