Newsletter Monday
Hello Reader,
I defy anyone to read these statistics in the BMJ and not feel a wave of disbelief.
Over a million children in England were referred for mental health support last year.
That’s almost double the number five years ago.
It’s such an enormous figure that my first thought wasn’t, “We need bigger mental health services.”
It was, what on earth has happened?
As both a GP and a parent, this one hits hard.
The BMJ described it as a mental health crisis. The Children’s Commissioner said these aren’t just numbers, but children whose lives have been put on hold, sometimes for years, while waiting for help.
And yet I can’t help wondering whether we’re looking at the end of the story instead of the beginning.
When I started in general practice nearly twenty years ago, children certainly struggled with anxiety, depression, bullying, bereavement and family breakdown. None of those things are new.
But a few things feel different now.
I see a lot of parents who are exhausted and at a loss as to what to do.
Sometimes they’ve spoken to school first. Sometimes the school has asked them to see the GP.
Often they’ve turned to friends and family, or searched online.
Almost always they’ve worried themselves sick.
And increasingly, the GP becomes the next stop. Not because we’re necessarily the right place, but because everywhere else seems either full, unavailable or no longer exists.
Last week I listened to an interview on the Radical podcast with Lord Richard Layard. He’s spent decades studying what makes societies happier and arguing that governments should care about wellbeing alongside economic growth.
One observation has stayed with me.
He said that, since around 2010, schools have increasingly become “exam factories.”
Whether you agree with that or not, I recognised something in it.
Both of my own children are coming to the end in the education system. I’ve seen the relentless focus on performance, targets and achievement, often at the expense of the arts and practical skills. Too many students leave believing that exam results define their value or what they have to offer.
Schools are trying to juggle more than ever, often with fewer resources, while also carrying responsibilities that would once have been shared much more widely. I’ve not spoken to a teacher in years who believes the current system is working.
Meanwhile, many parents are raising children without the village that previous generations took for granted.
Grandparents may live hours away.
Neighbours barely know each other.
Families are smaller.
Youth clubs have disappeared.
Communities feel less connected.
None of those things appear on a referral form.
But I suspect they matter.
When support disappears from everyday life, distress eventually finds its way into healthcare.
Not every child referred will go on to receive treatment, receive a diagnosis or experience a mental health crisis.
Neither am I suggesting we should simply tell young people to be more resilient.
Quite the opposite.
I think we should be asking why so many children feel overwhelmed in the first place, and start there.
Healthcare has an important role. Children with serious mental illness deserve timely specialist care.
But I worry that we’ve quietly come to expect the NHS to solve problems that begin far outside the walls of a hospital or GP surgery.
Loneliness.
Isolation.
Pressure.
Lack of community.
Lack of time.
Those are health problems too.
They’re just not ones a prescription or referral can fix on their own.
One million referrals should concern us all.
Not simply because the waiting lists are too long.
But because they ask a much bigger question about the kind of childhood we’re creating.
These children are not someone else’s problem.
They are the adults who will one day be looking after us, teaching our grandchildren, leading our communities and raising the next generation.
If over a million children are telling us something is wrong, perhaps it’s time we listened.
Health has always been bigger than healthcare.
Perhaps it’s time we started acting like it.
