On Friday (Oct 9th) the government published its independent review into the prevalence of mental health conditions, autism and attention deficit hyperactivity disorder (ADHD). Below, we respond to this review and the government’s separate guidance on Young Futures Hubs, which the review references in its recommendations.

Well Centre Co-Founder and Clinical Director, Dr. Stephanie Lamb, contributed to the review as a Topic Group Member [p. 464] alongside our partner, Prof. Johnny Downs of CAMHS Digital Lab. The Well Centre was cited as a case study in the ‘Neighbourhood delivery and the missing middle’ section [p. 421] where  

‘Evaluation found high levels of satisfaction, with 94% of young people reporting that they would recommend the service. It also reported statistically significant improvements in wellbeing, with more than half of young people showing clinically meaningful improvement following engagement.’ 

While recognising an increasing risk of overdiagnosis of autism and ADHD, the report shows that young people are not “snowflakes”: suffering from mental ‘distress’ has risen significantly since the 1990s, especially for under 18s, with anxiety and depression becoming more common in the population. This rise in distress, and resulting self-harm and mental-health problems, is linked by the review to a lack of housing, employment chances, opportunities, social media, and loneliness. 

None of these factors are new, but tackling each individual problem – and helping the young people most affected – requires remaking the systems which have led us to this crisis in young people’s health.

Anxiety, ill health, school non-attendance: these are not unsolvable problems - Well Centres see young people presenting with these symptoms every day. If we are to solve them at scale, however, it will require system change across the entire health service. 

That’s why we welcome the government’s (separate) announcements on ‘Young Futures Hubs’ - youth spaces with a universally accessible mental health component. These are mentioned in the review’s recommendations [p. 423], and, if delivered correctly, will go a long way towards reaching young people and giving them the support they need. 

However, these services will inevitably see young people with conditions that cannot be treated in a non-clinical setting. If youth health provision is not coordinated, more young people could be placed on waiting lists or referred to distant services. 

Local primary care services already treat many of young people's health problems, including physical and sexual health, in the community and without adding to the burden on specialist services. Yet primary care is not mentioned in the current guidance. We call on DCMS to add "local general practice” and/or “primary care networks (PCNs)” to the suggested health and clinical engagement leads listed under "Public health, wellbeing and specialist clinical services" in Annex A. 

We, as part of a wider alliance of primary care and health professionals working together to improve young people’s health across primary care and beyond, would welcome the opportunity to share learning from GP-integrated youth health services and to support DCMS the government as the guidance develops in developing this guidance further.