Stephen Scott: We neglect children’s mental health at our peril

Prof. Stephen Scott
Professor Stephen Scott CBE FRCPsych FMedSci, President of ACAMH. Stephen is a Consultant Child and Adolescent Psychiatrist in the CAMHS Adoption and Fostering Service and the Conduct Problems Service at the South London and Maudsley NHS Foundation Trust. He is also a Professor of Child Health and Behaviour at the Institute of Psychiatry, King’s College London and the Director of the National Academy for Parenting Research, London.

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Health and happiness”, isn’t that what we ask for? But what is the point of being physically well if we are miserable and don’t have a good life?

The key to a happy life begins in childhood. If good things are put into you, and mental health problems treated early, then you will probably do well later on — with satisfying relationships and a rewarding job. Fifty per cent of adult mental health disorders begin before the age of 14, and 75 per cent before the age of 18.

So obviously we should invest in children’s well-being. We know this when we choose a school for our children — as well as exam results, we look for a nurturing environment that promotes happiness. But we have no say over the quality of the mental services they get.

This is a tragedy, since approximately 16 per cent of children (five in a class of 30) have a serious, diagnosable mental disorder, ranging from anxiety and depression, to behavioural difficulties and ADHD — which have an even bigger effect in spoiling their lives. All of them are often cloaked in shame, so remain largely hidden.

This might be sad but acceptable, if there were no treatments. But we have lots of proven interventions that help young people, and set them up for success as adults.

Thus with anti-social/disruptive behaviour, trials with over 10,000 children show that teaching parents specific techniques has immediate benefits and leads to better school performance and lasting improvements.

But if they are not treated, my own research shows they grow up to cost 10 times extra, £250,000 more than well-behaved individuals. So as well as helping happiness, nipping children’s mental health problems in the bud saves the taxpayer thousands of pounds.

Yet sadly, Child and Adolescent Mental Health Services (CAMHS) are so stretched, with only £50 per head of population to provide outpatient services, that they often exclude children with disruptive behaviour, or who are not suicidal, psychotic or starving themselves. It is time to stop hiding the problem, bring it out into the light and provide the resources to help children be happier and have the chance to grow up as successful adults.


This comment article from ACAMH President Stephen Scott CBE, published in the Evening Standard (UK) on Friday 15 March 2021.


thanks Stephen

Very timely given the impact of COVID-19 and well put

I have worked as a consultant in many areas of CAMHS including in local authority secure homes and a young offenders institute. I am working in a substance misuse service right now. I couldn’t agree more. It is a reason for shame for our society.

Thanks Stephen, for highlighting this. Good mental and physical health complement each other. Working as a tutor with children afflicted with mental health disorders, many are missing out on school, play and on timely interventions from CAMHS. Cases need to be investigated thoroughly, especially for children who have suffered neglect and parenting problems. They end up receiving more attention from social services and the justice system. Some with ADHD like presentations, which seems more like preoccupations than inattention. How can we turn back the clock for them?

Don’t forget, schools also have an important role to play and are in a pivotal position to make a significant difference in young people’s lives, particularly in terms of early intervention/ prevention. This is even more important in today’s world, given the increasing cases of mental health issues, combined with the strain on CAMHS. I think ALL school staff should be trained in, and use, Restorative Approaches. Using a Restorative Approach not only teaches young people empathy, emotional literacy and to take responsibility for their actions, it also builds relationships and creates a sense of belonging to the school, which is an important protective factor.
Since working with you on the SPOKES project, Stephen, I have set up ‘Behaviour Matters’ and have been ‘banging the Restorative drum’ for over 10 years, trying to encourage as many schools as possible to become Restorative, as well as delivering Restorative Parenting workshops (amongst other things!).
We are now really trying to get more secondary schools on board, as this is where problems can become more serious, young people get excluded and a downward spiral can begin, so it’s even more important that conflicts are addressed appropriately, and issues are resolved and repaired.

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