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Role of paediatricians in children’s mental health subject of new position statement

The role of paediatricians in the prevention, early recognition and holistic care of mental health problems in children has been outlined in a new position statement from the Royal College of Paediatrics and Child Health (RCPCH).

The position statement follows an ‘unprecedented rise in demand for children’s mental health services’ as more ‘paediatricians are upskilling and expanding their role to care for and treat their young patients’, the RCPCH said.

Indeed, recent data from NHS Digital shows that one in five (20.3%) children aged 8-16 had a probable mental disorder in 2023, rising from 12.5% in 2017.

What’s more, the number of open referrals to Children and Young People’s Mental Health Services reached the highest on record with 496,897 referred to services in November 2023, an increase from 493,434 in October 2023.

The data also showed the number of urgent referrals – where crisis support is required – among under-18s reached a record high of 4,032 for November 2023. This was up from 3,355 the previous month.

Rates of self-harm remain high for young people, with almost a quarter (24%) of 17-year-olds self-harming each year. Suicide remains the leading cause of death for young people in the UK, according to the charity Papyrus.

Integrated support for children’s mental health

According to the RCPCH, a lack of staff and resources mean young people are being placed on long waiting lists, which can lead to more serious symptoms developing and an increased the likelihood of them presenting to emergency departments and paediatric settings in crisis.

‘It has never been more important for paediatricians to recognise that the mental health of our patients is our business,’ it said.

As part of its position statement, the RCPCH recommends paediatricians promote positive mental health in all their interactions and provide a safe environment for children in paediatric wards and emergency departments, by having appropriate staffing levels, and necessary training for managing acute distress.

The position statement also includes key policy recommendations to support effective joint working and integrated pathways with mental health services.

Improved support, training and increased capacity across the paediatric workforce is also a priority to support early recognition of and intervention for common mental health problems, the RCPCH said.

It is also calling for increased funding and capacity for community based mental health services so children can access quality and timely support before reaching extreme distress.  

Paediatricians are ‘most trusted profession‘

RCPCH officer for mental health Dr Karen Street said: ‘The entire children’s workforce has a role to play in tackling the current crisis in children’s mental health, but as paediatricians we are particularly well placed to make a difference. Research shows paediatricians are the most trusted profession for secondary school children, across all ethnicities and backgrounds and that children see doctors as a key group to support their mental health.

She added: ‘The paediatric profession is committed to holistic care for children and young people, which necessarily includes both their physical and mental health, and adapting to the changing challenges for children and young people to give our patients the best quality care and support – we now need Government to follow suit.

‘If we are ever to get out of this dire situation then we need meaningful support for health services and staff, as well as child focused polices that can improve the physical, emotional, social and educational wellbeing of young people. The responsibility to tackle this growing mental health emergency cannot be left to healthcare professionals alone.’

Dr Elaine Lockhart, chair of Royal College of Psychiatrists Child and Adolescent Faculty, added: ‘We fully support the work our paediatric colleagues bring to earlier identification and support of mental health difficulties in children seen within their services.

‘We also support their call for increased focus and funding of children’s mental health services so that there are well trained and resourced teams across the country who can meet the full spectrum of need from mild difficulties to severe mental illness.’