Rate of mental disorders among children remained stable in 2021 after previous rise, report shows
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.
Mental Health of Children and Young People in England 2021 showed that among six to 16 year olds, the proportion with a probable mental disorder remained at one in six (17%) in 2021. Among 17 to 19 year olds, the rate was also one in six (17%).
Figures were statistically similar2 in 2020 and 2021. In 20203, the rate of probable mental disorders was also one in six for both these age groups4.
Both years showed an increase from 2017, when one in nine (12%) six to 16 year olds and one in ten (10%) 17 to 19 year olds had a probable mental disorder.
This report looks at the mental health of children and young people in England in 2021 and how this has changed since 2017 and 20205. Views on family life, education and services and experiences during the coronavirus (COVID-19) pandemic have also been collected. The findings draw on a sample of 3,667 children and young people aged between six and 23 years old, who were surveyed in 2017 and 20216.
The survey was carried out earlier this year by the Office for National Statistics (ONS), the National Centre for Social Research (NatCen)7, University of Cambridge and University of Exeter.
This publication reports individual level change in mental health over time for the same group of children and young people. Some change may be due to different rates of mental health conditions being present at different ages. It shows 39% of children now aged six to 168 experienced a deterioration in their mental health between 2017 and 2021, while 22% saw an improvement.
Among young people now aged 17 to 23, 53% experienced a decline in mental health since 2017 and 15% 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%) than boys the same age (34%). This trend was also seen among those now aged 17 to 23, where young women were more likely to have experienced deterioration (61%) than young men (44%).
Other topics covered in the report included:
- Eating problems9: The proportion of 11 to 16 year olds with possible eating problems increased from 7% in 2017 to 13% 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% in 2017 to 58% in 2021.
- Sleep problems: In 2021, over a quarter (29%) of six to 10 year olds, over a third (38%) of 11 to 16 year olds, and over half (57%) 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% of 11 to 16 year olds and 13% 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%), cigarettes (98%), or cannabis or other drugs (99%) 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% in 2020 to 43% 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% 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%) 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% 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% of children aged six to 16 in 2021, parents reported having recently fallen behind with bills and for 4%, 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% of parents of six to 16 year olds with a probable mental disorder reported this, and 9% had become more likely to be unable to afford to buy food, or had used a food bank. This compares with 7% and 3% 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%) than children in the White British group (6%).
- Perceived impact of coronavirus restrictions: In 2021, 13% of 11 to 16 year olds and 24% of 17 to 23 year olds felt their lives had been made ‘much worse’ by coronavirus restrictions. In contrast, 4% of 11 to 16 year olds and 2% 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% 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%) as those unlikely to have a mental disorder (9%).
- 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% in 2020 to 94% in 2021. The proportion receiving regular support from school or college also increased, from 74% in 2020 to 80% in 2021.
- Special Educational Needs and Disabilities (SEND) support: In 2021, the parents of 46% 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
Notes for Editors
- The 2017 survey and the 2020 and 2021 follow-up surveys used the Strengths and Difficulties Questionnaire (SDQ) to assess different aspects of mental health, including problems with emotions, behaviour, relationships, hyperactivity, and concentration. Responses from parents, children and young people were used to estimate the likelihood that a child might have a mental disorder - this was classified as either ‘unlikely’, ‘possible’ or ‘probable’.
- Where two figures are stated to not be statistically significantly different or statistically similar, this means that they should not be compared other than to treat them as the same. This is because these estimates are based on a survey sample. If we were to repeat the survey several times, there is a good chance the two figures being compared would be exactly the same.
- Any comparisons between 2017, 2020 and 2021 must draw on the results presented in this report for two important reasons:
- While the probable mental disorder prevalence estimates presented in this report are based on the Strengths and Difficulties Questionnaire (SDQ), the initial Mental Health survey of Children and Young People 2017 reported on a different and more detailed diagnostic assessment of mental disorder (even though the SDQ was also used). Results presented in this report are based on a comparable measure of the SDQ using children and young people that were aged between six to 16 and 17 to 19 years at the time of each survey.
- As the cohort are slightly older in the 2021 follow-up, different age bandings have been reported than previous reports, with the 11-16 age group remaining the same. However, due to a methodological change to the derivation of 2017 estimates for this age group, any prevalence figures will slightly differ from those for 2017 in the 2020 report. See the Methodological Change Notice for more information.
- In 2020, 17% of children aged six to 16 and 18% of young people aged 17 to 19 had a probable mental disorder, which is statistically similar to 2021.
- This survey is the second follow-up to the 2017 survey, with the previous follow-up taking place in 2020. Both the 2020 and 2021 surveys used responses submitted online rather than taken face-to-face like the 2017 main survey. The 2021 survey also gave respondents the option to complete the survey over the telephone. It was decided that the SDQ was more suited to the shorter surveys conducted online in 2020 and 2021, which still gave robust estimates on children and young people’s mental health.
- The findings in this report are based on survey data collected from a sample of 3,667 children and young people aged between six and 23 years old in February and March 2021. These have been weighted so they are representative for all children in this age group in England as at 31 August, 2021. These children also took part in the MHCYP 2017 survey which had a bigger sample, and there were 2,541 children and young people who took part in all three surveys (2017, 2020 and 2021). The data is broken down by gender and age bands of six to 10 year olds, 11 to 16 year olds and 17 to 19 year olds for most categories, and 17 to 22 years old for certain categories, with some standalone estimates for 17 to 23 year olds included for 2021 where appropriate. The data is also broken down by whether a child is unlikely to have a mental health disorder, possibly has a mental health disorder and probably has a mental health disorder.
- The National Centre for Social Research is Britain’s largest independent social research agency. The Office for National Statistics is the UK’s largest independent producer of official statistics and the recognised national statistical institute of the UK.
- Ages of participants in the survey refer to their age as at 31 August, 2021.
- Respondents were asked five screening questions from the Eating Disorders Development and Well-Being Assessment (DAWBA) module. If they answered yes to a question, they were given a score of one, and if they answered no they were given a score of zero. These scores were added together to give a total score out of five. For 11 to 16 year olds, parent responses were used, and children were classed as ‘screened positive’ if they scored two or more out of five, otherwise they were classed as ‘screened negative’. For young people aged 17 and over, their self-report responses were used with a score of one or more classed as ‘screened positive’. Screened positive does not mean that the child or young person had an eating disorder, but indicates an increased likelihood of problems with eating.
- Please refer to the Survey Design and Methods Report for more detail on any of the survey methodology.
- For information on mental health and where to find support, visit the NHS website
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