Accumulating evidence shows that an increasing number of children and young people (CYP) are reporting mental health problems.

To investigate emotional disorders (anxiety or depression) among CYP in England between 2004 and 2017, and to identify which disorders and demographic groups have experienced the greatest increase.

Repeated cross-sectional, face-to-face study using data from the Mental Health of Children and Young People surveys conducted in 2004 and 2017, allowing use of nationally representative probability samples of CYP aged 5–16 years in England. A total of 13 561 CYP were included across both survey waves (6898 in 2004 and 6663 in 2017). We assessed the prevalence of any emotional, anxiety and depressive disorder assessed using the Development and Well-Being Assessment and classified according to ICD-10 criteria.

The prevalence of emotional disorders increased from 3.9% in 2004 to 6.0% in 2017, a relative increase of 63% (relative ratio 1.63, 95% CI 1.38, 1.91). This was largely driven by anxiety disorders, which increased from 3.5 to 5.4% (relative ratio 1.63, 95% CI 1.37, 1.93). The largest relative changes were for panic disorder, separation anxiety, social phobia and post-traumatic stress disorder. Changes were similar for different genders and socioeconomic groups, but differed by ethnicity: the most pronounced increase was among White CYP (relative ratio 1.88, 95% CI 1.59, 2.24), compared with no clear change for Black and minority ethnic CYP (relative ratio 0.85, 95% CI 0.52, 1.39). Comorbid psychiatric conditions were present in over a third of CYP with emotional disorders, with the most common being conduct disorder.

Between 2004 and 2017, the increase in emotional disorders among CYP in England was largely driven by anxiety disorders. Socioeconomic inequalities did not narrow. Disaggregating by ethnicity, change was evident only in White CYP, suggesting differential trends in either risk exposure, resilience or reporting by ethnicity.

We rely heavily on cut-off points of brief measures of psychological distress in research and clinical practice to identify those at risk of mental health conditions; however, few studies have compared the performance of different scales.

To determine the extent to which the child- and parent-report Strength and Difficulty Questionnaire (SDQ), Revised Children’s Anxiety and Depression Scale (RCADS), short Mood and Feeling Questionnaire (sMFQ) and child-report KIDSCREEN correlated and identified the same respondents above cut-off points and at risk of mental health conditions.

A cross-sectional survey was conducted among 231 children aged 11–16 years and 289 parents who completed all the above measures administered via a mobile app, MyJournE, including the SDQ, RCADS and sMFQ.

The psychopathology measures identified similar proportions of young people as above the cut-off point and at risk of depression (child report 14.7% RCADS, 19.9% sMFQ, parent report 8.7% RCADS, 12.1% sMFQ), anxiety (child report 24.7% RCADS, 26.0% SDQ-Emotional subscale, parent report 20.1% RCADS, 26% SDQ-Emotional subscale) and child-report internalising problems (26.8% RCADS, 29.9% SDQ). Despite strong correlations between measures (child report 0.77–0.84 and parent report 0.70–0.80 between the SDQ, sMFQ and RCADS) and expected directions of correlation with KIDSCREEN and SDQ subscales, kappa values indicate moderate to substantial agreement between measures. Measures did not consistently identify the same children; half (n = 36, 46%) of those on child report and a third (n = 30, 37%) on parent report, scoring above the cut-off point for the SDQ-Emotional subscale, RCADS total or sMFQ, scored above the cut-off point on all of them. Only half (n = 46, 54%) of the children scored above the cut-off point on child report by the SDQ-Internalising and RCADS total scales.

This study highlights the risk of using a screening test to ‘rule out’ potential psychopathology. Screening tests should not be used diagnostically and are best used together with broad assessment.

To develop effective mental health interventions for children and adolescents, it is essential to understand the intricate link between functional disability and mental well-being in this group.

To explore the network connections between various aspects of functional disability and mental well-being in young people with disabilities.

We analysed data from the Multiple Indicator Cluster Surveys in 47 low- and middle-income countries, tracking progress towards health-related sustainable development goals. Our focus was on children and adolescents aged 5–17 with functional disabilities. Mental well-being was gauged using carer-reported signs of depression, anxiety and disability on the Child Functioning Module. Network-analysis techniques were used to examine links between mental well-being and functional disability domains.

The study included 32 669 eligible children aged 5–17 with functional disabilities (14 826 females and 17 843 males). The core domains of disability with the strongest connections to poor mental well-being were difficulties in accepting change, making friends, behavioural control (controlling own behaviour) and remembering/concentrating. These associations remained largely consistent across different genders and developmental stages. However, there were notable gender differences and age-related shifts in the relationships between specific disabilities and mental well-being. In particular, signs of anxiety in males and depression in females were most associated with functional disability overall, while signs of depression had the closest links to disability in adolescents.

The network perspective may enable the design of tailored interventions and support services that consider age and gender differences. Further research should continue to explore these complex relationships, incorporating novel methodologies like network-analysis to enhance the understanding of these associations.

National policy in England recommends that young people be admitted to mental health wards that are age-appropriate. Despite this, young people continue to be admitted to adult wards.

To explore the impact of young people’s admissions to adult wards, from the perspectives of young people, parents/carers and mental health professionals working in adult services.

Semi-structured interviews were conducted with 29 participants to explore experiences of receiving and delivering care in adult mental health wards. Participants were four young people (aged 16–17 years), four parents/carers and 21 mental health professionals from adult mental health services in England. Data were analysed using framework analysis.

Young people’s admissions to adult wards tend to occur out of hours, at a time of crisis and when no suitable adolescent bed is available. Admissions were conceptualised as a short-term safety measure rather than for any therapeutic input. Concerns were raised about safeguarding, limited treatment options and a lack of education provision for young people on adult wards. However, exceptionally, for older adolescents, an adult ward might be clinically or socially appropriate. Recommendations to reduce adult ward admissions included better integration of adolescent and adult services, having more flexible policies and increasing community provision.

Our findings emphasise the importance of young people being admitted to age-appropriate in-patient facilities. Earlier intervention and increased provision of specialist care in the community could prevent young people’s admissions to adult wards.

A youth mental health crisis is considered one of the great challenges of our time, and research and clinical services in child and adolescent psychiatry have become a priority for governments and funders. Academic leadership is needed to drive forward research. It is not clear how many senior academic leadership posts (professorships) there are in child and adolescent psychiatry, nor how this benchmarks against a similarly sized medical specialty.

This study aimed to determine the number of professorships in child and adolescent psychiatry in the UK and Ireland compared to a similarly sized specialty. A secondary aim was to identify the number of clinical trials registered for mental and behavioural disorders in children.

We identified registered specialists in child and adolescent psychiatry and a similarly sized specialty who held full professorships in medical schools. We searched the International Standard Randomised Controlled Trial Number (ISRCTN) and ClinicalTrials.gov for trials.

As of 23 March 2023, there were 1725 doctors on the General Medical Council's (GMC) specialist register in child and adolescent psychiatry. The closest specialty in terms of number of registered specialists was neurology (N = 1724). We identified 24 professors in child and adolescent psychiatry across the UK and Ireland, compared to 124 in neurology. For every intervention trial registered for mental and behavioural disorders in children, there were approximately ten trials registered for diseases of the nervous system.

Despite equivalent numbers of medical specialists in child and adolescent psychiatry and neurology, there is a striking disparity in the number of professorship appointments. While young peoples’ mental health has, ostensibly, become a priority for policy-makers and funders, this is not reflected in medical professorship appointments. The paucity of senior academic child and adolescent psychiatrists has real-world implications for training, research, innovation and service development in mental health services.

Childhood bullying is a public health priority. We evaluated the effectiveness and costs of KiVa, a whole-school anti-bullying program that targets the peer context.

A two-arm pragmatic multicenter cluster randomized controlled trial with embedded economic evaluation. Schools were randomized to KiVa-intervention or usual practice (UP), stratified on school size and Free School Meals eligibility. KiVa was delivered by trained teachers across one school year. Follow-up was at 12 months post randomization. Primary outcome: student-reported bullying-victimization; secondary outcomes: self-reported bullying-perpetration, participant roles in bullying, empathy and teacher-reported Strengths and Difficulties Questionnaire. Outcomes were analyzed using multilevel linear and logistic regression models.

Between 8/11/2019–12/02/2021, 118 primary schools were recruited in four trial sites, 11 111 students in primary analysis (KiVa-intervention: n = 5944; 49.6% female; UP: n = 5167, 49.0% female). At baseline, 21.6% of students reported being bullied in the UP group and 20.3% in the KiVa-intervention group, reducing to 20.7% in the UP group and 17.7% in the KiVa-intervention group at follow-up (odds ratio 0.87; 95% confidence interval 0.78 to 0.97, p value = 0.009). Students in the KiVa group had significantly higher empathy and reduced peer problems. We found no differences in bullying perpetration, school wellbeing, emotional or behavioral problems. A priori subgroup analyses revealed no differences in effectiveness by socioeconomic gradient, or by gender. KiVa costs £20.78 more per pupil than usual practice in the first year, and £1.65 more per pupil in subsequent years.

The KiVa anti-bullying program is effective at reducing bullying victimization with small-moderate effects of public health importance.

The study was funded by the UK National Institute for Health and Care Research (NIHR) Public Health Research program (17-92-11). Intervention costs were funded by the Rayne Foundation, GwE North Wales Regional School Improvement Service, Children's Services, Devon County Council and HSBC Global Services (UK) Ltd.

This retrospective cohort study using routinely collected administrative clinical data from the Cambridgeshire and Peterborough Foundation Trust (CPFT) Research Database, aims to understand how many children and young people (CYP) with attention-deficit/hyperactivity disorder (ADHD) undergo successful transition from child and adolescent mental health services (CAMHS) and community paediatric services, to adult mental health services and investigate the factors that are associated with the successful transition of care in young people with ADHD to adult services.

Many young people with ADHD, in need of service transition from child to adult services, experience serious barriers in receiving the care they need, constrained by scarce resources, low capacity in specialist services and variable awareness or training across various levels of care.

We explored the numbers and clinical and socio-demographic characteristics of CYP with ADHD who undergo successful transition from CAMHS and paediatric services, to adult mental health services. We will explore whether children with certain sociodemographic factors/treatment/service attended are more likely than others to successfully transition using multivariable logistic regression.

Note results are rounded for statistical disclosure control. We identified 24,240 unique CYP for whom a referral (age < 18) exists to CPFT between 1 Sep 2007 and 31 Aug 2019 (with follow up until 2020). Of this cohort, 2300 were referred at any time to any ADHD service, 1760 CYP had a record of ADHD medication in their clinical notes at any time of whom 1590 CYP had a record of ADHD medication under the age of 18. Of these 1590 CYP, 330 had at least 1 year follow up in the database before and after their 18th birthday and a record of ADHD prescribing during the year before they turn 18. This is a cohort of CYP who should have transitioned from child to adult services. Of these 330, 160 (48%) had been referred to any ADHD service between their 17th and 19th birthday and 190 (58%) had any record of ADHD medication in the year after they turn 18. Further analyses will explore the characteristics of CYP who successfully transition, and we will carry out a series of sensitivity analyses.

With an increase in the number of children with ADHD who are prescribed medication, we can expect an increasing cohort of emerging adults who need continued care. This study will provide evidence on the current state of care to help identify areas for improvement.

The last few years have witnessed dramatic increases in presentations of eating disorders to mental health services for children and adults, which could relate to a greater number of people seeking help or to an increase in eating disorders at the population level. Aims: To evaluate the feasibility of online completion of a single module of the compare the Development and Well-Being Assessment (DAWBA) and to estimate the population prevalence of eating disorders among children and young people aged 6 to 19 years in 2017 and 2021, and to estimate the prevalence of eating disorders among emerging adults aged 20 to 23 years in 2021.

The Mental Health of Children and Young People in England was a cross-sectional survey of a probability sample that recruited 9,117 children and young people in 2017. Follow-up surveys were conducted in 2020, 2021 and 2022. The DAWBA, a multi-informant standardised diagnostic assessment, was completed by parents, teachers and young people aged 11 years or more in 2017. It covered all common mental health conditions, including eating disorders. In 2021 and 2022, parents and young people aged 11 years and over completed the five initial DAWBA screening items to assess eating difficulties as part of the follow-up questionnaire. In 2021, parents and young people who screened positive (n = 1030) were invited to complete the DAWBA eating disorder module online, and a small team of clinical raters reviewed their reports to assign diagnoses according to DSM 5.

There was a year delay in the provision of contact details to contact screen positives, and the response rate was 37% overall, comprising 28% of children aged 11 to 16 years, 23% of young people 17 to 25 years and 19% of parents initially invited. Our results illustrate the large and sustained increase in screen positives between 2017 and the follow-up surveys. We are currently quality-checking the clinical rating for the 2021 data, so we are close to a final prevalence of eating disorders for 2021.

There was an increase in the proportion of children aged 11–16 years with eating difficulties between 2017 (8.4% girls, 5.1 % boys) and 2021 (17.4 % girls, 8.4 % boys), which was maintained in 2021 and 2022 (17. 4% girls, 8.4 % boys). There were similar findings for young people aged 17 to 19 years (60.5% girls, 29.6% boys 2017, 76 % girls, 46% boys 2022)).

Inviting multiple informants provided data on more children and young people although many only had a single report from the person who screen positive. Wave 4 (2023) will integrate the eating disorder module into the original questionnaire to improve response rates. We suspect that the increase in the prevalence of eating disorders will be small despite the large and worrying increase in eating difficulties.

Liaison psychiatry provision for children and young people in England is poorly evaluated.

We sought to evaluate paediatric liaison psychiatry provision and develop recommendations to improve practice.

The liaison psychiatry surveys of England (LPSE) cross-sectional surveys engage all liaison psychiatry services in England. Services are systematically identified by contacting all acute hospitals with emergency departments in England. Questions are developed in consultation with NHS England and the Royal College of Psychiatrists’ Faculty of Liaison Psychiatry, and updated based on feedback. Responses are submitted by email, post or telephone. Questions on paediatric services were included from 2015 (LPSE-2), and we analysed data from this and the subsequent four surveys.

The number of acute hospitals with access to paediatric liaison psychiatry services increased from 29 (15.9%) in 2015 to 46 (26.6%) in 2019, compared with 100% provision for adults. For LPSE-4, only one site met the Core-24 criteria of 11 full-time equivalent mental health practitioners and 1.5 full-time equivalent consultants, and for LPSE-5, just two sites exceeded them. Acute hospitals with access to 24/7 paediatric liaison psychiatry services increased from 12 to 19% between LPSE-4 and LPSE-5. The proportion of paediatric liaison psychiatry services based offsite decreased from 30 to 24%.

There is an unacceptable under-provision of paediatric liaison psychiatry services compared with provision for adults. Number of services, staffing levels and hours of operation have increased, but continued improvement is required, as few services meet the Core-24 criteria.