Supporting the wellbeing of our children and young people is in all of our best interests, particularly as we emerge from the COVID-19 pandemic. This interest in child and young person wellbeing must come from everyone: nurses, health and social care services, government, schools and colleges, parents and families, communities and employers. All parties have to reflect and build upon current provision as they strive to deliver better wellbeing outcomes for all of our children and young people.
Supporting the wellbeing of children and young people has been a focus for nurses for many decades. The impact of the COVID-19 pandemic has emphasised the significance of providing this support, which is key as plans are made for recovery.
The number of children referred by their GP or teacher, for example, to NHS children's mental health services has, for the first time in 4 years, decreased. A referral was made, in 2020/2021, for 497 502 children, this is a decrease from 539 000 the previous year (Children's Commissioner, 2022). This decrease could be attributed to disruptions in service provision due to the pandemic. Since 2017, more children have been struggling with their mental health (this covers the pandemic period). One in six children now has a possible mental health disorder, which is an increase from one in nine children in 2017 (Children's Commissioner, 2022).
There has been some progress made to reduce the treatment gap between those children who need treatment and what is provided. The increase in need makes the provision of services and offering services in a more timely manner challenging. Only around a third of children (32%) with a probable mental health disorder are able to access treatment (Children's Commissioner, 2022).
The pandemic has continued to impact the lives of children and young people over the past 2 years as they have had to adjust to living with ongoing uncertainty, lockdowns and changes in restrictions. Subjects ranging from the Black Lives Matter movement, an increase in reports of sexual violence towards women, the ongoing emphasis on the environment and climate change are among the most reported concerns for children and young people (Children's Commissioner, 2021; The Children's Society, 2021; Department for Education, 2022). There are other concerns, such as the invasion of Ukraine, which will have a direct and indirect impact.
Although children and young people may be less at risk of becoming seriously ill or dying with COVID-19, they are still victims, collateral damage. The cost of COVID-19 will be felt by children and young people for many years to come as a result of lockdowns, difficulty accessing education, seeing friends and engaging in hobbies (essential for social development and wellbeing), and accessing services. They have also experienced death and dying.
For those who already experience mental health issues such as anxiety or depression, the pandemic is likely to have exacerbated these conditions and there will be others who are experiencing mental health issues for the first time.
Taken together, all these point to a youth mental health crisis on the horizon, if it has not arrived already. There has to be an increasing focus on public health within primary care and general practice, with the availability of a wider range of mind/body approaches. The physical, mental and social health needs of children and young people will only become the focus of all schools when each school has a full-time nurse, with nurses sitting on every governing board as a minimum. This investment in nurses will pay dividends as healing takes place in our schools. There is still more work to be done to ensure that every young person receives the support that they require for their mental health and wellbeing.