A scoping literature review of service-level barriers for access and engagement with mental health services for children and young people

Abstract

The worldwide-pooled prevalence of mental disorders in children and adolescents is estimated at 13.4% (Polanczyk, Salum, Sugaya, Caye, & Rohde, 2015). In the UK one in ten children aged 5–16 years suffer from a diagnosable mental health (MH) condition while many more are experiencing symptoms that, while not reaching the threshold of clinical disorder, are a source of distress for children, young people and their families (Green et al., 2005). Only 25% of children with clinically significant MH problems receive specialist care (Hagell, Coleman, & Brooks, 2015), while 43% report no MH related service contact at all (Ford et al., 2005). MH problems in childhood, unless treated, have a high level of persistence (Meltzer et al., 2003), with some conditions persevering through adolescence and into adulthood (Woodward & Fergusson, 2001). It is estimated that 25% of children with emotional disorders and 43% with conduct disorder still have the same condition three years later (Meltzer et al., 2003). A half of lifetime mental illnesses start by the age of 15 and 74% by the age of 18, increasing still further among those who use specialist mental health services by their mid-20's (Kim-Cohen et al., 2003). Failure to address MH problems early in life not only affects individuals' long-term functioning and wellbeing, but also produces significant societal costs resulting from increased healthcare usage, unemployment and antisocial behaviours (Joint Commissioning Panel for Mental Health, 2013). Snell et al. estimated yearly additional health, social care and educational costs associated with children psychiatric disorders in the UK at around £1.47bn (Snell et al., 2013).