Mental Health of Children and Young People in England 2022 - wave 3 follow up to the 2017 survey

This part of the report describes the mental health of children and young people in 2022, using the prevalence of probable mental disorders. Possible eating problems and psychotic-like experiences are also included, with trends over time where available.

This section describes the prevalence of probable mental disorder in children and young people aged 7 to 24 years living in England in April and May 2022.

Comparisons are presented as follows:

• for those aged 7 to 16, and 17 to 19 in 2017, 2020, 2021 and 2022
• for those aged 20 to 23 in 2021 and 2022 only, as this age group were not represented in the previous survey waves
• no comparisons over time are presented for those aged 24 in 2022, as this is the first wave of the survey series where participants have reached this age

The Strengths and Difficulties Questionnaire (SDQ) was used to assess different aspects of mental health, including problems with emotions, behaviour, relationships, hyperactivity and concentration.

Responses from parents, children and young people were used to estimate the likelihood that a child might have a mental disorder, this was classified as either ‘unlikely’, ‘possible’ or ‘probable’.

Please note that the mental disorder prevalence estimates in the initial MHCYP 2017 survey reported on a different and more detailed diagnostic assessment of mental disorder. Therefore, any comparisons between 2017, 2020, 2021 and 2022 must draw on the results presented in this report, which are based on a comparable measure of the SDQ using children that were aged between 7 to 19 years at the time of each survey. 

In 2022, 18.0% of children aged 7 to 16 years had a probable mental disorder, 10.8% had a possible mental disorder, and 71.2% were unlikely to have a mental disorder.

The prevalence of a probable mental disorder was 20.4% in children aged 11 to 16 years and 15.2% in those aged 7 to 10 years, but this difference was not statistically significant.

In young people aged 17 to 24 years, 22.0% had a probable mental disorder, 13.6% had a possible mental disorder, and 64.4% were unlikely to have a mental disorder.

In younger children aged 7 to 10 years, the prevalence of a probable mental disorder was nearly twice as high in boys (19.7%) as in girls (10.5%). Rates of a probable mental disorder were similar in boys (18.8%) and girls (22.0%) aged 11 to 16 years.

In young people aged 17 to 24 years, the pattern was reversed, with much higher rates in young women (31.2%) than young men (13.3%).

For more information see: Table 1.1 of the Excel data tables.

Figure 1.1 base: 7 to 24 year olds.

The prevalence of a probable mental disorder in children aged 7 to 16 years rose between 2017 and 2020, from 12.1% in 2017 to 16.7% in 2020. Rates in 2020, 2021 and 2022 were similar with no statistically significant differences between these years. In 2021, 17.8% of children in this age group had a probable mental disorder, and in 2022 the figure was 18.0%.

The prevalence of a probable mental disorder for both children aged 7 to 10 years and 11 to 16 years was higher in 2020 compared with 2017 but remained similar with no statistically significant changes between 2020, 2021 and 2022.

In young people aged 17 to 19 years, rates of a probable mental disorder rose from 10.1% in 2017 to 17.7% in 2020. Rates did not change between 2020 and 2021. However, there was an increase in the rate of a probable mental disorder between 2021 and 2022, from 17.4% in 2021 to 25.7% in 2022.

The overall rise in prevalence of a probable mental disorder between 2017 and 2022 was evident in boys and girls across both age groups (7 to 16 years, and 17 to 19 years).

Rates of a probable mental disorder for those aged 20 to 23 years were similar in 2021 (16.6%) and 2022 (18.7%). There was no 2017 or 2020 data for this age group.

For more information see: Table 1.2 of the Excel data tables.

Figure 1.2 base: 7 to 19 year olds.

This section describes trends in possible eating problems over time.

Young people aged 11 to 24 years and parents of children aged 7 to 16 years completed 5 screening questions from the Eating Disorders Development and Well-Being Assessment (DAWBA) module. 

‘Screening positive’ for a possible eating problem was defined as scoring above the threshold (answering yes to 2 or more items where a parent is reporting on a child and answering yes to 1 or more items where a young person is reporting on themselves) on these questions. The questions are available in the questionnaire and materials documentation.

This section presents data on children and young people aged 11 to 23 years, to allow for comparison with previous waves. For children aged 11 to 16 years, the prevalence figures reported are based on parent report. For young people aged 17 to 23 years, these figures are based on self-report.

These questions were not included in 2020, hence this section presents data for 2017, 2021 and 2022 only.

The different mode of data collection in 2017 (face to face) compared with 2021 and 2022 (online or telephone) may result in modal effects in responses, particularly for sensitive questions such as eating problems. While it is not possible to quantify the effects of this, caution should be taken when comparing results over time.

The rate of possible eating problems in 2022 was 12.9% in children aged 11 to 16 years. This rose to 60.3% in young people aged 17 to 19 years. Rates for young people aged 20 to 23 years were similar to those aged 17 to 19 years; 62.2% screened positive for a possible eating problem in 2022.

Across all age groups, the rate of possible eating problems was higher in girls than in boys:

• for children aged 11 to 16 years, the rate was 17.8% in girls compared with 8.1% in boys
• for young people aged 17 to 19 years, the rate was 75.9% in young women, compared with 45.5% in young men
• for young people aged 20 to 23 years, the rate was 76.6% in young women compared with 49.3% in young men 

In children aged 11 to 16 years, the rate of possible eating problems rose between 2017 (6.7%) and 2021 (13.0%), and then remained stable between 2021 and 2022 (12.9%).

In girls aged 11 to 16 years, this pattern was the same. Rates rose between 2017 (8.4%) and 2021 (17.8%) and were stable between 2021 and 2022. In boys, rates were similar between 2017 (5.1%), 2021 (8.4%) and 2022 (8.1%).

In young people aged 17 to 19 years, the prevalence of possible eating problems rose from 44.6% in 2017 to 58.2% in 2021. Rates remained stable between 2021 (58.2%) and 2022 (60.3%).

This trend was evident for young women and young men aged 17 to 19 years. In young women, rates rose from 60.5% in 2017, to 76.4% in 2021, and then remained stable in 2022 at 75.9%. In young men, rates were 29.6% in 2017 and 41.0% in 2021. The rate in 2022 (45.5%) was an increase on that in 2017 for young men.

Change between 2017 and 2022 in rates of possible eating problems could not be examined for those aged 20 to 23 years, for whom there was no 2017 data.

For more information see: Table 1.3 of the Excel data tables.

Figure 1.3 base: 11 to 19 year olds.

As in the Definitions section above: ‘Screening positive’ on the DAWBA Eating Disorders module does not mean that the child or young person had a clinically impairing eating disorder such as anorexia or bulimia but indicates an increased likelihood of broader problems or difficulties with eating.

The prevalence of ‘clinical’ eating disorders as classified by the ICD-11 or DSM-V systems is likely to be much lower in children and young people than the prevalence of possible eating problems identified by ‘screening positive’ on the DAWBA module. For example, in the MHCYP 2017 report, rates of eating disorder in girls aged 17 to 19 were 1.6%, while 60.5% screened positive. This is because the DAWBA screening questions are designed to detect all children and young people at risk, with very detailed follow up questions to determine the presence or absence of an eating disorder.

Recent research has tried to answer the question: what proportion of those who ‘screen positive’ on the DAWBA would be expected to have a clinically diagnosable eating disorder. To answer this, children, young people and parents of those who screened positive in 2021 were invited to complete the rest of the DAWBA Eating Disorder module. The findings suggest that only a small proportion would have a clinically diagnosable eating disorder, and that rates in the population remain low.

Findings from this 2022 wave therefore suggest that there has been an increase in the prevalence of children and young people who may have problems with eating since 2017. They cannot be taken to mean that there has been a similar increase in the prevalence of clinically diagnosable eating disorders.

This section describes the prevalence of psychotic-like experiences in young people aged 17 to 24 years in 2022.

‘Psychotic-like’ experiences (sometimes known as PLEs) include a range of experiences such as hearing or seeing things that others cannot, or a belief in having special powers. These are also sometimes known as 'unusual subjective experiences (USEs)' 

Experiencing 1 or more of these is relatively common and does not mean that a person necessarily has a mental health problem. Psychotic-like experiences can occur in people who do not have any mental health problems, as well as in those with conditions such as depression. Psychotic disorders themselves (such as schizophrenia) are rare, having a prevalence of less than 3% in young people.¹ However, experiencing psychotic-like experiences is thought to place young people at higher risk of developing problems in the future.

Young people completed the Adolescent Psychotic-Like Symptom Screener (APSS). Being ‘at-risk’ for psychotic-like experiences was defined as scoring 2 or more out of a possible 7 points. The questions are available in the questionnaire and materials documentation.

These questions were asked for the first time in 2022, and so no trends over time can be presented.

^{1 A Population-Based Cohort Study Examining the Incidence and Impact of Psychotic Experiences From Childhood to Adulthood, and Prediction of Psychotic Disorder | American Journal of Psychiatry (psychiatryonline.org).}

In 2022, 18.4% of young people aged 17 to 24 years were in the ‘at-risk’ group for psychotic-like experiences (that is, reported 2 or more experiences). There was no statistically significant difference in the rates for young women (22.6%) and young men (14.4%).

Young people with a probable mental disorder were more likely to be in the ‘at-risk’ group for psychotic-like experiences than those unlikely to have a mental disorder. Of those with a probable mental disorder, 36.4% scored in the ‘at-risk’ range, compared with 10.0% of those who were unlikely to have a mental disorder.

For more information see: Table 1.4 of the Excel data tables. 

Figure 1.4 base: 17 to 24 year olds.