The prevalence of significant mental health problems in children and young people (CYP) has been rising over the last two decades and currently stands at one in five of all 8–25-year-olds. Demand for CYP mental health support also continues to grow, with significant pressure on mental health services and the wider healthcare system. In November 2024, there were 78,033 referrals to CYP mental health services alone, with many facing significantly long waits. 

Addressing this ever-increasing problem is crucial, not only for those impacted but to move closer towards a more equitable society and dynamic economy in future years. Mental health problems in childhood often continue into adulthood which drives further demand and pressure on public services. The Government has set out the three key shifts it sees as vital to the future of the NHS. Arguably, the most important for CYP is the shift from treatment to prevention. Childhood is often thought of as a happy time, but this is not the case for some CYP who may experience family problems, poor housing, poverty and traumas such as abuse and neglect. Risk factors change over time and there is also growing evidence about how social media negatively impacts on CYP mental health. To address these risks the DHSC last year published a conceptual framework, which can help identify modifiable risk factors addressing which could help improve infant, child and adolescent mental health. 

Childhood is a key developmental stage, so intervening at the earliest opportunity, such as in the perinatal period and first two years of life can make a significant impact. It creates the building blocks for good mental health. This includes support for perinatal mental health, parenting and addressing attachment or relationship issues between the child and parents or carers. Parenting programmes also have a strong evidence base and for every £1 spent on them, they can generate nearly £16 in the long term. 

Most children are in school, so rolling out the Mental Health Support Teams (MHSTs) as proposed in the 25/26 NHS Planning guidance, is a good starting point. To ensure these services have impact, the roll-out needs to learn from the evaluation of the MHST trailblazers and work with schools to understand and meet their specific needs. Barnardo's economic analysis found that every £1 spent on MHSTs gives a return of £1.90, so we know investing in them is good value for money. Further research is now needed on the potential value of a whole school approach for mental health. Some of the NHS Confederation's members, including MyHappyMind and Place2Be, have strong evidence of reducing referrals to other services. 

It is positive the Government committed in their election manifesto to developing Young Futures Hubs, which are open access mental health services for CYP. There are existing early support hubs, many of which follow the Youth, Information, Advice and Counselling (YIAC) model. YPAS in Liverpool is one such example. The service is part of the mental health offer in the city and provides a range of different services to support local young people. One report on the cost effectiveness of the YIAC model found it achieved savings of £108 per young person, which was greater than the average cost of providing the service. The Fund the Hubs Campaign has just published its Blue Print for Young Futures Hubs which sets out how the Young Futures hubs could be implemented nationwide based on the experiences of those already delivering similar services. 

There are also NHS-led initiatives, such as developing neighbourhood multidisciplinary teams for CYP, which cover both physical and mental health problems. There is not one best model and it will be left for local systems to determine but neighbourhood teams could provide an opportunity to bring together a full range of professionals, working with CYP to provide holistic care at an early stage and prevent escalation. 

A good example of primary led CYP mental health is The Well Centre, in south east London, established and led by local GPs. Overall, the good news is that many CYP mental health interventions both make a difference and potentially save money that would otherwise be spent on worsening conditions or crisis interventions. However, there is also rising demand along with growing evidence of how mental health problems early in life have a scarring effect, for example, on job prospects. Therefore, we need both to understand and spread good practice in mental health provision while also spreading awareness of the issues and seeing a more joined up national and local approach to improving children and young people's mental health.