Emotional health and wellbeing, also referred to as mental health, affects an individual’s ability to cope and manage with change, transition and life events. Being emotionally resilient and having positive mental health will assist children and young people with their transition into adulthood. The majority of adult mental health disorders have their beginnings in childhood; 50% of adult mental health disorders (excluding dementia) start before the age of 14, and 75% (excluding dementia) start before the mid-twenties, so tackling problems when they first emerge is both morally right and cost effective.
It’s estimated that at least 9.6% of young people suffer from a diagnosable mental health problem, with many more experiencing issues around anxiety, stress and body image. This can lead to poor emotional wellbeing and low levels of resilience, resulting in young people being less able to cope with the challenges of life. Left unchecked, this can spiral into acute, long-term illness. Poor mental health in childhood is associated with a broad range of outcomes including poor educational achievement, a greater risk of suicide, substance misuse, antisocial behaviour, offending and early pregnancy. There are inequalities in good emotional health and wellbeing in children, with children from the most disadvantaged backgrounds being three times as likely to develop a mental health disorder.
Data and intelligence to support the understanding of emotional health and wellbeing in children and young people is recognised nationally as being problematic. Comparative data is limited to children and young people who have been admitted to hospital for certain conditions, whilst data relating to the larger number of children who may be experiencing mental health difficulties is limited to national research and local surveys.
Hospital admissions for mental health disorders
Wakefield has lower rates of hospital admission rates for mental health disorders in those aged under 18 than the national average. In 2012/13, there were 44 admissions to hospital because of a mental health disorder, a rate of 64.3 per 100,000 population aged under 18, compared to 87.6 in England.
Hospital admissions for self-harm
In contrast, the rate of hospital admissions as a result of self-harm is significantly higher in Wakefield compared to both the national and regional averages, and the rate is increasing. Local analysis has shown that the majority of self-harm admissions are due to self-poisoning by aminophenol derivatives (pain killers), and that around 60% of admissions are female.
Estimates of mental health disorders and emotional difficulties
A national survey of mental health disorders in young people, completed in 2004 by the Office for National Statistics, is the most authoritative source for estimating the numbers of children and young people with mental health difficulties. By applying the findings from this national research to the local population of Wakefield it is estimated that there are around 4,260 children with clinically diagnosable mental health disorders, 9.6% of children.
There will be many more children with lower-level or transient emotional, behavioural or social problems which will nevertheless have a significant impact on their educational, social and family functioning and will require intervention. For example, some children may be struggling to cope with the effects of family breakdown, illness or bereavement, or they may be experiencing bullying. They may not go on to be diagnosed with a mental health problem, but their emotional wellbeing, functioning and ultimately adult mental health is likely to be impaired if they aren’t offered timely support. Research suggests that, in addition to the 9.6% of children with diagnosable disorders, there are a further 15-20% that are likely to be experiencing severe emotional or mental health difficulties at any time. This would equate to a further 6,655 to 8,870 children in Wakefield.
These figures need to be regarded with some caution, they are based on national research which may not reflect the population of Wakefield, they can however be used to give a tentative estimate of the likely numbers. The two estimates indicate that there may be between 11,000-13,000 children with some level of emotional or mental difficulty living in Wakefield.
A Children and Young People’s survey was completed in 2015; a total of 3,223 pupils took part in 44 primary and 11 secondary schools in Wakefield district. The survey asked several questions that give an indication of emotional wellbeing. The Short Warwick-Edinburgh Wellbeing Scale (SWEMWBS) uses responses from a number of questions to give an overall score of wellbeing, the higher the score the higher the indication of positive wellbeing, the lower the score, the poorer the level of wellbeing. In both Year 5 (9-10 year olds) and Year 9 (13-14 years olds), 27% of pupils had low to medium low wellbeing.
Applying these proportions to the whole school age population suggests that there could be almost 12,000 children and young people who could benefit from support to improve their resilience and wellbeing. There are geographical differences in the proportion of pupils who have low and low to medium wellbeing scores; Wakefield Central has the highest proportion of primary school pupils (34%), compared to South East with the lowest proportion (19%). The highest proportion of secondary pupils with low and low to medium wellbeing scores is in Pontefract and Knottingley (31%), compared to Normanton and Featherstone with only 16%.
Pupils were also asked how much they worried about a list of issues; these included school work/exams, problems with friends, family problems, money problems and the way you look. The proportion of pupils who stated that they worry quite a lot or a lot about any of the issues listed increases with age, with 47% of primary pupils and 58% of secondary pupils stating that they worry quite a lot or lot. Across all year groups and for both boys and girls school work/exams was the issue that most pupils reported worrying about quite a lot or a lot.
Emotional and behavioural health of Looked After Children
Research shows that 45% of looked after children (LAC) have a diagnosable mental health condition ; since 2008 local authorities have had a duty to administer a screening questionnaire (for mental disorders); to the primary carers of any child that has been LAC for at least a year. The strength and difficulties questionnaire (SDQ) is the screening tool that is used; the questionnaire has 20 questions relating to emotional symptoms, conduct problems, hyperactivity and peer problems. A score of less than 14 is considered normal; 14-16 is borderline cause for concern and 17 or over is cause for concern . LAC in Wakefield in 2013/14 had a lower average score (13.7) than national (13.9) and regional averages (14.0). The average score of LAC has fallen year on year since 2011/12, when it was 14.0. Although the average score per LAC child is considered to be normal, around 50% of LAC in Wakefield have scores that are borderline or cause for concern.
Further information on emotional health and wellbeing can be found in the mental health needs assessment and on the JSNA website, in the Children and Young People’s Survey reports: