When Ellie’s 13th birthday came around this year, what should have been a day of celebration was tinged with deep sadness for her family. She revealed that she had not asked for presents because she did not think she would be alive for another year.
“Our daughter was struggling with depression before the lockdown caused by the pandemic,” her mother said. “This worsened and we were left trying to care for a suicidal child, which was incredibly stressful, lonely and unrelenting. The situation was worsened massively by the slow response of NHS mental health services.”
After Ellie expressed suicidal thoughts, her family got her an initial phone assessment with children’s mental health services. Ellie was told she would get urgent help, which was provided via a phone appointment with a psychiatrist in September. They prescribed antidepressants and said there would be a further six-month wait for the cognitive behavioural therapy that they thought Ellie needed.
Child and adolescent mental health services (CAMHS) have been reduced during the pandemic, with most support provided online or by phone. Referrals to mental health services have fallen: Birmingham children and young people’s mental health services, for example, have recorded a 50% reduction since March. This could be because of reduced contact with GPs and schools, two of the main referrers for mental health support.
Meanwhile, children are experiencing more problems. Evidence from a Guardian investigation suggests self-harm rose by 77% in the first few months of school compared with the same period last year. Prescriptions for sleeping pills for under-18s between March and June 2020 were up 30% on two years ago.
“The awful delay in accessing any support has actively perpetuated her depressive belief that nothing will ever improve or change,” Ellie’s mother said. “What is worse is that when we have called the so-called ‘crisis’ number – by definition something that you will only do in a really distressing emergency – we have received contradictory, confusing information. We have been directed to websites that don’t exist and, shockingly, advised to Google side-effects of an antidepressant medication when I called to say that my child’s mental state had significantly worsened since she started to take them.”
Speaking anonymously, a child and adolescent psychotherapist who works in schools said the situation had changed in recent months. Initially, some children found lockdown better because their lives slowed down. But as the pandemic progressed, there has been around a fivefold increase in attendance.
“We have a kind of slow but steady stream of eating disorders and children developing problems with food that are higher than usual. It’s a control battle with food which may relate to so many other things being way out of control,” the psychotherapist said.
“Some families will come with an anxious child or call about it when the anxiety is collective and has overwhelmed the whole family,” they added. “I think accessing the NHS is harder and all that is offered now is pretty much online. People want children to be seen, and the only way to do that at the moment is to pay for it.”
The psychotherapist said there were immense pressures on children, with regards to exams and having to socially distance. “A lot of [young people] worry about getting back to achieving and getting back into the right academic standard and what will become of next year’s GCSEs and A-levels, transitioning to university and that sort of stuff.”
Tina Rowen, the head of a school in Greater Manchester, said that when children came back, staff did some work to identify those of concern and noted a larger number of what they described as “newly vulnerable” – young people who were fine before lockdown but had since developed problems.
“There is a huge demand for counselling,” she said, adding that the isolation of lockdown had had a huge impact. “My school is fully inclusive and we have 42% disadvantaged pupils … We take a whole range of children. We’ve had to take money from one place and move it to another for Place2Be, a charity that offers counselling in schools, and other schools do the same. The government could provide more money for counselling in school as the NHS waiting lists are too long.”
Ellie’s mother said she had been under the impression that child and adolescent mental health services were where to go for help. “This is not the case … It has been extremely stressful and I just want the best help for my daughter.”
*Some names have been changed