Children and young people's mental health

Healthwatch Herefordshire undertook a large-scale project on children and young people’s mental health after it was identified as one of the county’s priority issues. The project engaged with 3,898 young people through surveys, focus groups, school visits and youth events to explore experiences of mental health support, access to services and factors affecting wellbeing. 

The report found that schools across Herefordshire provide a wide range of mental health support, including pastoral care, wellbeing centres, counselling, school nurses, peer support schemes and mental health awareness activities. However, provision varied considerably between schools, and some young people reported not knowing what support was available. Participants felt that schools were doing a great deal to support wellbeing but could benefit from sharing good practice and learning from one another. 

Young people and school staff highlighted a need for stronger communication between schools and external mental health organisations. Many respondents felt that schools were not always clear about referral pathways or aware of all available community services. The report found that young people who had used organisations such as Strong Young Minds, CLD, wellbeing ambassador programmes and community groups generally viewed them very positively, suggesting that greater promotion of these services could improve access to support. 

Bullying emerged as one of the most consistent themes throughout the project. Young people repeatedly identified bullying as a major contributor to poor mental health and one of their greatest concerns when moving from primary to secondary school. Participants felt that tackling bullying more effectively would have a significant positive impact on wellbeing. 

Many young people said they wanted schools to provide more opportunities to talk openly about mental health, additional support for those struggling, better signposting to services and more education about mental wellbeing throughout the curriculum rather than only in PSHE lessons. There were also calls for more consistent counselling services and greater support from trained staff. 

The report found that the environment in which support is delivered can have a significant impact on young people’s comfort and engagement. Some young people reported that attending appointments in familiar settings such as schools reduced anxiety and made it easier to engage with professionals. Others commented that some clinical environments felt uncomfortable or intimidating.

Among young people who had experienced mental health difficulties, experiences of support varied. Some reported receiving support for only a few weeks, while others received help for longer periods or had ongoing support. Several participants highlighted long waiting times for services and expressed concerns that mental health difficulties could worsen while waiting for treatment or counselling. 

The project also explored the role of technology. Young people identified several apps and digital tools that supported their mental wellbeing, with the Headspace app and music platforms such as Spotify mentioned most frequently. However, participants also cautioned that online information could sometimes be unhelpful or unsafe, highlighting the importance of online safety and evidence-based digital resources. 

The findings suggested that mental health difficulties often begin during early adolescence, with peaks in reported symptom onset at ages 11 and 15. Family members, friends and teachers were identified as the most important influences encouraging young people to seek help. When they did seek support, GPs were the most common source of professional help, underlining the importance of primary care services being equipped to respond to young people’s mental health needs. 

Young people generally valued support from trusted adults, peer support schemes and opportunities to discuss mental health openly. They also highlighted concerns about exam pressure, homework, family issues, bereavement, social media and sleep disruption as important factors affecting wellbeing. 

Overall, the report concluded that while there was much good practice in Herefordshire, improvements were needed in consistency of support, communication with external services, anti-bullying work, waiting times, and awareness of available mental health resources. Healthwatch recommended establishing a Youthwatch group to ensure young people’s voices continue to influence services, maintaining the Schools Mental Health Forum, strengthening anti-bullying initiatives, improving promotion of community support services, considering the impact of treatment environments, encouraging peer support approaches and developing greater consistency in whole-school mental health provision across the county.