Delivering early intervention mental health support for young people
By Kate Newhouse, CEO, Kooth Digital Health
I was struck by the tone of Alan Milburn’s interim report on young people and work, which reads as an alarming warning about the challenges facing young people today, and exposes the fundamental failures of our current approach to supporting them.
Unlike many typical policy papers, it does not shy away from the scale, urgency, or human impact of this challenge.
The report opens with a stark reminder: “One million lives.” Nearly one million young people aged 16 to 24 are not in education, employment or training (NEET), with “aspirations thwarted, opportunities lost, futures placed on hold.”
It’s a powerful framing, moving the conversation beyond statistics and economics, to the reality of a generation disconnected from opportunity.
And I strongly agree with the seriousness of the issues set out. Britain is no longer facing a marginal youth employment problem; as Milburn argues, it is confronting a systemic challenge at the point where young people are supposed to transition into adulthood. The report is clear that this is not simply a labour market issue, nor solely a health issue. It is a challenge with profound implications for the country’s financial sustainability and social cohesion.
The scale of the problem is becoming increasingly difficult to ignore. The number of young people unemployed due to ill-health has more than doubled over the last decade, while the proportion of disabled young people who are NEET citing mental health as their primary condition has nearly doubled to more than four in ten.
The report estimates that the annual cost of almost one million NEET young people now stands at £125 billion, underlining why this situation cannot continue.
Importantly, by setting out the challenge in such stark terms, the report also creates a clear sense of purpose and momentum for change. It signals that this can no longer be treated as a peripheral issue and, hopefully, will help set the stage for the kind of serious policy reform and investment needed to support young people before they become detached from education, employment, and wider life opportunities.
For me, one of the clearest messages in the report is that mental health prevention and early intervention can no longer sit on the edges of the system – they need to be central to our response to this challenge.
There remain major gaps in support for young people who do not meet thresholds for specialist mental health services but still need help. It’s while young people are on these waiting lists, trying to navigate fragmented pathways, or simply not quite ‘at the level’ required to receive help, that difficulties can escalate – potentially lasting into adulthood and impacting their future life outcomes, including engagement with education and work.
There has been strong national rhetoric from the Government around shifting healthcare “from treatment to prevention” but the question increasingly being asked across the mental health sector is what incentives or wider structures are in place to help local systems deliver that shift in practice.
These concerns have only grown following the publication of the latest NHS planning guidance, which removed the longstanding children and young people’s mental health access target, despite wider ambitions around prevention and early intervention within the 10 Year Health Plan.
What stayed with me after reading yesterday’s report was Milburn’s recognition that prevention and early intervention services remain vulnerable to short-term funding cycles or risk being treated as discretionary add-ons, rather than core infrastructure that helps prevent more acute need developing down the line.
The report also reflected a similar recognition that was raised in the Interim report of the Independent review into mental health conditions, ADHD and autism, of the need to rethink how support is organised, concluding that there is a responsibility to create provision that is less dependent on diagnostic thresholds, more responsive to functional need, and available through earlier, more accessible forms of support.
This reflects a growing understanding that mental health support should not be contingent on diagnosis alone, but available earlier, meeting young people where they are and based on the needs young people are experiencing. If prevention is genuinely the ambition, it needs to be funded and prioritised as seriously as crisis care and treatment.
Digital mental health and wellbeing interventions are a clear example of this challenge. They are often discussed as part of the future of mental healthcare, and we know young people are increasingly seeking support online. However, to make this a reality, we need to ensure consistent access to safe, digital support for all young people and continue strengthening the evidence base around what works and how effectiveness should be measured.
There are also commissioning barriers that risk holding digital, preventative services back. The Government’s focus on ‘NICE-recommended’ technologies can favour interventions linked to diagnosis and clinician oversight, while preventative digital support risks being overlooked.
As commissioning responsibility shifts to Mental Health Trusts, we are already seeing digital interventions treated as a ‘nice to have’ rather than a core part of the mental health support offer.
To deliver on the ambition of prevention on a population level where access, affordability and equity are must-haves, digital support must be recognised as a mainstream part of the pathway, not an optional add-on.
At Kooth, we see every day the difference accessible, digital wellbeing support can make for young people who may otherwise face long waits or not engage with traditional services at all. Through confidential online support delivered through moderated peer communities, one-to-one professional support accessible within minutes not weeks, and self-guided tools and activities, services like Kooth can provide young people with timely help at the point they first need it - often long before problems escalate into crisis and require more acute intervention.
Milburn’s final report later this year is an important chance to confront the consequences of a system that is failing too many young people, and to set out a credible plan for change.
If we are serious about preventing a generation from becoming disconnected from education, employment and opportunity, early intervention and prevention in mental health must move from a broad aspiration to meaningful action.
We owe it to the younger generation to make that shift now, because every year of delay risks more young people being denied the opportunities they deserve.
As a country, we cannot afford to waste their talent and potential; as a society, we should not accept leaving a generation behind.