About the NSPCC
We’re leading the fight against child abuse in the UK and Channel Islands. We help children who’ve been abused to rebuild their lives, we protect children at risk, and we find the best ways of preventing child abuse from ever happening. Learning about what works in the fight against abuse and neglect is central to what we do. We are committed to carrying out research and evaluation to make sure the approaches we’re taking are the right ones and we share what we have learnt with partners.
Abuse ruins childhood, but it can be prevented.
That’s why we’re here. That’s what drives all our
work, and that’s why – as long as there’s abuse
– we will fight for every childhood.
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1. NSPCC Cymru/Wales is pleased to have the opportunity to respond to the Children, Young People and Education’s Committee on the emotional and mental health of children and young people in Wales. Our remarks are underpinned by the following articles of the United Nations Convention on the Rights of the Child:
· Article 19: a child’s right to be protected from violence and abuse
· Article 24: a child’s right to enjoy good physical and mental health
· Article 39: a child’s right to support to recover from abuse
Child maltreatment and mental health
2. The impact of abuse on children and young people’s mental health includes issues such as anxiety, depression, substance misuse, eating disorders, self-harm, anger and aggression, sexual symptoms and age inappropriate sexual behaviour[1]. More specifically, child sexual abuse can be associated with feelings of betrayal, powerlessness, stigmatisation, guilt and traumatic sexualisation, as well as difficulties forming and maintaining relationships, mental health-related problems resulting from trauma and physical health problems[2]. Neglect and emotional abuse negatively impacts all areas of a child’s life, from their development and behaviour to their ability to form relationships with other children and adults, and their performance at school. They are more likely to experience depression, have high levels of daily stress, low self esteem and some even attempt suicide.[3]
3. In Wales, a high number of children remain victims of maltreatment:
· There were 3,059 children on a child protection register on 31st March 2016[4]. The NSPCC estimates that for each child on the child protection register, another 8 have suffered maltreatment but do not come to the attention of statutory authorities.[5]
· The rate of looked after children due to abuse and neglect in Wales (68%) is still higher than in England.[6]
· In 2015/16, police in Wales saw a rise (25%) in the number of recorded sexual offences against children.[7]
· Research suggests up to 9 in 10 children abused at an early age go on to develop a mental illness by the time they're 18[8]
4. In view of this context, it is vital to ensure that children who are victims of abuse and neglect are given the necessary support to overcome their experiences. Accessing the right support at the right time can make a huge difference to a young person’s outcomes and life chances.
5. That is why in January 2016, the NSPCC launched a UK- wide campaign called It’s Time. The aim of the campaign is to secure a commitment from all relevant stakeholders to prioritise consistent, high quality therapeutic support for children and young people who have experienced abuse and neglect. This Committee inquiry is an opportunity to take stock on what that support looks like for vulnerable children and young people in Wales.
Service delivery in a new legislative context
6. In 2015/16, 1 in 3 Childline counselling sessions in the UK related to mental health and wellbeing, with an 87% increase from the previous year in the number of sessions mentioning problems accessing support.[9] In 2016, we asked health, education and social care professionals in the UK whether the current provision of therapeutic services was meeting the needs of children for whom the effects of abuse or neglect was a primary concern. Although the Welsh response sample was small, results indicated that the level of service provision was insufficient to meet need.[10] That is why we strongly welcomed the Together for Children and Young People Programme (T4CYP).
7. Following the entry into force of two key pieces of legislation, the Social Services and Wellbeing (Wales) Act 2014 and the Well-being of Future Generations (Wales) Act 2015, local areas have completed their assessments of the needs of people who need care and support and of well-being. These will form the basis of service planning for early intervention and prevention in years to come. Monitoring this process should help to ascertain whether the Together for Children and Young People Programme is successful at improving service delivery for vulnerable children and young people. To this end, NSPCC Cymru/Wales has analysed all available Population Needs Assessments (PNAs) under the Social Services and Wellbeing (Wales) Act 2014, and all Well-being Assessments (WBAs) under the Well-being of Future Generations (Wales) Act 2015 with a view to evaluating how the emotional and mental health needs of children and young people who have been abused are being assessed and met at local level.
Emotional and mental health is a key priority for local assessments.
8. We are pleased to see that children and young people’s mental health features as a priority in the overwhelming majority of PNAs and WBAs. However, the format and style of the assessments varies: some just list local issues, others offer more in the way of analysis about what the future direction of service development should be. Regional plans and well-being plans which are currently being developed will need to be scrutinised to ensure that appropriate services are being developed to respond to the emotional and mental health needs of children and young people, and that there is appropriate cross over with the Together for Children and Young People programme. This is particularly important as only one assessment explicitly mentions T4CYP.
Adverse Childhood Experiences and their impact on emotional and mental health.
9. We welcome the fact that the overwhelming majority of assessments recognise the negative impact of Adverse Childhood Experiences (ACEs) on children and young people’s mental health. There is also an acknowledgement that children and young people in the care system are at higher risk of developing poor mental health. The main reason for children and young people entering care in Wales is abuse and neglect, and the Public Health Wales research on ACEs includes child maltreatment issues such as verbal, mental, sexual and physical abuse, and being raised in a household where domestic violence and substance misuse are present.
10. Early intervention services should be developed and existing support strengthened as a priority to break the cycle of ACEs and prevent children entering care in the first place. It will be particularly important to tackle child neglect, which has been the main reason for children being placed on child protection registers every year between 2002 and 2016 in Wales.[11]
Access to mental health services
11. Despite the Together for Children and Young People programme being launched at the end of February 2015, many PNAs highlight access to CAMHS as an issue which needs to be addressed. Some of the feedback comes from young people themselves, who seem to be struggling to access support for emotional and mental health issues. The reason for this may be that assessments were carried out before any improvement coming from the Together for Children and Young People Programme started becoming apparent at local level.
12. Some areas report a worrying increase in self-harm. This is consistent with figures we obtained at the end of 2016, which showed that nearly 1,200 children in Wales were admitted to hospital after harming themselves in the last year- a 41% rise over three years.
13. While we welcome the recent announcement by Welsh Government that all areas have now met their waiting time targets for assessment for CAMHS, there is a need to further scrutinise how CAMHS services are meeting the needs of vulnerable children and young people, especially with regard to the therapeutic support provided to children and young people recovering from abuse. We particularly welcome the recent announcement by Welsh Government of the pilot project involving placing trained CAMHS staff in schools, and feel that this will be worth monitoring.
14. We would also wish the Committee to scrutinise what support is available from universal and targeted services for children and young people who do not meet the threshold for CAMHS.
Children in care and mental health
15. Some areas also highlight the need to ensure that looked after children have access to appropriate support services: out of 7 PNAs, 4 refer directly to the importance of ensuring better mental health for looked after children. Statutory guidance on part 6 of the Social Services and Wellbeing (Wales) Act 2014 (looked after and accommodated children) highlights the importance of meeting the emotional and mental health needs of children in care through the care and support planning process. We welcomed this, and the requirement for the entry into care health assessment to include mental health. However, there is no requirement for a specialist professional to carry out this assessment. We would wish the Committee to look into how the mental health needs of looked after children are being assessed and met through the care and support planning process.
Conclusion: the cost of late intervention
16. Getting the right support at the right time for children and young people who have experienced abuse and neglect is a moral imperative, but it also carries significant financial benefits in an age of reduced budgets.
17. As part of a project carried out in 2015 on the emotional wellbeing of LAC, the NSPCC asked the University of Loughborough to carry out cost modelling using their cost calculator for children’s services and it concluded that a child’s unstable and unsupported experience of care costs £22,415 more per year than another child’s stable and well-supported care. This costing exercise was carried out in an English context but it can be helpful in illustrating the need to ensure support is put in place at an early stage to avoid problems escalating and leading to placement breakdown and poor outcomes. [12]
18. Figures from the Early Intervention Foundation also show that in Wales we spend £1.1bn per year on the damaging problems that affect children and young people such as domestic violence and abuse, child neglect and maltreatment, mental health problems, youth crime and exclusion from education and the labour market. While this figure is substantial, it is only the immediate fiscal cost so does not capture any lasting effects into adult life and sometimes into the next generation, nor the wider social and economic costs. [13]
19. We hope that this analysis is of use to the Committee in their scrutiny of the Together for Children and Young People Programme, and in formulating recommendations for the future of emotional and mental health support for children and young people in Wales.