Mental health
Children and young people’s mental health
‘Mental health is as important to a child's safety and wellbeing as their physical health. It can impact on all aspects of their life, including their physical wellbeing, relationships and educational attainment. Mental health can also change over time, to varying degrees of seriousness, and for different reasons.’ [1]
Mental wellbeing and resilience
Nationally, an estimated one in five children and young people had a probable mental
disorder in 2023 [2]. Locally, the 2021 Children and Young People's Quality of Life Survey survey provided new insight into the emotional health and wellbeing of almost 5,000 children and young people at school and college in Herefordshire. It revealed that the majority were happy with their
life: 75% of primary pupils and between 50 and 60% of older CYP. However, large minorities had low mental wellbeing scores: 25% of primary pupils and 48% of older students.
The most common worries across all ages were about their future, the way they look, and, especially for teenagers, their own mental health. Even at primary age, 28% of boys worried about their future, and 34% of girls worried about the way they look. 33% across all ages were afraid to go to school at least sometimes because of bullying.
Building resilience (the ability to cope with adversity and adapt to change) in children and young people can have life-long protective benefits. Only 24% of primary and 13% of older pupils had a high resilience score (based on answers to what they do if something goes wrong or if they don’t succeed). Across multiple indicators emotional wellbeing and resilience was generally lower amongst teenagers and girls in particular; for example 28% of girls from Year 7 onwards weren’t happy with life, compared to 10 to 13% of boys of all ages. Inequalities were also noted amongst disabled and economically disadvantaged pupils, and these children were also most likely to say that they or their family had sought help for their mental health: 40% of secondary pupils with a disability compared to 25% without, and 20% of those eligible for free school meals compared to 12% who were not.
Mental ill-health
Mental health risk factors are often inter-related and compounding, and mental ill-health of parents is a significant risk for children’s wellbeing. Mental health support for a family member is one of the most common reasons for needing Early Help in Herefordshire (identified in 73% of new cases in 2020-21), and parental mental ill-health is observed in many social care assessments (29% in 2020-21).
Depression was the second most common LTC for children and young people registered with a Herefordshire GP in 2024 (behind asthma). Currently (October 2024), 13% (275) of children and young people aged 10 to 19 years have a diagnosis of depression. Depression is particularly prevalent among teenagers with 96% of these cases amongst those aged 15 to 19 years.
The CLD Trust provides specialist mental health services for children and young people in Herefordshire. According to its Annual Report for 2023-2024, the number of referrals it had received increased by 30% during the year.[3] From April 2023 to March 2024, overall 1,660 children and young people were referred to the CLD Trust for emotional health and wellbeing support, 7% directly from Child and Adolescent Mental Health Services (CAMHS), which provide services for CYP with persistent and complex issues.
Published data suggest that Herefordshire had the highest rate in England for under18s being admitted to hospital for mental health conditions in 2022-23. However, such indicators may be influenced by local variation in referral and admission practices as well as variation in incidence or prevalence. Nevertheless, the local rate was significantly higher in the last two years than before 2019-20, with 120 admissions in 2022-23 compared to fewer than 70 a year.
More detail on children and young people’s mental health will be available once the Mental Health Needs Assessment undertaken in 2024 is published.
Adults’ mental health
Having good mental health makes life easier. It helps us to calm and comfort ourselves when we’re upset, to cope with the losses, changes, fears and uncertainties in life, to make and keep good relationships with other people and to learn.’[4]
‘Good mental wellbeing throughout life’ is one of the two priorities of the Herefordshire Joint Health and Wellbeing Strategy (JLHWS); four ambitions relate to people feeling:
- Satisfied with life and having a positive sense of personal wellbeing.
- Able to access appropriate mental health information and services.
- Safe from harm in their community.
- Connected to their community. [5]
Mental wellbeing
Levels of personal wellbeing are generally similar to nationally; in 2022-23 the ONS Annual Population Survey (APS) suggested that relatively few people had scores indicative of low life satisfaction (6%), happiness (8%), or feeling worthwhile (6%).
More detailed insights come from the 2021 and 2023 Herefordshire Community Wellbeing Surveys (CWS). The Warwick and Edinburgh Mental Wellbeing Scale is a composite measure of overall mental wellbeing.[6] In 2023, 37% of adults (aged 18+) had good mental wellbeing, while 8% had poor. Overall levels of mental wellbeing were similar to 2021, but there were significant inequalities, with lower levels for example amongst people living with a disability, those in deprived areas and social renters.
The APS and CWS suggest that somewhere between a fifth and a quarter of Herefordshire adults had high levels of self-reported anxiety in 2022-23, similar to England overall. In the 2023 CWS, 24% had high levels, down from 28% in 2021.
Similarly to overall mental wellbeing, those living in the most deprived areas were much more likely to have high anxiety levels (38%). In addition, inequalities were also noted in some other groups, such as minority ethnic communities (37%) and those receiving care (34%). Significantly, 45% of those who ‘often’ or ‘sometimes’ felt lonely also hadhigh anxiety.
Mental ill-health
Levels of mental ill-health (prevalence) are based on GP registers. In 2022-23, 20,350 adults aged 18+ (13%) had a diagnosis of depression, and over the past five years there have been an average of around 2,000 new diagnoses a year. In 2023-24, 1,500 people of any age (0.8%) had a diagnosis of schizophrenia, bipolar affective disorder, or other psychoses. These rates are amongst the lowest 40% in England.
The number of emergency admissions to hospital due to intentional self-harm across people of all ages has fallen in the last four years from around 300 a year to 170 in 2022-23, and the age-standardised rate is now significantly below England’s.
There can be an association between suicide and mental ill-health. The suicide rate has been similar to England since at least 2001, and has not changed significantly over this period.
A Mental Health Needs Assessment (not yet published) was undertaken in 2024 to support the mental health ambitions set out in the JLHWBS. It noted two areas of service provision for adults which are currently significantly worse than in England, related to attending contacts with community and outpatient mental health services and support for those entering drug treatment who also need help with their mental health.
It also noted that based on the age profile of the county and estimated age-specific prevalence of mental ill-health, we would expect to see more older people accessing mental health services than currently are. There are also a lack of local mental health and wellbeing data for several high-risk groups and in some cases it is not currently possible to even determine numbers at risk, for example sex workers.
[1] Child mental health: recognising and responding to concerns, NSPCC, 2025.
[2] One in five children and young people had a probable mental disorder in 2023, NHS England. November 2023.
[3] The CLD Trust Annual Report, CLD Trust.
[4] About mental health, Mental Health Foundation.
[5] Herefordshire Joint Local Health and Wellbeing Strategy 2023 - 2033, Herefordshire Council, 2023.
[6] The Warwick-Edinburgh Mental Wellbeing Scales - WEMWBS, University of Warwick - Warwick Medical School.