With the coronavirus pandemic adding fresh weight to already struggling mental health services for young people, we must urgently realise the cost of overlooking young minds. A worsening mental health crisis among younger generations will exacerbate the economic burdens to come, and could have impacts which reverberate long into the future. 

"Mental health services for children fail to meet soaring demand: The ongoing crisis is evidence of systematic discrimination against children."

These are words that I wrote almost exactly three years ago. Now I sit here reflecting on our current coronavirus crisis and what it means for our young people. Before we think about the impact of this crisis on the mental health of young people, let me set the scene pre-Covid-19.

Back in 2017, our editorial in the BMJ lamented the miserable progress on supporting our children and young people (CYP) with mental health problems in the UK over the preceding two decades, since the publication of a seminal report ‘Every Child Matters’. For example, although 75% of mental health problems start in childhood and adolescence, historically only 6% of our mental health budget has been allocated to CYP.

Even before the virus there was evidence that our children were experiencing ever increasing mental health problems.

So, what has been the progress over the past three years to demonstrate that every child does actually matter? There’s some good news. Within England (and similar work elsewhere in the UK), we welcomed the publication of the government’s green paper pledging to install mental health teams in schools, and work has started at pace – with the aim of covering the whole of England within the next 10 years.

There’s a lot that can happen to a child over a decade. Our children need more, a lot more and a lot sooner. As we wait to see how the impact of this pandemic unfolds, it does not take much of a stretch in imagination to foresee that this existing mental health burden is only going to rise, with potentially ever greater numbers of CYP waiting for help. Getting support in schools will also be vital as many frightened, and some traumatised children make their way back to education. Some of these children will have suffered enormously through the impact of living in lockdown, with no respite from abusive parents, domestic violence orliving with a parent with a mental illness or addicted to alcohol or drugs.

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Even before the virus there was evidence that our children were experiencing ever increasing mental health problems. Take the recent prevalence survey from the government (which took over a decade to be funded, NHS digital 2018): emotional problems were on the up and over half of older teenage girls with a mental health disorder are self-harming. That’s more than 50%. The worry now is that this rate is likely to climb even higher due to this crisis as young people struggle to cope with fears for their future. Rates of self-harm and suicide rose during the global recession (Fegert 2020), however, that did not bring all the additional burdens of this pandemic such as isolation, loss of education, and the fear of contagion, illness and death.

Social advantage does not preclude mental health problems, but it certainly acts as a buffer for some. Tragically, that buffer will have now been removed for many as a result of the economic devastation of the pandemic.