The survey reports on the mental health of children and young people in England.

One in six children has probable mental disorder in 2021 – continuing 2020 peak

A survey published today by NHS Digital found one in six children in England had a probable mental disorder in 2021 – a similar rate to 2020 but an increase from one in nine in 2017.

The survey, called Mental Health of Children and Young People in England 2021, involved experts from the University of Exeter. It showed that among six to 16 year olds, the proportion with a probable mental disorder remained at one in six (17 per cent) in 2021. Among 17 to 19 year olds, the rate was also one in six (17 per cent).

Figures were statistically similar in 2020 and 2021. In 2020, the rate of probable mental disorders was also one in six for both these age groups.

Both years showed an increase from 2017, when one in nine (12 per cent) six to 16 year olds and one in ten (10 per cent) 17 to 19 year olds had a probable mental disorder.

The survey was carried out earlier this year by a team including the University of Exeter, the Office for National Statistics (ONS), the National Centre for Social Research (NatCen)^, and the University of Cambridge. It was funded by the Department for Health and Social Care and UK Research and Innovation, and commissioned by NHS Digital. The researchers from the University of Exeter Medical School’s Children and Young People’s Mental Health Research Collaboration (ChYMe) included Dr Tamsin Newlove-Delgado, who was an academic consultant on the survey, and Dr Shelley Norman and Franki (Frances)  Mathews, who also worked on designing the survey and writing the report.

The survey reports on the mental health of 3,667 children and young people aged 6 to 23 in England in 2021 and how this has changed since 2017 and 2020. Children, young people and parents were also surveyed about their experiences of family life, education, and support for mental health problems during the pandemic. The survey series used the same questionnaire in 2017, 2020 and 2021 to assess different aspects of mental health, including problems with emotions, behaviour, relationships, hyperactivity, and concentration. Responses were used to estimate how likely it is that the child might have a mental disorder, this was classified as either ‘unlikely’, ‘possible’ or ‘probable’.”

Dr Tamsin Newlove-Delgado, of the University of Exeter, said the finding that the prevalence of probable mental health problems in children and young people had remained stable since the 2020 peak was “concerning”. 

She said: “Many young people have found it very challenging to negotiate the milestones of leaving school or home, starting work or study or looking for jobs in very different circumstances. A quarter of 17 to 23 year olds said restrictions had made their lives much worse. Two-fifths of young people with a probable mental disorder also reported that they hadn’t sought any help or advice between August 2020 and Spring 2021, which is worrying when we know that getting treatment early can help prevent more severe problems later. 

She added: “We need to bear in mind that the situation has changed since the survey took place, when the country was in the third period of lockdown. With the lifting of restrictions, hopefully there have been many positive changes in children and young people’s lives which might improve wellbeing. However, it’s important for all of us to remember that some children and young people may find the return to school, college or university to be stressful and difficult, or may experience anxiety around lifting of restrictions and may need more help and support.  

“The longer term impacts on mental health and wellbeing are yet to be felt, and we must not leave the most affected groups of children and young people behind as we gradually emerge from the pandemic. We need to continue monitoring children and young people’s mental health and wellbeing over the coming months and years, so that we can identify, plan and provide support for those that need it most, as well as thinking about recovery for society as a whole.” 

The report found 39 per cent of children now aged six to 16 experienced a deterioration in their mental health between 2017 and 2021, while 22 per cent saw an improvement.

Among young people now aged 17 to 23, 53 per cent experienced a decline in mental health since 2017 and 15 per cent experienced an improvement over that time. 

Girls now aged between 11 and 16 were more likely to have experienced a decline in mental health (43 per cent) than boys the same age (34 per cent). This trend was also seen among those now aged 17 to 23, where young women were more likely to have experienced deterioration (61 per cent) than young men (44 per cent). However, some of this change may be due to different rates of mental health conditions being present at different ages.

Frances Mathews, of the University of Exeter, also worked on the report. She said the survey found that 47.5 per cent of parents and 59.7 per cent of young people reported that they had sought help about  mental health concerns from family and friends. She said:  “We need to continue to raise awareness around mental health across society as a whole. This is particularly relevant in schools, as 68.3 per cent of parents of children with a probable mental disorder told us the help and support they accessed was via education services. This really highlights the important role that schools play in child mental health and wellbeing.”

Other topics covered in the report included:

• Eating problems: The proportion of 11 to 16 year olds with possible eating problems increased from 7 per cent in 2017 to 13 per cent in 2021. Rates were higher for older age groups. Among young people aged 17 to 19, the proportion with a possible eating problem rose from 45 per cent in 2017 to 58 per cent in 2021.
• Sleep problems: In 2021, over a quarter (29 per cent) of six to 10 year olds, over a third (38 per cent) of 11 to 16 year olds, and over half (57 per cent) of young people aged 17 to 23 were affected by problems with sleep on three or more nights of the previous seven. Across all age groups, levels of sleep problems were much higher in those with a probable mental disorder.
• Loneliness: In 2021, 5 per cent of 11 to 16 year olds and 13 per cent of 17 to 22 year olds reported feeling lonely often or always. Rates were higher in girls and young women than in boys and young men, and in those with a probable mental disorder, compared with those unlikely to have one.
• Substance use: In 2021, most 11 to 16 year olds reported that they had not used alcohol (94 per cent), cigarettes (98 per cent), or cannabis or other drugs (99 per cent) in the previous seven days. While rates of cigarette and drug use remained similar in 2020 and 2021, the proportion of 17 to 22 year olds who had had an alcoholic drink in the previous seven days fell from 56 per cent in 2020 to 43 per cent in 2021.

The report also covers a number of wider topics within the context of the coronavirus (COVID-19) pandemic.

• Social media: In 2021,17 per cent of 11 to 16 year olds using social media agreed that the number of likes, comments and shares they received had an impact on their mood, and half (51 per cent) agreed that they spent more time on social media than they meant to. Girls were more likely to agree with both statements than boys. Responses were similar in 2017 and 2021.
• Family connectedness and functioning: Children and young people aged between 11 and 23 with a probable mental disorder had lower levels of family connectedness than those unlikely to have a mental disorder. Looking at family functioning, in 2021 16 per cent of six to 16 year olds were living in a family with reported problems with functioning. The prevalence of family functioning problems were similar in 2020 and 2021.
• Household circumstances since August 2020: For 8 per cent of children aged six to 16 in 2021, parents reported having recently fallen behind with bills and for 4 per cent, parents could not afford to buy enough food or had needed to use a food bank more. Children with a probable mental disorder were more likely to live in households that had fallen behind with bills, rent or mortgage during the pandemic - 13 per cent of parents of six to 16 year olds with a probable mental disorder reported this, and 9 per cent had become more likely to be unable to afford to buy food, or had used a food bank. This compares with 7 per cent and 3 per cent respectively of those unlikely to have a mental disorder. These findings were similar to levels in 2020. Black and Black British six to 16 year olds were about three times more likely to live in a household that had recently fallen behind with bills, rent or mortgage (19 per cent) than children in the White British group (6 per cent).
• Perceived impact of coronavirus restrictions: In 2021, 13 per cent of 11 to 16 year olds and 24 per cent of 17 to 23 year olds felt their lives had been made ‘much worse’ by coronavirus restrictions. In contrast, 4 per cent of 11 to 16 year olds and 2 per cent of 17 to 23 year olds felt these had made their lives ‘much better’. Children and young people with a probable mental disorder were about twice as likely to report that restrictions made their lives much worse, compared with those unlikely to have a mental disorder.
• School absence: Overall, 11 per cent of six to 16 year olds missed more than 15 days of school for any reason during the 2020 Autumn term. Children with a probable mental disorder were twice as likely to have missed this much school (18 per cent) as those unlikely to have a mental disorder (9 per cent).
• Learning resources: There was an increase in the proportion of 6 to 16 year olds with a laptop or tablet they could work on at home – this rose from 89 per cent in 2020 to 94 per cent in 2021. The proportion receiving regular support from school or college also increased, from 74 per cent in 2020 to 80 per cent in 2021.
• Special Educational Needs and Disabilities (SEND) support: In 2021, the parents of 46 per cent of six to 16 year olds with SEND reported a reduction in the support their child received due to the coronavirus pandemic.

Read the full report

Mental Health of Children and Young People in England 2021

Note: The Mental Health of Children and Young People 2021 survey was carried out by a team including the University of Exeter. The views expressed here are solely those of the academics from the University of Exeter.

Date: 30 September 2021