The postcode lottery effect on children’s mental health prescriptions

The postcode lottery effect on children’s mental health prescriptions
© shutterstock/fizkes

A new study by the University of Aberdeen found that mental health prescriptions for children are up by nearly 60%. To discuss this further, Monet Bailey spoke with William Ball RN, a Research Fellow at the University of Aberdeen about the team’s findings.

Mental health and wellbeing have never been so important. More children and young people are suffering from mental health problems than ever. Increased social media use, the COVID-19 pandemic and unrealistic beauty standards are just some of the added pressures that young people are facing.

To bring some light on children’s mental health statistics, a team of researchers from the University of Aberdeen conducted a study into one Scottish health board finding a steep rise in mental health prescriptions for children and surprising health inequalities regarding gender and affluence.

Monet Bailey spoke with William Ball RN, a research fellow at the University of Aberdeen to explore children’s mental health.

New research from the University of Aberdeen found that mental health prescriptions for children had increased by 56% since 2015 in one Scottish health board. What are the driving factors behind this figure?

Since 2015 we’ve seen a steady rise in the rate of mental health prescriptions for children in NHS Grampian. While this study did not explore the potential explanations for this pattern, other research shows that the proportion of young people reporting symptoms of poor mental health has also increased over time. This suggests that there is an increasing need for support or treatment for these children. However, we cannot say conclusively from this analysis whether the increase in prescriptions is due to more children needing/seeking help or a change in prescribing practice.

The study highlighted clear disparities in mental healthcare in areas in poverty versus wealthy regions. What is the effect of the postcode lottery on the level of support a child with mental health conditions will receive in Scotland? What measures could be implemented at policy level to address this?

We found a clear social gradient in both mental health prescribing and in referrals to specialist CAMHS. Children living in the most deprived areas received double the rate of prescriptions and referrals compared with children in the least deprived areas. This indicates a higher level of need in these areas but not necessarily a lower level of support or treatment. We know that the circumstances in which we live have a big influence on our physical and mental health. Children living in the most deprived areas have less access to resources and opportunities that would lead to better mental health. As well as properly funding and staffing children’s mental health services, we should be looking to support children and families who are struggling the most in the middle of this cost-of-living crisis.

What role does gender play in the prevalence of mental health conditions and their treatment for children?

We found some very clear differences between boys and girls. Boys were more likely to receive medications used to treat ADHD and they receive these medications in their younger years. Girls were more likely to receive anti-depressants in their mid to late teens. In terms of referrals to CAMHS, the rate of referral for boys and girls was roughly equal prior to 2020. Since COVID-19 there has been a dramatic change, with a 25% increase in the rate of referral for girls, but almost no change in the rate for boys. Clinicians are well aware of these patterns and recognise that gender plays a role in the type of mental health support children need. However, the recent spike in referrals for teenage girls is concerning and this group should receive a particular focus for support.

The study highlighted that gaps in data and the lack of an integrated children’s medical record system is posing a challenge to researchers. What could be done to reduce the burden that this places on researchers and medical professionals?

At present mental health support for children takes place in a number of settings, including in schools, primary care, and hospital teams as well as through charities and the private sector. This current study was only able to access information held by the NHS, but that doesn’t tell us the whole story. In order to get a more comprehensive picture of when and where children are seeking and accessing help for their mental health, we need greater integration of data sources.

William Ball RN
Research Fellow
University of Aberdeen
Institute of Applied Health Sciences | Aberdeen Centre for Health Data Science

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