Children and young people and mental health crisis care
Half of all mental illness (except dementia) starts before the age of 14. Three quarters of lifetime mental health disorders have their first onset before 18 years of age. Crisis can show itself as self-harm, overdose, an abnormal mental state, a psychiatric emergency or many other ways.
It is common for children and young people to experience crisis. It is part of the mental health difficulties that will ultimately lead to three quarters of adults’ mental health problems. A crisis is often the first time a child or young people presents to a mental health services. Where services are delivered in partnership, with clear plans and good communication, their needs are well served but unfortunately, this is not always what happens.
It is important to note that for children or young people presenting in crisis, it is rarely due to a mental health problem alone. Difficulties in relationships with peers, parents or carers, stress about housing, money, education, as well as difficulty accessing appropriate care where they live, are some of the possible factors. As a result, an NHS-only response is not likely to resolve the crisis and its causes. Therefore every contact with a child or young person in crisis must explore the wider areas of their lives.
Children and young people have told us they want care that is integrated and uses an approach that is child, youth and family-friendly. It should recognise their needs, support them in a positive way and help them to cope. Those with learning difficulties frequently experience particular difficulties in accessing the right care, at the right time and in the right place.
A range of national strategies and policies mandate action. These include Future in Mind, the Five Year Forward View for Mental Health and the Mental Health Crisis Concordat. For London, the Commissioning Standards for Crisis Care and our Acute Care Standards for Children and Young People clearly set out expectations of quality and access that should be met. We worked with children and young people and their families to develop a set of recommendations for improving London’s crisis care for children and young people.