Referrals to Cygnet’s psychiatric intensive care units in its Child and Adolescent Mental Health (CAMHS) hospitals more than doubled between 2019 and 2022.
Prior to the global virus in 2019, 255 referrals of young people were made to psychiatric intensive care units run by Cygnet Health Care. By 2022, this had risen to 596, an increase of 134%.
Admissions to the units saw a 41% increase in that time.
There an increase in the number of young people presenting with issues such as low mood, insomnia, stress, anxiety, anger, irritability, emotional exhaustion, depression and post-traumatic stress symptoms following lockdown.
One of the biggest increases in presentation was seen in disordered eating.
Similarly, referrals to its inpatient acute services rose by 61%, increasing from 668 young people in 2019, to 1078 throughout 2022.
Dr Triveni Joshi, is a consultant psychiatrist who specialises in child and adolescent psychiatry. She is the Medical Director at Cygnet Hospital Joyce Parker, which offers hospital admissions for young people dealing with mental health difficulties.
She says lockdowns would have played a massive part in the decline in mental health for young people and is a leading cause in the spike in numbers of young people needing support.
She said: “We won’t know for many years whether the virus itself disturbed young people’s neurological development but we have emerging evidence which tells us about the detrimental impact of lockdown,” she explained.
“It impacted young people’s mental health and wellbeing severely, particularly those who had pre-existing mental health conditions.
“In my view the biggest concern was the isolation. We know that lack of socialisation is a key factor in depression. The young people became trapped in their homes.
“They were missing social contact and no way of engaging in activities which would have previously boosted their mental health such as sports clubs and activities with their friends.
Not having that outlet, as well as the huge sense of anxiety about what was happening to the world around them, would have been overwhelming and little wonder they struggled.”
Dr Joshi said there was a fourfold increase in referrals for eating disorders with demand rising both for community services and also inpatient beds. She said the increase in the number of young people with eating disorders can be partly attributed to the perils of social media.
She explained: “It might have been the case that their food intake gave the young people a sense of control when everything else around them seemed so uncontrollable.
“An increase in the use of social media and programmes around healthy eating and exercise, which actually were targeted towards the general population, alongside the unrealistic ideals around beauty and body shaming, may have had a detrimental effect in this very unusual context for young people.”
Dr Joshi also talks about the change in approach to mental health services in the community and the impact that would have had.
“Community services had to offer their services very differently so what were face-to-face clinics became virtual appointments and people became less available.
“They were not able to offer sessions the way they would have done. From the young people we have admitted, they have found the lack of contact with their community mental health teams was very detrimental.
“As demand started to surge, resources became less available. And so we had the explosion in numbers.”
Meg, 15, is a service user on Unicorn Ward at Cygnet Hospital Sheffield, a CAMHS Tier 4 PICU service which provides support for young people who have complex needs and require high intensity nursing care.
She was admitted after making attempts on her life last year.
“I struggle to socialise with people and I got used to not being around anyone during lockdown,” she explained. “When restrictions lifted and I returned to school and needed to interact, my problems got a lot worse.
“Even during lockdown, I didn’t have anyone to talk to. You had to be severely unwell to get the right support. That’s the situation I ended up in.
“Without Covid, I might have had the same struggles but I would have had access to the coping strategies I needed a lot earlier.
“Perhaps then I wouldn’t have attempted suicide and I wouldn’t be on a psychiatric intensive care unit now.”
It is a similar story for Lily, also 15, who has struggled with her mental health since she was six years old and things worsened for her during lockdown. After taking several overdoses, she was admitted as an inpatient in December 2022.
She explained: “When Covid happened, a lot of the help I was used to receiving was cut back. It was really limited.
“It felt like there wasn’t the space, people or time to help me. I was receiving community support when it first appeared and suddenly, my appointments stopped. I got less help, and things started to worsen very quickly for me.
“In-person therapy is so important and when people aren’t able to access the care in the community they need, even those with relatively minor mental health problems could spiral.”