In summary: The Children’s Commissioner’s latest report shows more than a million children were referred to mental health services in one year, around one in ten, almost double 2018/19. Demand on this scale cannot be met by treatment alone. Preventative mental health and wellbeing education in schools reduces it, with independently evaluated returns of up to 46 times the investment where myHappymind was used across one NHS integrated care system.
What does the latest report show?
The Children’s Commissioner for England, Dame Rachel de Souza, has published her annual report on children’s mental health services. More than a million referrals were made to children’s mental health services in a single year. That is around one in ten children, almost double the level recorded in 2018/19.
These are not abstract numbers. They represent more than a million children in distress, waiting for support the system is struggling to provide. The Commissioner is clear that we cannot keep accepting that the only option for ever more children is a referral to specialist services.
Why is more treatment not the answer?
The pressure on specialist provision is already well documented. Around three in four children with mental health needs do not get the help they require (Department of Health, Future in Mind, 2015), and only about half of those referred to CAMHS show reliable improvement (NHS England, Mental Health Services Data Set, 2022). The likelihood of a young person having a probable mental health problem rose by around 50 per cent between 2017 and 2021 (NHS Digital, Mental Health of Children and Young People in England), leaving services overstretched and schools under growing pressure.
A system built mainly to react cannot keep pace with rising need. All of these children need support. The difficulty is that when help does not come earlier, more and more of them reach the same point, where a referral to specialist services is the only option left. Prevention is about giving children the right level of support at the right moment, so that fewer reach crisis and specialist help is there for the children who need it.
“Not every child who is struggling with their emotional health and wellbeing needs a clinical referral. Access to a trusted professional such as a teacher or mentor who can help them to understand their emotions and develop effective coping skills can often be just as effective. myHappymind supports schools to embed that universal layer of mental health provision so specialist mental health support could be reserved for the children who needed it most.”
What does mental health crisis prevention look like in schools?
Prevention here means preventing mental health difficulties from escalating into crisis. It means giving every child, from their earliest years, the skills to understand and manage their mental health before problems take hold: how their brain works, how to recognise and regulate their emotions, how to build relationships, and how to develop resilience and self-esteem. Delivered universally in schools, this acts as a first-line intervention that catches need early and reduces the flow into targeted and specialist services.
Done well, it reduces burden in two directions at once. It eases pressure on CAMHS, Mental Health Support Teams and SENCOs by preventing referrals, and it reduces burden on schools by giving staff a consistent, structured approach rather than adding to their workload. The classroom change is measurable: in schools using the programme, the share of teachers reporting that children had a way to self-regulate during times of stress rose from 18 per cent before to 95 per cent after (myHappymind National Impact Report, national teacher survey).
myHappymind is a preventative, NHS-backed mental health and wellbeing programme delivered this way. It is used in over 2,000 settings across the UK and commissioned by the NHS and local authorities in 40 areas. Every child takes part, including children with SEND, without the need for withdrawal or separate delivery.
How does this align with national policy?
The direction of national policy is already moving towards prevention. The government’s 10 Year Health Plan for England sets out a shift from sickness to prevention, reaching people earlier rather than waiting to treat them. Mental Health Support Teams are expanding towards national coverage, SEND reform and the move to a more inclusive mainstream point the same way, and the Ofsted 2025 framework places wellbeing, inclusion and attendance at the centre of inspection. NICE guideline NG223 recommends universal, whole-school approaches to social, emotional and mental wellbeing as standard practice.
A universal prevention programme operationalises each of these agendas at once, which is part of why it lands with commissioners as well as schools.
Does prevention work, and is there evidence?
Yes, and the evidence is independent and evaluated at area level.
An evaluation across the Hampshire and Isle of Wight integrated care system found cost avoidance of £17,587,115 against an investment of £377,730. That is a return of 46 times the investment, calculated across reduced CAMHS, SENCO and MHST referrals, fewer suspensions and safeguarding incidents, and improved attendance. Within that same evaluation, 1,504 CAMHS referrals were prevented. A separate evaluation in Bradford District and Craven found 673 CAMHS referrals prevented in a single year, with a return of 14.4 times the investment.
Children with mental health difficulties are around three times more likely to miss significant amounts of school (Viner, Pearce & Hope, 2026), which is why wellbeing and attendance move together in the data below. An independent analysis by Portsmouth City Council compared schools using myHappymind against those that did not, over three years Suspensions and absence rose across both groups in line with national trends, but the increase was much lower in myHappymind schools. Suspensions rose by 20 per cent in myHappymind schools compared with 118 per cent in others, and severe persistent absence rose by 33 per cent compared with 66 per cent. A further independent analysis of Bury local authority attendance data, covering 64 primary schools over four years, found that myHappymind schools reduced persistent absence at 7.5 times the rate of comparison schools.
An independent evaluation of the myHappymind programme by the Centre for Mental Health, the independent mental health research charity, adds a national, multi-stakeholder layer to this picture. Drawing on surveys from teachers, headteachers, parents and children, alongside interviews with commissioners, and covering every module of the programme across two demographically distinct areas, it found consistent positive impacts on children’s emotional regulation, self-esteem, confidence and resilience. Headteachers pointed to a calmer school culture and improved staff understanding of mental health. The Centre for Mental Health noted that its findings align with the earlier Portsmouth analysis, independent reviews reaching consistent conclusions.
Taken together, this evidence points to a consistent pattern. When children are taught early how their brain works, how to regulate their emotions, and how to build resilience and relationships, fewer reach the point of needing specialist support, demand falls, and the return on investment is realised at system level. For areas with the greatest need, that also makes prevention a practical lever for narrowing health inequalities.
The crisis is real. So is the alternative.
The Children’s Commissioner is right that we cannot keep referring ever more children for treatment and call it a strategy. Children in crisis need help now. Every other child needs us to act earlier, so that fewer reach that point at all.
Prevention is possible, it is evidenced at area level, and it is already working in thousands of schools, reaching over a million children, parents and staff. The opportunity now is to reach many more.
Read the evidence in full. Our National Impact Report brings together the independent evaluations, case studies and system-wide data behind myHappymind’s preventative approach. Read the myHappymind National Impact Report
For the independent view, you can also read the Centre for Mental Health evaluation of myHappymind.
For commissioners. If you are exploring how to reduce demand and meet your mental health and inclusion priorities in schools, find out about myHappymind for the NHS and local authorities or book a conversation with our team.
Frequently asked questions
According to the Children’s Commissioner’s latest annual report, more than a million children were referred in a single year, around one in ten children, almost double the 2018/19 figure.
By teaching every child to understand and regulate their emotions early, fewer children escalate to the point of needing specialist support. Independent evaluations have found 1,504 CAMHS referrals prevented across one NHS integrated care system and 673 prevented in one local area in a single year.
Independent, area-level evaluations of myHappymind found returns of up to 46 times the investment across Hampshire and Isle of Wight, and 14.4 times in Bradford, driven by reduced referrals, better attendance and fewer suspensions.
Depending on local arrangements, prevention can be funded through NHS children and young people’s mental health budgets, public health, Mental Health Support Team funding, or local authority inclusion budgets.
myHappymind is a preventative, NHS-backed children’s mental health and wellbeing programme used in over 2,000 settings across the UK. It teaches children self-regulation, resilience and self-esteem as part of a whole-school approach.
