Despite demand for mental health services at record levels, the government last week scrapped plans to publish its long awaited cross-departmental 10-year strategy to tackle the crisis. Instead, it announced a decision to publish a broader plan that will cover a range of long-term health conditions, such as cancer and respiratory conditions, alongside mental health, under a ‘Major Conditions Strategy’.  

Over the course of the last year, thousands of people with lived experience of mental illness contributed to the plans which were due to be released last week. Unsurprisingly, the last minute U-turn has received widespread condemnation from across mental health and children’s sectors. Despite acknowledging the link between chronic health conditions and poor mental health, mental health charities argue the new strategy risks excluding children and young people in particular, who are “less likely to experience chronic ill-health yet are the most likely to benefit from early action to protect their mental health”.  

In 2019, the government set out funding commitments in the NHS Long Term Plan to boost mental health spending by £2.3bn a year, although progress is difficult to track and soaring mental health statistics show this either isn’t working or isn’t enough. Many argue the problem lies in the lack of investment in the mental health workforce; or any attempts to address the drivers of growing demand – such as the need for reform of both adult and children’s social care. With vague promises of yet further consultation later in the year, this latest decision risks kicking solutions to ease the mental health crisis further into the long grass.  

Issuing a written statement to Parliament, the Health Secretary Stephen Barclay MP stated: “Tackling the major conditions that lead to people spending more years in ill health is a significant opportunity to improve the lives of millions of people”. Whilst there is some logic to looking at a more joined up approach to health policy, there is a risk the strategy could be too broad to be meaningful, or conversely, so specific that it ignores other major health conditions, comorbidities, and, ultimately, children’s health. The big problem with lumping mental health with other major conditions is that it is currently organised and funded through an almost entirely separate system within the NHS. That means any overarching strategy risks trying to retrofit solutions designed for a physical health system onto mental health services, leading to tokenistic and not widespread reform. 

Why it matters for adoption 

According to NHS Digital data, there has been a 60% increase in probable mental health conditions among children in England between 2017 and 2021 – meaning one in six children have a probable mental health condition. Undoubtedly this has not been helped by a global pandemic and the current cost of living crisis, but the problem was showing well before 2020. 

This data becomes even more bleak when we look closely at the mental health of particularly vulnerable groups of children and young people, such as those with care experience. Children who are adopted are more likely to have mental health needs than their peers because of early trauma, neglect, and abuse. This was highlighted in last year’s Adoption Barometer which showed nearly half of children represented were diagnosed with social, emotional and mental health (SEMH) needs. 

Furthermore, while adolescence can be a challenging time for all young people, our research shows that those who are adopted are far more likely to experience difficulties with their mental health during this difficult transition. NHS Digital data shows that 17.4% of 17-19 year-olds in 2020/21 reported probable mental health disorders, however almost half (45%) of adopted 16-25-year-olds represented in our Barometer survey published last year had been involved with mental health services in 2021. Added to this, one quarter of adopted 16-25-year-olds were reported as having been involved with drug and alcohol misuse and 12% of 13-18-year-olds were known or strongly suspected to have been involved in criminally exploitative activities (e.g. county lines, child sexual exploitation). More than a quarter of adopted children were reported to have harmed themselves during 2021.  

Adoption UK has consistently called on government to embed mental health support into front line services, training education and health professionals in early childhood trauma and associated conditions such as Fetal Alcohol Spectrum Disorder and Attachment Disorder; and to improve the transition between child and adult services to help prevent young people ‘falling off a cliff’ during this period. We have seen some real successes from this campaigning, such as the national NICE standards for FASD. Ultimately, however, national policy solutions remain elusive, no doubt impeded by the need for joined up working between Whitehall departments. On a more local level, Regional Adoption Agencies such as One Adoption West Yorkshire and Adoption Counts have set up effective collaboration across agencies and a clear expectation on services such as Children and Adolescent Mental Health Services, other health services and education to be able to offer a high quality, ongoing package of appropriate support delivered from day one and available throughout childhood and beyond.  

With the 10 year plan scrapped, we await the government’s response tomorrow to the Independent Review of Children’s Social Care in England, and can only hope the measures they set out will help to improve the mental health of those children and young people with care experience, including those who are adopted. 


by Katharine Slocombe

Policy Advisor, Adoption UK