Children and young people's mental health and emotional wellbeing (health and wellbeing needs in South Tyneside)

There are a number of risk factors for mental health and emotional wellbeing that have been identified through research. These include:

• Poverty,
• Maternal and infant health,
• Learning disabilities,
• Ethnicity, gender, and sexual orientation,
• Work, education and early years development,
• Family breakdown or social issues (including when children require care and support),
• Lifestyle and behaviours (although these can be a result of MHEW need as well as a cause),
• Offending,
• Chronic disease.

On many of the areas above South Tyneside is shown in routinely collected (and publicly available) data to be worse than the England average, and often regional peers.

Using the Children and Young People Mental Health Profile Tool 'Those at Risk' are outlined in the following profile - Primary Prevention - Adversity and Primary Prevention - Vulnerability

Using the Children and Young People's Health Benchmarking Tool we can see South Tyneside's absolute and relative position on a number of key risk factors:

Poverty

• There are over 6,500 children under 16 living in poverty in South Tyneside (2013), which at 25.9% is significantly higher than the national (18.6%) and regional averages (23.3%),

Maternal and infant health

• South Tyneside has the worst smoking in pregnancy rate in the country at 25.9% (2014 / 15),
• Locally breast feeding initiation and maintenance rates are low at 53% for initiation and only 24.4% at 6 - 8 weeks. These rates are significantly lower than national averages,
• Evidence clearly illustrates the importance of reducing the exposure of babies to second-hand smoke, and promoting breast feeding to improve the health of the baby and promote a strong bond between the mother and child. These both lead to improved MHEW in the child over their lifetime,
• Although South Tyneside has made great progress on reducing under 18 conceptions (down by half since the early 2000s) they are still higher than the national average.

Learning disabilities

• People with learning disabilities are more likely to experience mental health problems (Emerson, E. et al, 2008)[9]. Estimation of the population prevalence of learning disability is problematic and should be treated with caution. The estimated number of children with a learning disability in South Tyneside are:
  • 80 5 - 9 year olds,
  • 175 10 - 14 year olds,
  • 240 15 - 19 year olds,
• These rates for different age groups reflect the fact that as children get older, more are identified as having a mild learning disability. The Foundation for People with Learning Disabilities (2002)[10] estimates an upper estimate of 40% prevalence for mental health problems associated with learning disability, with higher rates for those with severe learning disabilities.The estimated total number of children with learning disabilities with mental health problems in South Tyneside are:
  • 35 5 - 9 year olds,
  • 70 10 - 14 year olds,
  • 95 15 - 19 year olds.

Ethnicity, gender, and sexual orientation

• South Tyneside has a predominantly white population with over 93% of the 0 - 19 population recognised as White British, leaving around 2,000 non-white children. The largest non-white population group is the Asian / Asian British: Bangladeshi at around 2% of the 0 - 19 population which is largely found in the Riverside / Ocean Road areas of South Tyneside.
• The Government estimates put the numbers of LGB between 5 - 7% of the population. At an approximate rate of 6%, this would equate to 9,167 LGB people in South. [11]
• There are no data around LGBTQ young people or those who don't identify as cisgender. There are no comprehensive data about LGBTQ young people who accessed MHEW services.

Work education and early years development

• The percentage of children achieving a good level of development at the end of reception is significantly worse than the national average, at 60% locally (2014 / 15). This is even lower for children who are eligible for free school meals at 46%,
• South Tyneside (in 2014) has a significantly higher proportion of 16 - 18 year olds not in education employment or training (6%) when compared to the national average (4.7%),

Family breakdown or social issues

• South Tyneside had 180 families in 2013 / 14 recorded as homeless (number of applicant households with dependent children or pregnant women accepted as unintentionally homeless or eligible for assistance) - this give South Tyneside a significantly higher rate than the national average.
• Looked-after children are more likely to experience mental health problems (Ford, T. et al, 2007)[12]. It has been found that among children aged 5 to 17 years who are looked after by local authorities in England, 45% had a mental health disorder, 37% had clinically significant conduct disorders, 12% had emotional disorders, such as anxiety or depression, and 7% were hyperkinetic (Meltzer, H. et al, 2003)[13].
• In 2014 South Tyneside was recorded as having 310 children in care which gives a significantly higher rate than the national and regional average.
• There is a clear association between domestic violence, abuse and substance misuse and mental health problems in mothers, and also children. There can also be an impact on child emotional and cognitive development.
  • Around 10% of South Tyneside's 900 substance misuse clients (who are known to service) are living with a child, another 40% of clients have a child but don't live with that child.

Lifestyle and behaviours

• South Tyneside has over a third of year 6 pupils classified as being overweight or obese (significantly higher than the national average). This could have significant implications for the emotional health of many children in South Tyneside,
• There are also a significantly higher proportion of children aged 15 smoking regularly in South Tyneside (7.7%) compared to the national average of 5.5%,
• Locally there are also significantly higher rates of hospital admissions due to alcohol specific conditions and substance misuse than England.
• In 2014 - 15 there were 154 young people (<18) in specialist substance services in the South Tyneside community. There has been a steady decline in numbers in treatment since 2012-13 (then 173 per year). The majority of children in service are males (68%).

Offending

• South Tyneside has a significantly higher rate of 10 - 17 year olds receiving their first reprimand, warning or conviction per 100,000 population when compared to the national rate. This equated to 78 children in 2014 in South Tyneside. This has increased year on year in South Tyneside since 2012, but not statistically.

Chronic disease

• All children will likely have many different health problems during infancy and childhood, but for most children these problems are mild, they come and go, and they do not interfere with their daily life and development. For some children, however, chronic health conditions affect everyday life throughout childhood. [1]
• Chronic condition is an "umbrella" term. Children with chronic illnesses may be ill or well at any given time, but they are always living with their condition. Some examples of chronic conditions include (but are not limited to) asthma (the most common), diabetes, and cancer.

To reduce the risk of mental health problems there is a suggested Five-a-Day for Health and Happiness:

• Connect - how to connect with people around you
• Be active - exercise, move about, change your surroundings
• Keep learning - try something new, learn to cook, read
• Take notice - ask questions, notice positive things in your life
• Give - do something for someone else, say thank you, volunteer

Health Related Behaviour Questionnaire

• In 2006 and 2012 / 13 there was a health related behaviour questionnaire completed in schools in South Tyneside (conducted by the SHEU at Exeter University). HRBQ 2006 and 2012 / 13 HRBQ 2012/13 reports.
• The 2012 survey showed that in year 4 - 6 (aged 8 - 11 year olds in primary school) 72% were worried about at least one of the items listed in the questionnaire:
• 41% worried about exams / tests, 30% about crime, 28% about family problems.
• The table below illustrates the emotional wellbeing results results for years 8 and 10 from both the 2006 and 2012 / 13 surveys:

• The main issues of concern cited by pupils continue to be exams and "The way I look". This also corresponds with qualitative data collected from the Youth Parliament.

[1] chronic health condition as a health problem that lasts over three months, affects a child's normal activities, and may require hospital admissions, outpatient appointments and / or home health care