‘Soaring demand’ for youth mental health services

The last two decades have seen a ‘seismic shift’ in the demand for youth mental health services, new research suggests, with one in five young people in the UK now accessing specialist mental health care by age 18.

The NHS child and adolescent mental health services (CAHMS) has seen a four-fold increase in patients in less than 20 years – rising from 5.8% of young people born in 1991 to 20.2% of those born in 2005.

The study was conducted using data collected in Wales, providing a proxy for the broader UK picture.

Published in the British Journal of Psychiatry, the findings suggest that the levels of mental ill health have risen year on year since 2004, with a marked acceleration after 2010. The researchers say this indicates a long-term mental health trend rather than a post-pandemic spike.

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Although mental illness is known to be rising among young people around the world, the numbers and proportions of the youth population who present to CAMHS are unclear, and there is a limited amount of mental health surveillance data of young people in the UK, the researchers said. To meet demand and provide adequate care for young people, up-to-date evidence is needed.

The researchers used data from Wales as a proxy for UK-wide CAMHS demand, because all four nations share similar CAMHS structures and drivers of mental health need. The data came from the Secure Anonymised Information Linkage (SAIL) databank, which covers most of the Welsh population.

Using the healthcare records, the researchers calculated the annual prevalence of CAMHS contacts between 2004 and 2023. They also tracked how many children born between 1991 and 2005 accessed mental health specialist care before their 18th birthday.

The findings show that among individuals born in 1991, one in 17 had attended CAMHS before they turned 18. In comparison, one in five individuals born in 2005 had attended CAMHS by the same age.

Adolescents are much more likely than younger children to use CAMHS. In terms of gender, in the early 2000s, the researchers found that almost equal numbers of boys and girls used the service, whereas by 2022, nearly twice as many girls attended CAHMS as boys.

Ian Kelleher, study lead and Professor of Child and Adolescent Psychiatry at the University of Edinburgh, said: ‘This study provides the clearest picture yet of the soaring demand for CAMHS.

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‘There has been a seismic shift in the numbers coming to CAMHS, but there has been far too little research to understand why this is the case.

‘Contrary to a lot of public discourse, this is not a post-pandemic issue – this trend has been building consistently for over a decade.’

The researchers say the findings provide reliable evidence to plan and evaluate how mental health services are delivered, as well as to shape policy decisions amid rising service needs.

However, there is still a pressing need for further research to understand what is causing the dramatic increases in childhood mental ill health.

Professor Kelleher added: ‘Unlike oncology or cardiology services, there is far too little research and evaluation taking place in CAMHS.

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‘Clinicians want to provide the best possible care, but we need stronger modern evidence on which to base our treatment decisions.

‘Robust clinical research programmes are not a luxury, they are the only way to ensure our systems and treatments are effective for today’s young people.’