Improving mental health services for children who have experienced abuse and neglect Analysis of local area plans for children’s mental health services and practical guidance on developing services to meet local need

Child sitting on the floor, looking out the windowWe know that children and young people who have been abused and neglected can develop a range of mental health problems (Norman, 2012; Independent Inquiry Into Child Sexual Abuse, 2017). So it’s vital that they are provided with appropriate support.

Since 2015 Clinical Commissioning Groups (CCGs) in England have been required to produce Local Transformation Plans setting out how they will improve children’s mental health in their area. These need to be refreshed annually.

In 2016 we analysed the first set of plans and found that many didn’t recognise and address the mental health needs of children and young people who have been abused.

In 2017 we looked at the refreshed plans to see what progress had been made, and as a result of our research we developed guidance on how best to design and deliver services for children who have been abused and neglected

Authors: Ben Sundell, Alana Ryan and Almudena Lara
Published: 2017

We examined the first round of refreshed Local Transformation Plans which were due in October 2016. In total 116 refreshed plans were due for publication but we were only able to access and analyse 98.

We found that, although there has been some improvement over the past year, the particular needs of children who have been abused and neglected are still being overlooked.

Key findings include:

  • 80% of refreshed plans recognise that mental health issues can be attributed to abuse or neglect in childhood, representing an improvement on last year’s results (67%)
  • 16% of the refreshed plans reference an adequate needs analysis for children and young people who have been abused and neglected, in line with last year’s results
  • 27% of refreshed plans do not mention services for children and young people who have been abused and neglected, representing a marginal improvement on last year’s results (34%)
  • 87% of refreshed plans mention services for looked-after children which represents a small improvement on last year’s results (85%), but not all of these include references to children and young people who have been abused and neglected
  • plans continue to lack clarity over whether extra resources are being allocated to services for children who have been abused and neglected
  • 93% of refreshed plans involved young people in service design.
About the NSPCC 3
Acknowledgements 3
Executive summary 4
Introduction 5
The impact of abuse and neglect on the mental wellbeing of children 6
Gaps in support 8
Analysis of Local Transformation Plans 10
Data analysed 11
Main findings 12
Best practice 19
Conclusion 22
Annex A 23
Annex B 25
Annex C 27

The toolkit

Our analysis showed much room for improvement in the way children who have been abused and neglected are considered in child mental health service design. So in 2017 we held a series of interactive workshops to share best practice about planning mental health provision for these vulnerable children. This toolkit was developed from the discussions.

It includes guidance and examples of best practice on:

  • Recognising that some groups of children are more vulnerable to mental health problems than the wider population, including children who have been abused and children in care.
  • Carrying out a needs analysis of vulnerable groups using a range of sources.
  • Providing evidence-based services for vulnerable groups.
  • Engaging with children and young people.
  • Collaboration and information sharing between Clinical Commissioning Groups (CCGs) and other stakeholders.
  • Outcomes and indicators to measure progress.

Please cite as: Sundell, B., Ryan, A. and Lara, A. (2017) Transforming mental health services for children who have been abused: a review of local transformation plans for children and young people’s mental health and wellbeing. Review of refreshed plans 2016/17. London: NSPCC.

NSPCC (2018) Local transformation plans toolkit: Guidance on how best to design and deliver services for children who have been abused and neglected. London: NSPCC.

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  1. Independent Inquiry Into Child Sexual Abuse (IICSA) et al. (2017) The impacts of child sexual abuse: a rapid evidence assessment: summary report (PDF). London: Independent Inquiry into Child Sexual Abuse