Introduction

One in ten children aged 5-16 years has a clinically diagnosable mental health problem and, of adults with long-term mental health problems, half will have experienced their first symptoms before the age of 14. Self-harming and substance abuse are known to be much more common in children and young people with mental health disorders – with ten per cent of 15-16 year olds having self-harmed. Failure to treat mental health disorders in children can have a devastating impact on their future, resulting in reduced job and life expectations.

Mental ill health can affect anyone and have a significant effect on the lives of individuals, their families, communities, and wider society. Together with substance misuse, mental illness accounts for 21.3% of the total morbidity burden in England. Mental ill health is associated with many forms of inequalities, which people living with severe mental illness are particularly vulnerable to experiencing and are largely driven by complex and interrelated factors. PHE Strategy, 2020-25 outlines Better Mental Health as one of ten priorities with an ambition to contribute towards measurable improvements in mental health[1].

Globally, it is estimated that 1 in 7 (14%) 10–19 year-olds experience mental health conditions [2], yet these remain largely unrecognized and untreated. Adolescents with mental health conditions are particularly vulnerable to social exclusion, discrimination, stigma (affecting readiness to seek help), educational difficulties, risk-taking behaviours, physical ill-health and human rights violations.

The Mental Health of Children and Young People (MHCYP) survey, conducted in 2022 reveals that:

• In 2022, 18.0% of children aged 7 to 16 years and 22.0% of young people aged 17 to 24 years had a probable mental disorder.
• In children aged 7 to 16 years, rates rose from 1 in 9 (12.1%) in 2017 to 1 in 6 (16.7%) in 2020. Rates of probable mental disorder then remained stable between 2020, 2021 and 2022.
• In young people aged 17 to 19 years, rates of a probable mental disorder rose from 1 in 10 (10.1%) in 2017 to 1 in 6 (17.7%) in 2020. Rates were stable between 2020 and 2021, but then increased from 1 in 6 (17.4%) in 2021 to 1 in 4 (25.7%) in 2022.
• 11 to 16 year olds with a probable mental disorder were less likely to feel safe at school (61.2%) than those unlikely to have a mental disorder (89.2%). They were also less likely to report enjoyment of learning or having a friend they could turn to for support.
• 1 in 8 (12.6%) 11 to 16 year old social media users reported that they had been bullied online. This was more than 1 in 4 (29.4%) among those with a probable mental disorder.
• 11 to 16 year old social media users with a probable mental disorder were less likely to report feeling safe online (48.4%) than those unlikely to have a disorder (66.5%).
• 1 in 5 (19.9%) 7 to 16 year olds lived in households that experienced a reduction in household income in the past year. This was more than 1 in 4 (28.6%) among children with a probable mental disorder.
• Among 17 to 22 year olds with a probable mental disorder, 14.8% reported living in a household that had experienced not being able to buy enough food or using a food bank in the past year, compared with 2.1% of young people unlikely to have a mental disorder.

Data Overview

Oldham's rate of 56.7 per 100,000 for hospital admissions for under 18s is lower than the regional average of 100.2 per 100,000 and the national average of 99.8 per 100,000. Oldham's rate was previously higher than the England rate and has experienced a decrease of 47.7% compared to 2015/16. During the same period the North West rate has decreased by only 9.7% and the England rate has seen an increase of 16.7%. Oldham's rate is second lowest across Greater Manchester.

Figure 1: Hospital admissions for mental health conditions <18 years trend
Source: OHID/HES

Figure 2: Hospital admissions for mental health conditions <18 years across Greater Manchester
Source: OHID/HES

Hospital admissions for self-harm in children have increased in recent years, with admissions for young women being much higher than admissions for young men. With links to other mental health conditions such as depression, the emotional causes of self-harm may require psychological assessment and treatment. Both the Oldham and England rate for hospital admissions as a result of self-harm in 10 to 24 year olds have remained relatively stable between 2015/16 and 2021/22, with the Oldham rate below that of the national average. Latest data reveals Oldham to be 3rd lowest across Greater Manchester. A further breakdown by age band is displayed below. Rates are higher than England for 10 to 14 year olds and lower for both 15 to 19 year olds and 20 to 24 year olds. For 20 to 24 year olds, Oldham has the lowest rate across both Greater Manchester and CIPFA neighbours.

Figure 3: Hospital admissions as a result of self-harm <18 years by age group, 2021/22
Source: OHID/HES

The National Clinical Practice Guidelines published by the British Psychological Society state that children with learning or physical disabilities have a risk of developing a mental health problem compared to the national population [3]. Oldham has a lower rate (1.7%) of primary school aged children with social, emotional and mental health (SEMH) needs compared with the England average of 2.6%. Whereas the England rate has increased in recent years, the Oldham rate has seen a slight decline. Rates amongst secondary school children are more similar to the national average, with Oldham's latest rate of 3% only slightly below the England rate of 3.2%. Across Greater Manchester and CIPFA neighbours, Oldham's rate of school children with SEMH is lowest with a rate of 2.5%.

Figures 4&5: Primary and secondary school pupils with SEMH trend

Source: OHID/HES

Figure 6: All school pupils with SEMH across Greater Manchester
Source: OHID/HES

Figure 7: All school pupils with SEMH amongst CIPFA neighbours
Source: OHID/HES

The rate of new referrals provides local health and care systems with an important measure of demand. It will help to assess how the demand reflects the mental health needs of the local population and if the demand can be met by current service provisions. It is a measure of the number of referrals made to mental health services in the time period which will reflect factors such as the prevalence of mental ill health in the community, the capacity of primary care services to manage this need, local secondary mental health services and the expectation that the secondary services are able to accept referrals. Oldham's rate of new referrals to secondary mental health services for under 18s is lower than the national and regional averages. Although rates are lower, Oldham's rate has seen the largest increase at 88%. North West has experienced an increase of 31% and England an increase of 44%. Oldham's rate is second lowest across Greater Manchester and 5th lowest across CIPFA neighbours.

Figure 8: New referrals to secondary mental health services <18 years trend
Source: OHID/HES

Figure 9: New referrals to secondary mental health services <18 years across Greater Manchester
Source: OHID/HES

Figure 10: New referrals to secondary mental health services <18 years amongst CIPFA neighbours
Source: OHID/HES

Further Information & Resources

NHS Advice Page
Find advice and support about mental health for children, teenagers, students and parents.

Mind - Information for young people
Information for young people to help with understanding mental health, wellbeing and types of mental health problems.

YoungMinds
YoungMinds are a mental health charity for children, young people and their parents.

WHO Mental Health of Adolescents Fact Sheet
Fact sheet on adolescent mental health

Mental Health of Children and Young People in England 2022
This report presents findings from the third (wave 3) in a series of follow up reports to the 2017 Mental Health of Children and Young People (MHCYP) survey, conducted in 2022. The sample includes 2,866 of the children and young people who took part in the MHCYP 2017 survey.
The mental health of children and young people aged 7 to 24 years living in England in 2022 is examined, as well as their household circumstances, and their experiences of education, employment and services and of life in their families and communities.

References

[1] OHID Children and Young People's Mental Health and Wellbeing Data Profile, accessed November 2023, https://fingertips.phe.org.uk/profile-group/mental-health
[2] Institute of health Metrics and Evaluation. Global Health Data Exchange (GHDx)
[3] National Collaborating Centre For Mental Health. Depression in Children and Young People - Identification And Management In Primary,Community and Secondary Care. London: The British Psychological Society; 2005.