Better mental health support would help young people and the economy
BMJ 2025; 388 doi: https://doi.org/10.1136/bmj.r270 (Published 10 February 2025) Cite this as: BMJ 2025;388:r270
Rising mental health needs among children and young people are driving record demand for support services and having devastating effects on their futures.1 Rates of young people presenting to healthcare services with diagnosable levels of distress have almost doubled since 2017.2 But, instead of this increasing public and political concern, we’re seeing the opposite.
Mental health is in danger of falling off the government’s agenda or being dismissed by a “sick note culture” narrative that we hoped would be left behind with the previous administration.3 The current government’s policy responses on mental health have so far been muted and misplaced, with key opportunities missed or mishandled.
The Children’s Wellbeing and Schools Bill currently going through parliament mentions wellbeing only twice in its 128 pages, bar repeats of the bill’s name.4 The much lauded pledge to introduce early support mental health hubs in every community is at risk of being watered down by the government’s insistence on delivering these through the lens of knife crime prevention. At the end of 2024 it seemed that the mental health investment standard was poised to be cut, until outrage from the mental health sector forced the government to backtrack.5
This is not what we expected of a government that promised to deliver one of the most ambitious mental health manifestos in a generation. We know that the ambition is still there, but the government is arguing that economic pressures are limiting it.
Missed interventions
However, there should be no competition between solving the mental health crisis and fixing the economy. Investing in young people’s mental health should be one of the cornerstones of a fiscally responsible government. Many in the current generation of young people will enter the workforce ill prepared for work after struggling through school and further education—not to mention the effects of the pandemic, climate breakdown, and political instability—without getting the support they need to recover, build resilience, and thrive.
Alongside the moral argument for helping children reach their potential with appropriate mental health support, there’s an economic one. Poor mental health is estimated to cumulatively cost at least £300bn a year in England.6 This has major implications for productivity,7 and spending on working age incapacity and disability benefits is forecast to rise by £21bn a year in real terms by 2028-29.8
We know that mental ill health is driving rising benefit claims among young adults.9 We also know that young people are faced with a crumbling mental healthcare system. When they’re unable to get help at an early stage, too many of their mental health needs escalate. This negatively affects their ability to participate in education, work, and their personal lives, and it costs the NHS more to help them once they reach crisis point. It’s no wonder the early intervention safety net isn’t working.
The Darzi review last year highlighted that mental health services received only 10% of NHS spending despite mental health accounting for at least 20% of the UK’s morbidity burden.10 Only 8% of the mental health budget goes on services for young people.11 By the time someone reaches 24 years of age, 75% of any mental health problems are established12—so, by underfunding young people’s services, we’re missing a critical window to intervene. And any financial benefits of this approach are made redundant by the skyrocketing cost of poor mental health to society and public finances.
Investment and expansion
The government has shown signs that it’s prepared to be bold in its approach to public service reform. For example, it’s taking a far more supportive approach than the previous government to helping young people into work after they’ve struggled with mental health.13
A couple of crucial moments in the coming months will test whether the government will rise to this challenge. The 10 year plan for health14 and phase 2 of the spending review15 are perfect opportunities to announce investment in mental health services for children and young people. The government’s plans for NHS reform are focused on greater prevention of ill health, more community care, and better use of technology. These shifts could transform the quality of mental healthcare for young people, but they won’t be possible without upfront investment.
This investment should come in several forms, not only the protection of the mental health investment standard. The government must also commit to closing the treatment gap in young people’s mental health. Fewer than half of those with diagnosable need currently have access to NHS support,2 and committing to meet 70% of need by the end of this parliament requires a relatively small investment. An effective settlement should also increase the areas of local government funding crucial to supporting the mental health of vulnerable young people. The public health grant should be returned to 2015-16 levels, and special educational needs and disability funding—which we project will be in deficit by over £8bn by 2027—must be massively expanded.
These steps will improve the lives of millions of young people and their families and will build the legacy of a happier, healthier, more productive future for young people. We urge the government to take them.
Footnotes
Competing interests: None.
Provenance: Commissioned, not externally peer reviewed.