The report provides examples of how enrichment can reach some of the most marginalised children with poor school attendance, some of whom are less likely to respond to other methods of engagement. While the evidence-base on links between education and enrichment needs further investment, the report’s case studies show the correlations between enrichment and attendance, with children and young people with higher attendance telling our researchers they are more likely to be attending school because of enrichment activities.
The research was commissioned by NCS Trust and the DofE and highlights the potential of enrichment activities to boost student engagement and improve attendance. It was conducted in response to the growing concern about school absenteeism, which has risen dramatically in recent years.
One of the most shocking and upsetting moments I experienced during my term as Children’s Commissioner for England was being told by a parent that their child had attempted to take their own life. Their daughter had done this not because she didn’t want to live any more, but because she was so desperate for treatment that she felt she had no other way of getting NHS support.
The NHS has come a long way over the last decade. Access to help and earlier intervention has improved support for many children. But at the same time there has been an extraordinary rise in the number of children and young people with mental health problems. Ten years ago, parts of the NHS were in a state of denial about this issue. That is no longer the case, and funding has increased. However, over recent months we have seen a growing and concerning trend amongst some to explain these problems as being due to ‘Generation Snowflake’.
This is nonsense and is not grounded in evidence or in the daily realities of many children, young people, and their families. The fact is that a growing number of young people are now struggling to enter the workforce or dropping out of education due to mental health problems. This is a disaster not only for their life chances, but also for our economic productivity, public services, and society.
The current Government was right to recognise this in Opposition, and to commit itself to raising the healthiest generation of children following the election. For Ministers to deliver on their aim, they will need to put systems in place that make children a top priority, and which recognise the wide-ranging and long-lasting benefits of tackling problems from the earliest possible moment.
The Government’s new place-based, neighbourhood health models offer a crucial opportunity to do that, and to reform the health system so that support for children with mental health problems is transformed. The 10 Year Health Plan for England, “Fit for the Future”, includes a welcome recognition that early help is crucial.
By adopting whole-system, place-based models, the Government can integrate health, education, and community support around families and children’s needs in a way that hasn’t happened enough over recent years. The new Best Start Hubs, Family Hubs and Young Futures Hubs provide great opportunities to reform and join up services, to embed early intervention, and to make children and young people’s mental health everybody’s business.
We have long argued for a more ambitious programme of reform and investment in children and young people’s mental health - to cut the cost of crisis, and to deliver help to those who need it. Our Future Minds campaign with other leading children and young people’s organisations has called for children and young people’s mental health services to meet 70% of diagnosable needs by the end of this Parliament. That funding should focus on early intervention approaches delivered in communities, such as mental health hubs and other non-specialist services.
Our work in Humber and North Yorkshire over the last 18 months, set out in this report, shows what can be achieved when the whole system comes together to prioritise children and young people. The report provides an in-depth learning synthesis from a local reform pilot and sets out a practical model for ICB leaders, Directors of Children’s Services, and local leaders to transform support for children and young people. It should be seen as a tool to use in tandem with the new national neighbourhood health model, new Best Start Family Hubs and Young Futures hubs. Taken together, these are the best opportunities in a generation to transform our approach to children’s health and wellbeing.
Sticking our heads in the sand, simply blaming over-diagnosis, and hoping it all goes away is not a strategy. Building a modern, integrated, place-based system that meets the needs of children is the only way forward.
England is facing a profound and accelerating crisis in the mental health and wellbeing of children and young people. Over the past decade, the prevalence of mental health conditions has risen sharply, with one in five children aged 8–to-16 years and one in four young adults now experiencing a diagnosable condition. The demand for support has far outpaced system capacity: NHS children and young people’s mental health services (CYPMHS) currently reach only around 40% of those in need; waiting times remain long, and many young people deteriorate while waiting for help.
While Integrated Care Boards (ICBs) planned to spend approximately £1.1 billion on CYPMHS in 2023/2024, children’s mental health typically accounts for just 8% of total mental health budgets, despite the scale of the impact of children’s mental health problems on childhood and adult life chances and the evidence that earlier mental health interventions have a high return on investment through improved wellbeing. Investment patterns remain skewed toward acute crisis services rather than prevention, and nonspecialist community-based provision is thinly resourced in many areas. Geographic variation compounds inequity: spend per child can differ fivefold between areas, which means a young person’s prospects of receiving help may hinge on their postcode rather than their need.
This report shows that the current system remains structurally misaligned with the nature of the problem despite increased funding and policy attention. The system is overly reactive, fragmented across sectors, and focused too heavily on crisis response and clinical thresholds rather than prevention, early intervention, and the wider determinants of mental health.
These problems require system transformation. This is why the Centre for Young Lives has tested a new approach and developed the ‘Growing Up Well’ model that can allow the insights to be adopted by ICBs throughout England and within the devolved nations.
The Centre for Young Lives adopted a partnership-based approach in its work with the Humber and North Yorkshire Integrated Care Board. The Centre did not restrict its focus on the upstream symptoms of system failure - long waiting lists, rising referrals, or increasing crisis admissions – but worked with local partners to address the root causes of poor mental health and wellbeing.
This meant synthesising the evidence showing how poverty, inequality, trauma, educational disengagement, fragmented services, and lack of early support interact to drive rising needs. It meant understanding how an increase in the numbers of children not ready for school exacerbated the SEND crisis and how this, in turn, related to the increased levels of anxiety and depression seen in the adolescent population. The work involved understanding how system design itself can unintentionally exacerbate these pressures.
The outcome of this evidence-informed approach was recognition that children’s mental health cannot be “fixed” by the NHS alone. Sustainable improvement requires coordinated action across health, education (including universities), local government, voluntary and community organisations, and neighbourhood services, aligned around shared outcomes and informed by robust evidence.
The Centre for Young Lives positioned itself not as a service deliverer, but as a system partner and catalyst - bringing together evidence, data, lived experience and policy insight to support local leaders to rethink how support is designed and delivered. The Growing Up Model provides a mechanism that allows the ICBs to play a role as an anchor institution able to connect and coordinate all the stakeholders needed for a genuinely integrated delivery of services that can fully support children and young people.
The Centre’s work in Humber and North Yorkshire was explicitly grounded in an evidence-based framework that we developed through our national leadership role within the Child of the North campaign. This programme, led in partnership with universities across the North of England and the Northern Health Service Alliance, synthesised extensive research from health, education, economics and social policy to identify the structural drivers of poor outcomes for children and young people and to articulate a set of scientific principles for addressing these issues.
A clear message emerged from this work: inequality is not a marginal issue affecting only the most disadvantaged but a systemic problem that affects everyone. Concentrated disadvantage drives higher levels of need, greater demand for crisis services, and increased pressure on public systems, reducing their capacity to support all children, including those in more affluent communities. Inequality drains resources, limits resilience, and undermines outcomes across entire systems and regions. Addressing inequality is therefore both a moral and a practical imperative.
The Child of the North (CotN) reports articulated seven principles that should guide longterm reform for children and young people: putting children first; addressing inequity; adopting place-based approaches; ensuring public services work together; placing education at the heart of delivery; embedding research and innovation; and sharing information effectively. The principles form the conceptual foundation for the Growing Up Well model set out in this report. They provide a lens through which the challenges, the Humber and North Yorkshire experience, and the final recommendations should be understood.
We have translated the seven CotN principles into practice over the past eighteen months through a national trailblazer in Humber and North Yorkshire. In partnership with the ICB, local authorities, schools, voluntary organisations and universities, the Centre for Young Lives supported the development of the place-based, outcomes-led Growing Up Well model designed to radically improve children and young people’s health and wellbeing.
A critical enabler of this work was the Humber and North Yorkshire Futures Group, which created the space for long-term, strategic collaboration beyond the normal day-to-day operational pressures facing ICBs. Through the Futures Group, the Centre worked closely with universities, businesses, the voluntary sector and research partners to bring evidence, data and evaluation directly into system leadership and decision-making. This included the development of connected data infrastructure, neighbourhood-level insight, and test-and-learn approaches to understand what works, for whom, and in what contexts.
The ICB’s decision to make children and young people’s mental health a “golden ambition” provided the leadership signal needed to align partners across sectors. Practical changes followed: expanded school-based and community support; stronger integration between clinical and non-clinical provision; improved use of data to identify gaps and inequalities; and meaningful engagement with children and young people to shape priorities. Challenges remain, and demand continues to rise, but the trailblazer has ‘proved the principle’ that system change is possible through ICB infrastructure when leadership, evidence, and partnership are aligned.
This report sets out the Growing Up Well model as a framework of national significance. It aligns closely with the Government’s NHS 10-Year Health Plan and the shift toward neighbourhood health systems, offering a practical way to move from hospital-centred, reactive care toward prevention, early intervention, and community-embedded support. It shows how Integrated Care Boards can work with local governments, education (including universities), and the voluntary sector to create a coherent system that meets children’s needs earlier and more effectively.
The report shows how the Growing Up Well model translates the seven CotN principles into concrete actions for ICB policy, commissioning, and delivery. The actions include making children and young people’s health a core system priority; rebalancing investment toward early help and prevention; scaling neighbourhood-based health and wellbeing hubs; strengthening the role of schools and colleges; investing in connected data and population health management; embedding co-production; and building leadership capacity and learning networks.
Young people have been exceptionally clear about the kind of support they need and where they want to receive it. They ask for accessible, stigma-free help, in places they already trust - schools, youth clubs, community spaces - and adults who can form consistent, enduring relationships with them. They want the conversation about mental health to be open, visible, and normalised, with easy routes into support and practical help that does not depend on meeting a clinical threshold. They value holistic approaches: volunteering, sport, creative activities, cooking, and social connection that sustains their sense of belonging and self-worth. They emphasise continuity - “someone who believes in me and sticks around” - and prefer environments that feel welcoming and familiar rather than medicalised or intimidating.
Many describe traditional services as overly clinical, bureaucratic, and remote from their daily lives. When asked to contribute their views, they want to see tangible followthrough and feedback, signalling an appetite for genuine co-production. The Growing Up Well model is built on these requests from young people.
The Humber and North Yorkshire ‘test and learn’ programme shows what is possible when systems focus on the root causes rather than the symptoms. England has an opportunity to move from managing crisis to enabling wellbeing by adopting the Growing Up Well model across its ICBs and placing children first, addressing inequality, grounding action in evidence and working in partnership across places.
Evidence underpinned the approaches trialed and tested throughout the Growing Up Well project. The Growing Up Well model is built and can be scaled through concrete changes to policy, commissioning, and delivery.
There is an ongoing crisis in the mental health and wellbeing of children and young people in England which is not being adequately recognised or responded to by decision makers at any level and is still not a top priority.
The peak age for the onset of a mental health problem is 14.5 years old.1 50% of all mental health problems are established by age 14, rising to 75% by age 24.2 Mental health problems during this period can significantly disrupt developmental processes, making young people particularly vulnerable to experiencing poor outcomes such as poor academic outcomes, unemployment, teenage pregnancy, drug and alcohol abuse, suicide risk, crime and exploitation, and physical health problems. Suicide is the main cause of death in people under the age of 35, with 1,840 people losing their life by suicide in 2023, over three-quarters of them boys and young men. Over 200 teenagers are lost to suicide each year.
