A whole-system preventative approach to youth mental health and wellbeing, underpinned by investment in the services that address the social determinants of poor mental health and investment in community and acute mental health services, would have improve population wellbeing and reduce the number of young people who are out of the labour market due to ill-health.
About the Local Government Association
- The Local Government Association (LGA) is the national voice of local government. We are a politically led, cross-party membership organisation, representing councils from England and Wales.
- Our role is to support, promote and improve local government, and raise national awareness of the work of councils. Our ultimate ambition is to support councils to deliver local solutions to national problems.
Local government as democratically elected leaders of place play a key role in stimulating local economies and want to ensure that employers have a supply of skilled workforce to meet the current and future business demands in local areas. Councils also want to ensure that every young person, no matter their background, has the tools and support to progress in life and reach their potential.
As part of their wider role in supporting children and young people and in shaping their local skills and employment system, councils have several statutory duties relating to ensuring all young people up to the age of 18 (25 for those with learning difficulties) participate in education or training. Despite having these wide-ranging responsibilities that demand close working with local providers, partners and employers, councils have very few formal levers over commissioning or co-ordination of provision to ensure their statutory duties are met.
Councils also have a key leadership role and formal mental health responsibilities. Promoting good mental wellbeing and preventing poor mental health is vital to help individuals and communities stay healthy, live meaningful lives, and potentially avoid the need for long term care. More importantly, it helps individuals to secure and sustain employment and training, reach their potential, and make a valuable contribution to society and the economy.
To help the number of young people struggling with mental health into employment, it is vital that that the Government commits to strong action, backed with increased investment, to meet current, unmet and new demand for mental health support that has built up during the pandemic and tackle treatment waiting times. We are calling on the Government to roll out early support hubs nationwide to help the increasing number of young people who are struggling with mental health issues. These hubs allow young people to access mental health support in the community without a referral.
The LGA is calling for Government to develop a cross Whitehall strategy that puts the needs of children and young people at its centre. This will support all partners that support young people’s mental health and wellbeing – including councils and the NHS – to work more collaboratively and effectively, with clear outcomes and roles for all partners.
Government must shift to a whole system approach of prevention, intervention, and treatment to improve young people’s mental health. This should be backed by investment in all parts of the mental health system, investment in community provision and the wider services that support wellbeing and tackle the socio-economic drivers of mental ill-health, such as housing and welfare support.
Integrating mental health support with employment support is an effective way of supporting people with mental health into employment and further training. Empowering councils with the right powers and flexibilities to expand this support across the country, will be vital to helping young people who are NEET (not in education, employment, or training) to access needed treatment, build their confidence, and move into work.
Councils and combined authorities, with the right powers and resources, could do far more to support young people to secure and sustain education, employment, and training (EET), by creating an integrated skills and employment system tailored to local needs. The LGA’s Work Local model is a ready-made blueprint for making this happen. By giving democratically elected local leaders the power and funding to work with local partners – businesses, training providers, the education system –to join up careers’ advice and guidance, employment, skills, apprenticeships, business support services and outreach in the community, they could deliver improved outcomes for young people at reduced cost. Work Local would allow councils to effectively deliver their statutory duties and provide the wraparound support for those with complex needs and those experiencing disadvantage.
What impact is mental ill-health having on young people when transitioning into education, employment, or training?
Are there any differences for young people with protected characteristics?
Mental ill-health is a significant barrier to education, employment, and training. A recent report by the Prince’s Trusts’ identified that the most common reason why NEET young people are struggling to find a job or not looking for work is due to a mental health problem or disability (39 per cent).
Recent statistics show that one in four young people aged 17 to 19 have a probable mental health condition, up from one in six in 2021.
The impact of the COVID-19 pandemic has exacerbated pre-existing issues in relation to mental ill-health. This is illustrated in many councils’ local NEET data, which shows a significant growth in the number of young people who are not active in the labour market due to ill-health; with mental ill-health being a prominent factor.
Councils’ family and youth services report that the pandemic had a significant impact on many young people’s development, from which some young people have not yet recovered. This has shown up in a variety of ways including more young people finding it difficult to engage with people outside of their family unit and having poor levels of motivation in school.
Councils also report that there is an increased number of young people who find it difficult to engage on a 1:1 basis with support services. There is evidence of increased levels of social anxiety and a lack of readiness to participate in education, employment, or training. Some young people appear to have lower aspirations and are making decisions based on short term goals, rather than considering longer term ambitions. For example:
- Durham County Council report that in June 2019, 26.1 per cent of 16-18-year-olds were NEET. This had risen to 33.0 per cent in June 2022. (Department for Education: Local Authority Client Caseload Information System, June 2022).
- Somerset County Council report that at the start of this academic year, 429 young people, nearly 9.0 per cent, (from a cohort of approx. 5,300) have withdrawn from their college courses. Some of these have found new destinations but over 65.0 per cent (283) are now NEET/not known. This is an increase from this time last year and the main reasons for withdrawal are mental health/anxiety/not coping with the course (local college data.)
Social inequalities are associated with a higher risk of mental ill health, with children and young people from disadvantaged backgrounds and minority groups more likely to experience poor mental health.
Children from low-income families are four times more likely than those from the wealthiest households to have a serious mental health difficulty by the time they leave primary school. There are also clear links between poor mental health and health and racial inequalities, with rates of mental health problems often higher among some black and ethnic minority groups than for white people. Recent research from the IFS Deaton Review identified that mental health inequalities are complex, with intersectional factors such as race, gender, geography, and class all playing a role in influencing a young person’s chance of growing up mentally healthy.
It is well established that there is an inter-generational pattern to mental health. Children whose parents experience mental health issues are two to three times more likely to experience mental health themselves, than children whose parents do not. It is estimated that four million children in the UK, equating to one in three, have a parent with poor mental health.
LGBTQ+ children and young people report significantly higher levels of mental health problems, and often face particular barriers including bullying, and feelings of vulnerability and difference, which impact their emotional health and wellbeing and their ability to engage in employment, education and training.
Children and young people in rural or remote areas face particular mental health and wellbeing challenges, including a higher risk of alienation and social isolation. Children and young people in areas with poor, infrequent or unreliable public transport infrastructure also face particular barriers in accessing support from mental health services, which tend to be centralised in urban areas, and in access training or work opportunities. These barriers are disproportionately experienced by children from low-income families, those experiencing disadvantage and those with complex needs.
Practitioners report that cultural background is a key factor in how young people interact with mental health support services. Rethink Mental Health states that fear, stigma, and lack of culturally sensitive treatment can act as barriers to accessing mental health care for people from ethnic minority backgrounds.
It is also reported by those working with young people that young women are possibly more likely to seek mental health support earlier, with a stereotype for young men to ‘get on with it’.
Many councils have put in place targeted initiatives and developed pathways to successfully support young people who face additional barriers or have complex needs into work or further training. This includes targeted work with young people with special educational needs, young offender backgrounds, those from ethnic minority groups, and those with experience of the care system.
Such interventions are additional to standard national initiatives and are typically financed through council funding or through a range of external funding bids. Funding provided at the local level through Integrated Care Systems can also help to provide a localised bespoke support approach to children and young people’s mental health services, when this is prioritised. For example:
- Hackney Borough Council has designed a number of programmes focussed on an inclusive approach to employment which engages and supports those experiencing disadvantage in the area, including, care leavers, young people with disabilities, and young black males. This includes their supported internships programme that provides a stepping-stone to employment for young people with SEND. Five years ago, the council also established ‘Hackney Council Apprenticeships’ to create new placements within the council. The scheme proactively recruits underrepresented groups and ensures that those that may not normally get invited to interview are given a first interview opportunity.
- Devon County Council offers mental health support through the Devon Youth Hub/Exeter Works. The programme provides open access support, 1:1 bespoke support for young people, and group work tailored to LGBTQ+ young people, young carers, children in care, care leavers, those experience mental health issues.
What support is available to young people with mental ill-health who are currently in education, training, or employment?
How effective is this support? Which groups does this work for?
Councils have a key leadership role in promoting positive mental health in their local communities and providing information, care, and support across the life course. Promoting good mental wellbeing through a preventative approach and early help can help individuals and communities stay healthy, live meaningful lives, and can potentially reduce the number of people who require treatment from acute mental health services.
Supporting good mental health and wellbeing is intrinsically linked with other agendas and is underpinned by wider public services– including housing, welfare, public health, social care, employment, social inclusion, economic development, and community safety. Councils are uniquely placed to connect all parts of the system.
Councils’ roles and responsibilities in mental health include:
- System-wide local leadership through Health and Wellbeing Boards.
- Integrated Partnerships and place-based care and support systems.
- Statutory duties and powers related to adult social care and mental health for children and young people and for adults under the Mental Health Act.
- The overview and scrutiny of mental health provision.
Councils have a critical role to play in reducing inequalities and enhancing inclusion and cohesion within their communities. Councils also provide and commission information and advice on local services that can offer mental health support. Many of these services are culturally specific, such as advocacy.
There is a mixed menu of support on offer across the country. This can include:
- Child and Adolescent Mental Health Services (CAMHS): supported by both councils and NHS partners, provide mental health services for young people. Demand regularly outstrips the provision of CAMHS services. For example, in Devon County Council there are around 2,000 children and young people currently on the waiting list for services across the County and limited financial capacity to increase provision to meet this demand. NHS figures earlier this year show ‘open referrals’ – children and young people in England who are undergoing treatment or waiting to start care – reached 420,314 in February. This is the highest number since records began in 2016.
- In school pastoral support: many areas have an informal and formal school specific offer. This ranges from straight pastoral and in-school guidance and counselling services, through to formal recruitment of counsellors and other health professionals where schools have identified specific areas of concern / concentrations of need. The offer of support is often under extreme financial or short-term funding pressure as they are additional to core budget requirements.
- Post-16 EET transition service: between the ages of 16 and 25 young people are expected to make key life-long decisions as they transition to higher and further education, move into jobs, leave home, start relationships, and begin families. Councils as part of their NEET statutory duties work with providers and colleges to ensure that there is adequate support in place to help young people transition from school to further education. Mental health advice and support has become an increasingly large part of this, with 1-2-1 advice focused on improving confidence and addressing anxiety and depression as core issues. For example, Salford City Council and partners have a range of provision to support transitions from pastoral teams in further education colleges to transition mentors who support year 11 and year 12s who have been in alternative provision, with built in wraparound support for the whole family.
- Transition from children to adult mental health support: councils ensure that children and adults’ mental health services work together, and commission and deliver support to young people transitioning from children to adult services. For young people the transition can means changes to their treatment, in the people who treat them, where they go for treatment and a change in their support worker. To avoid this process resulting in anxiety and exacerbating mental health issues, it vital that young people receive the right support at this critical time. LGA’s improving transition from children to adult mental health services provides best-practice guidance to help councils ensure the right support is in place to ensure an effective transition. For example, Staffordshire County Council has established a mental health support pathway referral process that provides information about getting advice, where to go for help and getting emergency support.
The LGA have consistently raised that the current system is failing to deliver effective early intervention. There is a lack of data about the children and young people who are accessing lower-level mental health support and the outcomes these interventions achieve. The responsibilities for providing and overseeing earlier intervention in mental health are unclear. An understanding of what good looks like in terms of universal provision for mental health has not been developed, and the system is incentivised to strive for targets that relate to providing access to specialist support at the acute end of need, rather than assessing children and young people’s long-term outcomes.
Wider community-based services play a critical role in supporting children and young people’s mental health and support them to build resilience, for example, youth services. Access to sport, play, culture leisure activities and other non-academic experiences also support children and young people to be engaged members of their community, improving involvement in education, and bolstering their resilience.
What additional support could be offered to young people with mental ill-health to get them into work, education, or training?
Examples of evidence and best practice? What recommendations would you put forward?
It is vital that that Government commits to strong action, backed with increased investment, to meet current, unmet and new demand for children’s mental health support that has built up during the pandemic and tackle child and adolescent mental health services (CAMHS) waiting times. We need a whole system approach to prevention, intervention, and treatment, to provide young people with timely access to the right interventions that enable them to stay mentally well.
The LGA is calling for Government to develop a cross-Whitehall strategy that puts the needs of children and young people at its centre. This will support all partners that support young people’s mental health and wellbeing – including councils and the NHS – to work more collaboratively and effectively, with clear outcomes and roles for all partners.
It is essential that the Government recognises the lead role of councils in promoting good mental health and drives a shift away from the current medical model of treating mental health towards a focus on prevention and expanding the availability of mental health support in the community. Focussing on prevention and intervention at an early stage is vital to prevent problems before they escalate and improve children and young people’s wellbeing.
To expand access to mental health support in the community, we have long been calling for Government to roll out Early Support Hubs in every area. These centres, which can be accessed without a referral, bring together various services to support young people’s mental health and emotional wellbeing through an early-intervention approach, including youth services; sexual health, drug and alcohol, health, and wellbeing practitioners; and mental health practitioners.
Integrating mental health and employment support
Integrating mental health support with employment support, as part of a wrap-around approach, has proven to effective in supporting those with mental health needs into work.
As conveners of place, who work across and link with other local services – such as mental health, housing, family support and childcare – councils are uniquely placed to lead this approach. Many councils already run devolved or local employment support programmes which include tailored support for mental health. Expanding this support across the country, will be vital to helping all young people to access the mental health support they need and build their confidence to move into work. For example:
- Greater Manchester Combined Authority’s (GMCA) ‘Working Well’ suite of devolved and test-and-learn employment and health related programmes, take a whole-population approach to health, skills and employment. The programme combined physical and mental health support – including talking therapies- and advice on drug and alcohol problems, skills, education, and housing to support people who had been unemployed for more than two years. Each participant had their own keyworker to help them get the right support at the right time, keep them motivated, and develop their confidence and independence. To date, these programmes have supported more than 60,000 people, helping more than 15,500 into work - a success rate of 26 per cent.
- Babergh and Mid Suffolk District Councils provide a tailored support offer for young people facing additional barriers to further education, training and employment through a number of initiatives. At the Thrive Project, a multi-disciplinary team of qualified youth workers, teachers, curriculum experts, SEND experts and social, emotional and mental health experts, provides tailored alternative provision with 1:1 mentoring, coaching, personal careers advice and guidance and wider bespoke support.
- Bristol City Council has developed Bristol Works, a programme dedicated to providing work experience, mentoring and skills development to children and young people who are most at risk of becoming NEET. The programme has supported the delivery of Career Coach, a bespoke five-year coaching programme that matches children in care with local employer mentors. It matches volunteer coaches with young people, aged 13 or 14 and looked after by the local authority, with inspirational local professionals, based on their interests and preferred ways of learning.
Bristol WORKS for Everyone is a tailored provision for SEND young people that starts from year 9 with careers exploration and moves beyond year 11 with progression planning and supported mentoring into paid employment.
Realising Talent provides additional support to SEND 14-16 year olds in need of support to improve their opportunities at, and transitions to Post-16 education and training.
Tackling the drivers of poor mental health
The cost-of-living crisis is pushing more people into poverty and disadvantage and is already causing a decline in the population’s physical and mental health. Without further intervention, this is set to get worse. As a fundamental pillar of a preventative approach, Government needs address the socio-economic drivers of mental ill-health, which include poverty, poor housing, food insecurity and insecure and low-paid employment. Crucially, this must include creating a fair and accessible welfare system, boosting the supply of affordable and safe homes, ensuring timely access to healthcare services, reforming social care, and increasing access to green spaces and culture and leisure opportunities.
Unemployment and economic inactivity are linked to worse mental health outcomes. And while employment is generally beneficial for mental health, the opposite is true of work that is low-paid, insecure or puts workers health at risk.
Those with the lowest qualifications are most likely to face insecure or poor-quality employment and unemployment. Therefore, it is vital that Government remove barriers to supporting young people who may not have got the qualifications they need the first-time round, to access training to upskill or reskill. There must be a cross-Government approach, working with local government, to training, employment support and job creation, to remove existing barriers to training and employment. In particular, the Department of Work and Pensions and Department for Education (DfE) need to work more closely to strategically align their policies and objectives, with the DWP prioritising skills and training more highly within its plan for jobs and employment support. Government should also reform Universal Credit eligibility rules to enable claimants to continue accessing benefits, including the childcare element of Universal Credit (which should be paid in advance, not in arrears), while undertaking work-related training.
The wider determinants of mental health should be addressed through a holistic approach. The LGA commissioned a report, “Our Place: local authorities and the public’s mental health’, which builds on existing good practice and supports councils to take a ‘whole-place’ approach to improving wellbeing, reducing inequality and preventing poor mental health at the local level. This includes integrating mental health across all agendas including housing, employment, social inclusion, economic development, and community safety. Local authorities are uniquely placed to connect all parts of the system and knit together local strategies to tackle health inequalities. There are many examples of how this is being effectively implemented:
- Bristol City Council – Thrive Bristol: Thriving at Work
- Camden and Islington Council – Addressing determinants of poor mental health using Making Every Contact Count (MECC) and Psychologically Informed Consultation and Training (PICT)
- Leeds City Council – Mentally Healthy Leeds: a whole city approach
Youth work has a key role to play in supporting young people pursue positive paths in life and avoid negative outcomes such as long-term unemployment and mental and physical health difficulties further down the line. Youth services provide young people with a safe space to go and enable them to foster trusted relationships with adults who can provide advice, guidance and help them to make positive choices, cope with difficult circumstances and improve their wellbeing through social connection.
Due to cuts to local government funding, councils have had to make extremely difficult decisions about how to allocate increasingly scarce resources, with councils having to prioritise urgent help for children who are at immediate risk of harm. As a result, since 2010/11 youth services have seen their funding reduced by 69 per cent; more than 4,500 youth work jobs have been cut and 750 youth centres closed. The availability of open-access universal provision has been particularly hard hit, as resources have been targeted at those in greatest need.
Despite a very challenging funding picture across the country, some councils are reinvesting in youth provision because they know the value of these services. There are also many best-practice examples of how council services are adding significant value to young people’s wellbeing, socio-emotional development, academic attainment, and career and further training opportunities through their work with schools.
However, greater national support and investment is needed to re-instate vital youth provision in every area, to adequately support all young people with the ongoing impacts of the pandemic and through the rising cost of living. The LGA continues to call on Government for sustainable core funding for local government, to enable all councils to re-invest in youth services and deliver a strong long-term youth service offer and re-instate universal open-access services. This should be backed with a clear national vision for youth services and a workforce strategy.
The National Audit Office report on support for vulnerable adolescents found that while departments work together on programmes and initiatives, there is no overall strategic assessment to plan services across an area, which risks gaps or an overlap in provision. To address this, the LGA has called for better join up across government, working with councils, to support vulnerable adolescents.
Improving youth employment support
Young people were one of the groups worst impacted by COVID-19, both in terms of their participation in the labour market and the impact on their mental health and wellbeing. Youth unemployment can have significant long-term effects, with periods of unemployment having a ‘scarring’ effect on young people’s future employability and wage potential. Therefore, it is important to ensure that young people can access timely employment support to avoid long-lasting adverse impacts.
Councils, despite having wide-range statutory responsibilities for young people, have very few formal levers over commissioning or co-ordination of provision to meet them. Our research shows that the skills and employment system remain highly complex and fragmented – delivered across 49 employment and skills-related schemes or services across England, managed by multiple Whitehall departments and agencies, and delivered over different boundaries by various providers – with no one local point of coordination. This is echoed by a recent National Audit Office report which highlighted that there are a growing number of national skills programmes which are disjointed and hard for learners, employers and training providers to navigate.
Funding for skills and employment support is short-term, fragmented and held centrally, and powers to affect change are too remote, unless a council is situated in an area with a devolution deal. This makes it extremely challenging for local government to provide place leadership and coordinate, plan, target, and join-up provision, or build in the right wider support for those with complex or additional needs.
Despite these challenges, councils continue to work hard to support participation in education, employment and training through commissioning devolved and local discretionary provision, and by joining-up and adding value to national schemes. For example:
- South Gloucestershire Council have established its Community Learning and Skills Service which provides both learning and career coaching and mentoring opportunities for residents. Working closely with other providers and business, and as part of the West of England Combined Authority it is bringing together adult community learning, employment support and post 16 and pre-16 transitions support, to create a coherent local offer which is available for residents of all ages through a ‘one-stop shop’ model. This approach has proven accessible especially those who are the most vulnerable and those experiencing disadvantage.
Local government could do much more to support young people and bring together an effective all-age skills and jobs offer around ‘place.’ Work Local, our plan for a devolved and integrated skills and employment system is the blueprint for making this happen. Work Local would give democratically elected local leaders the power and funding to work with partners, such as schools, colleges, further education providers and local employers, to join up careers’ advice and guidance, employment, skills, apprenticeships, business support services and outreach in the community.
By giving councils the right flexibility and funding, a Work Local approach would enable councils to create services tailored to the needs of their local youth population and build in wraparound support for those with complex barriers.
The underpinning principles of Work Local are:
- a ‘one stop’ service rooted in place
- clear and responsive local leadership
- driven by local opportunities and needs
- within a common national framework for devolution of strategy, financing and delivery of employment and skills
- underpinned by Devolved Employment and Skills Agreements (DESA)
- delivering better outcomes at lower cost.
Work Local would enable councils to take a holistic approach to planning and commissioning employment, training, skills provision and integrate it with other services to better meet local needs and close gaps in provision. Using local data and intelligence, councils are well-placed to work with schools, providers, businesses, and other partners to join-up the supply and demand side of skills and employment programmes, including identifying and re-engaging NEET young people with early support; providing careers advice and guidance to those who are vulnerable to support effective post-16 transitions and promote the well-being of all children and young people. It would also allow councils to join up progression pathways across their place and align provision with local and national skills demand and job opportunities.
Good public transport networks are essential to provide all young people with access to education, training and employment opportunities, healthcare, and other essential services, as well as facilitating social contact, unlocking leisure opportunities, and helping to develop young people’s independence and confidence. A Work Local approach, alongside wider progressive devolution and sustainable, streamlined funding for local transport would enable all areas to strengthen whole-place approaches that take into account the public transport links that young people need and deliver the right mix of transport options.
Opportunities in the labour market
Councils and combined authorities are committed to supporting young people access the training they need to tap into emerging labour market opportunities, for example in the green and digital industries.
The nation currently lacks the right mix of skills to meet future demand. Skills gap predictions for the LGA revealed that by 2030, there would be an oversupply of three million people with low and intermediate qualifications and 2.5 million too few higher skilled workers compared to jobs generated. These gaps were starker within places than between them, emphasising that ‘place’ really does need to be factored in when designing and targeting provision.
There is a fundamental need for a whole systems approach to bring together decisions around infrastructure and capital investment to maximise job opportunities for young people.
What are the likely impacts on youth employment should these proposed recommendations take place?
Are there specific short-term implications? What are the long-term implications?
In the short-term, Work Local approach would have a positive impact on young people and employers, who are recovering from the COVID-19-related lockdowns.
For employers, it will provide them with an increased supply of labour, particularly important for those sectors that are experiencing staff and skill shortages. It will also provide them with the reassurance of support for them and their employee if any issues arise during the initial phase of employment. For young people, it will provide them with tailored support at a critical point in transition stage and increase the likelihood of them securing and sustaining their employment and not becoming NEET.
Our independent cost benefit analysis found that for a typical medium sized authority, introducing a Work Local Model could improve employment and skills outcomes by about 15 per cent, meaning an extra 2,260 people improving their skills each year and an extra 1,650 people moving into work. This would boost the local economy by £35 million per year and save the taxpayer an extra £25 million per year. This would be the single most effective intervention to improve the outcomes for young people and NEETS.
A whole-system preventative approach to mental health and wellbeing, underpinned by investment in the services that address the social determinants of poor mental health and investment in community and acute mental health services, would have improve population wellbeing and reduce the number of young people who are out of the labour market due to ill-health. Accessing early support will help young people to resolve difficulties, prevent issues from escalating and develop strategies to maintain their mental wellbeing. This can subsequently help a young person adapt, cope, and respond positively to stresses in the education, training and workplace.
Given the UK’s rising labour market and skills gaps and low productivity, investment in measures that can support more economically inactive young people into the workforce balances the long-term benefits to individuals, communities and the economy.