Lead: Dr. Corine Driessens, Professor Peter W F Smith

Team: Fiona Lacey, YoungMinds

Start date: October 2022

Ends date: September 2024

Background

For the past 2 decades, the prevalence of emotional mental health disorders, such as anxiety and mood disorders, has been growing among English children and adolescents. It is estimated that on any day 16% of young people in English society experience emotional mental health problems and the majority of young people have experienced some period with mental health problems by age 14. About 50% of the young people with mental health problems continue to experience these problems from age 14 into young adulthood and about 75% of the adults with mental health problems report their onset of these problems before age 24. These figures are still an underestimation of the growing public health crisis as estimation methodology was biased. There is proof that people experiencing mental health problems are more reluctant to participate in epidemiological surveys. For instance, it was found that attrition and sporadic non-response to the Avon Longitudinal Study of Parents and Children (ALSPAC) survey was dependent on presence of emotional mental health problems. The methodology used to estimate mental health parameters from existing cohort study data should therefore take this missing data dependent on mental health status (nonignorable missing data, Missing-Not-At-Random – MNAR data) into account.

In the proposed study we will apply MNAR methodology to a currently active discussion on the need to expand mental health services to young people with mental health problems currently not receiving mental health services. On the one hand is the concern for medicalization of mental health problems that are experienced in the scope of normal development. The health care providers are concerned that young people will be disempowered if their sense of resilience is diminished (Foulkes, 2021). On the other hand, is the concern that there are serious inequalities in accessing mental health care services and service access needs to be facilitated for these underserved subpopulations.

Currently 1 in 4 of the children and young people experiencing mental health problems receive mental health care services. Barriers to mental health service access has been explored among those currently receiving or trying to access mental health services. However, there is a lack of knowledge what happens to those young people not seeking mental health services.