Providing effective mental health support for children and young people is a crucial part of practice.
Sadly, research shows that those with social care involvement are three times more likely to not receive the Child and Adolescent Mental Health Services (CAMHS) they require. This is despite evidence that one in two young people with a social worker have mental health difficulties and are referred at higher rates.
For World Mental Health Day we want to shine a light on a group of young people who face startling inequalities when trying to get mental health support and provide recommendations for improvements.
As a team of researchers, including members who have been through the mental health and social care system, we wanted to know the reason for this inequality.
Our research was part of the NIHR-funded COACHES project, a collaboration between the University of Cambridge, Kingston University, King’s College London, National Children’s Bureau, the British Association of Social Workers (BASW) and the Care Leavers Association examining data from over 100,000 young people across two NHS trusts.
From examining over 20,000 case notes relating to 70 diverse young people our study has found that young people with social care involvement were frequently rejected by mental health services because their needs were viewed as too ‘complex’ or caused by their current situation. It was often cited that ‘social’ factors were to blame caused by instability at home, but it was unclear what this meant.
Taliah Drayak, co-author with lived experience of children's social care and mental health services, said:
When the support services that are there to help, only seem to help others and not you, you develop negative coping strategies that impede your wellbeing and capacity to achieve for life.
Talia Drayak
It is crucial that children and young people receive the required support they need. Drawing from our research and personal experiences we have suggested the following recommendations to improve services.
A review of 'social stability' as the basis for mental health access.
Crisis points and transitions often exactly the time when young people want support.
Better integration of child and adult mental health services to adequately support all members of a family.
Automatic access to mental health assessment: Any child in contact with social work should be offered a specific assessment to understand their mental health needs.
Young people should be empowered to decide when and where this assessment takes place.
Promote independent advocates and translators.
As a young person it is your right to be supported and you are entitled to have an adult on your side at all appointments.
Developing staff expertise in both social work and mental health needs.
Services require adequate social work expertise and understanding of the unique needs of young people with all forms of social work.
No young person should have to face stigmatising assumptions about their social situation.
Co-located mental health services between children’s social care and Child and Adolescent Mental Health Services (CAMHS) so that young people can go to a one-stop-shop to get support.
Serve children living in poverty.
CAMHS should be supported to develop a tailored offer for children living in poverty (e.g. transport vouchers), in coordination with anti-poverty organisations and local authorities.
Utilise the diversity of possible therapies.
CAMHS should be supported to provide a variety of therapies that do not require young people to have 'stability'.
It is something to be earned not expected for young people who have often been let down by many other systems.
The research team are grateful that policy-makers are listening.
Recommendations from this study have been incorporated in the Children at the Table report, the UK Trauma Council and have been incorporated into the Education Select Committee 2025 who have agreed to support a pilot of a co-located mental health services between children’s social care and Child and Adolescent Mental Health Services (CAMHS).
By listening to research we can improve support for all children and young people’s mental health.