I recently attended the Local Government Association Annual Public Health Conference and Exhibition 2019, in association with the Association of Directors of Public Health, 21st March 2019, in Central London.  The 2012 Health and Social Care Act transferred public health responsibilities from the NHS to local government.  Local Authorities work with the health, voluntary and community sector, with a view to improving the health and wellbeing of children and young people. 

Today's event is one such collaboration.  Occurring annually, it aims to explore and build on the challenging, innovative work being undertaken by councils and public health teams with their partners and local communities. The focus this year was on developing and supporting resilient, healthy communities. 

The lack of services to support the mental wellbeing of the young population has been identified as an issue that needs to be addressed to safeguard their future.  Professor Dame Sue Bailey, Chair, Children and Young People's Mental Health Coalition, cited the inequalities that have a negative impact on their mental wellbeing of young people as:

• Poverty and low income
• Homelessness and insecure housing
• Debt and financial difficulty
• Discrimination and harassment
• Physical ill health

Childhood mental health problems can increase risk later in life: 75% of adults who have mental health problems first became unwell either in childhood or adolescence.  Experiencing mental health problems so early in life can also increase the risk of other difficulties in adulthood, such as addiction. 

"Every child has a right to mental health; fairness, protection, and mental autonomy.”

Professor Dame Sue Bailey, Chair, Children and Young People’s Mental Health Coalition

One child in every thousand will have a serious mental health issue. 

All children occasionally misbehave. 20% will present with persistent behavioural problems, and 6% will develop conduct disorder.  Professor Bailey highlighted that proven interventions for behavioural problems, such as parent support groups, are inexpensive and highly effective.  She went on to set out the three key principles for improving children and young people's mental health in schools:

• Better balance between attainment and wellbeing
• Better training and support for staff on mental health
• Better support for children and young people when needed

There is an opportunity for schools to play an important role in supporting the mental wellbeing of the young population.  The school environment is the first major influence on a child's mental health outside of the family home.  It is an opportunity to mitigate negative influences and reinforce positives.  The list of young people at risk encompasses a diverse group; both children who bully and get bullied; children of parents with mental health problems; children affected by neglect, violence and maltreatment; children with experiences of Adverse Childhood Experiences; looked after children; children with disabilities and health problems; and LGBT young people.  

Professor Bailey signposted the Mentally Healthy Schools initiative, which takes a whole-school approach to the mental health and wellbeing of pupils.  For more information, visit the website here: https://www.mentallyhealthyschools.org.uk/whole-school-approach/

Nathan Dennis, Director of First Class Legacy, advised that many young people, predominantly young black men, are experiencing Post-Traumatic Stress Disorder as a result of being exposed to violence.  First Class Legacy are a grass-roots organisation supporting young people in and around Birmingham, where they have found that knife crime is significantly impacting the mental health and well-being of the young population.   

Their response has been to create culturally and psychologically informed safe spaces, where young people can release emotional stress and explore experiences of discrimination and stigma.  He stressed the importance of cultivating a culture of co-production, so that big charity initiatives don't miss out on collaborating with grass-roots organisations, who have established meaningful relationships within local communities. 

Louisa McGeehan, Director of Policy, Rights and Advocacy, Child Poverty Action Group, highlighted that poorer children have worse cognitive, social-behavioural, and health outcomes. She stressed that child poverty in the UK is stealing away children's life chances due to the education, health, and wellbeing divide. 

"Poverty is now a major public health issue.”

Louisa McGeehan, Director of Policy, Rights and Advocacy, Child Poverty Action Group

Peter Townsend Poverty in the United Kingdom (1979), defined child poverty as:

"Individuals, families and groups in the population can be said to be in poverty when they lack the resources to obtain the types of diet, participate in the activities, and have the living conditions and amenities which are customary, or at least widely encouraged or approved, in the societies to which they belong.  Their resources are so seriously below those commanded by the average individual or family that they are, in effect, excluded from ordinary patterns, customs and activities."

Louisa McGeehan highlighted that, by 2010, 1.1m children had been lifted out of poverty as a result of the Child Poverty Act.  She noted that, as deprivation levels fell so did money worries, which lead to increased spending on items such as fruit and vegetables, children's clothes and books, and decreased spending on alcohol and cigarettes. 

Contributing Factors to Rising Child Poverty  

Parents with low and stagnating wages struggle to meet the rising costs of housing and childcare.  A government commitment to social security spending cuts of £40 billion per year by 2021 was preceded by the abolition of the Child Poverty Act, leaving children at considerable risk.  SMC (Social Metrics Commission) figures found that children are more than three times as likely to be poor than pensioners. 

With rising costs and falling incomes, the poverty gap is extending into working parent families.  The issue is now so severe that the extra cost of food in school holidays can push a family from just about managing into hardship, with parents skipping meals to feed their children. 

Louisa McGeehan revealed that the hardest hit are single parents, larger families of three or more children, and disabled children.  She referred to paediatricians quoted in Poverty and child health: Views from the frontline, who revealed instances of parents diluting milk because they couldn't afford formula milk, children not attending appointments due to parents not being able to afford travel costs, and children with respiratory problems due to living in damp and over-crowded  accommodation.

The Child Poverty Action Group have identified a number of areas where children can be more supported.  They suggest: promoting the take-up of free early years entitlements; addressing the childcare needs of parents of children with special needs; protecting and reviving Sure Start Children's Centres; introducing extended schools with breakfast, after school and holiday childcare; providing equal access to enriching activities; extending universal free school meals where possible; and avoiding stigmatising poorer children by requesting voluntary parental contributions and charges for materials and activities.

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Caitriona Fitzsimons Digital Reporter