Is there a crisis of childhood?

04 October 2019

Children in the UK are buckling as a result of unprecedented social pressures, political turmoil and a void in government policies that should keep them safe and well, says a recent report. Journalist Jo Waters asks what can be done to help avert a crisis.

Childhood is under threat: that is the bleak finding of a recent survey from charity Action for Children (AfC). Instead of feeling safe, carefree and protected, our children are increasingly experiencing bullying, stress, depression and anxiety – as well as worrying about social media and even ‘adult’ threats such as Brexit, terrorism and poverty. The poll of 5000 children, parents and grandparents reveals that most think childhoods today are becoming worse (one-third of children and two-thirds of parents and grandparents). Children are not only struggling to cope with the rising pressure to pass exams and newer issues related to mobile phones and the internet, but to face up to the ‘harsh realities of the world’ (AfC, 2019a).

AfC deputy chief executive Carol Iddon says that bullying was the main concern for all three generations in the survey Choose childhood: building a brighter future for our children. Parents and grandparents said they felt ill-equipped to deal with cyberbullying and social media worries.‘They didn’t grow up in the digital age and they don’t realise that bullying today can be relentless as it goes on outside school through mobile phones. Children are constantly exposed to it, even in the family home,’ says Carol.

Too much pressure to ‘fit in’ also came out as a top concern for young people in the survey. Other frequently cited issues were worries about schoolwork and exams, falling out with friends and their own physical appearance. More than a quarter of young people (29%) were also worried about their own mental health (AFC, 2019a).

Wider worries

Children in the survey also said they worried about wider issues, with 91% (some as young as 11) expressing concerns about Brexit, homelessness, poverty, terrorism, climate change, and being the victim of crime or inequality, including sexism and racism (AfC, 2019b).

‘This is hardly surprising – if their parents are talking about the impact of Brexit and whether they’ll lose their job, children do pick up on it and start to worry, too,’ says Carol. ‘These issues are also on the news and social media constantly and are hard to avoid.’

Many children and families are still feeling the impact of the 2008 crash and the austerity measures that followed, the report claims. Parents often face job insecurity and low pay. The report highlights the fact that 4.1 million children in the UK were classed as living in poverty (Child Poverty Action Group (CPAG), 2019a), and 70% of them live in a family where one parent works (CPAG, 2019b). (For more on the effects of poverty on children’s lives, see page 48).

‘I hear people say that austerity is over, but it isn’t; the impact is going to be felt for some time yet,’ says Carol. 
‘All these worries permeate down to children.’

Added to this, in England, Wales and Northern Ireland there has also been an increase in children subject to a child protection plan or on a child protection register (Children and Families Directorate, 2019; Department for Education, 2018; Welsh Government, 2018), but despite this rising need, funding for local authority children’s services was cut in England by £3bn (29%) between 2010-11 and 2017-18 (Children’s Society, 2019).

Specifically, the AfC report highlights that resources in England have been diverted away from early years interventions such as health visiting, children’s centres and Sure Start to later-stage ‘crisis’ interventions. However, in Scotland (Scottish Government, 2018) and Wales (National Assembly for Wales, 2018) a number of initiatives have seen new funding allocations for early intervention services.

Carol says: ‘Every 15 minutes a child goes into care, but if that child was supported earlier, many of these cases could be avoided. I know of one young man with complex needs whose care is costing £13,000 a month. He has been traumatised by abuse and now each time he is moved he is re-traumatised.’

So it is the UK’s most vulnerable children who are being hit the hardest by the growing crisis in childhood, as the AfC report found.

How is childhood changing?

Michelle Moseley, a former health visitor and now a lecturer in primary care and public health nursing at the University of Cardiff, says the findings of the AfC report are ‘very concerning’ especially given the significant
cuts to HV and school nurse (SN) numbers in England (see CP cuts).

Recently retired developmental psychologist Dr David Whitbread says of the report: ‘All of this comes as no surprise. There’s nothing remotely child-friendly about what we are providing for children. This is the culmination of government policies in education, health and social support for decades. I’d definitely say we have
a crisis in childhood.’

David, the former director of PEDAL: Centre for Research in Play and Education at the University of Cambridge, adds: ‘Children today are over-regulated, over-supervised and don’t get as much opportunity for independent play. They don’t engage in the type of outdoor play that helps builds resilience.’ He says that numerous studies have shown that children who are not allowed to play outdoors – in activities such as climbing trees – are more prone to mental health conditions such as anxiety and have less resilience.

‘Children in the UK start school at age four and are subjected to lot of academic pressure from an early age with SATs and other forms of testing, with fewer opportunities for play. League tables, Ofsted inspections and high-stakes testing of young people are not good for anyone, including teachers. We need a complete rethink.’

Educational psychologist Dr Dan O’Hare, a member of the British Psychological Society’s education and child psychology division’s committee confirmed that more children today are experiencing anxiety and emotional difficulties. ‘Dealing with anxiety makes up a high proportion of the work I do with children, and this does affect their learning. If a child is worrying about their housing or whether they have money to eat, of course it will affect their achievement in school.’

Dan also says parents can sometimes underestimate how much friendship group problems impact on their children. ‘When it comes to social media, it’s not social media itself that’s the problem, but how much children use it and what other things it is stopping them doing,’ he explains. ‘It’s the kids who use it too much or who don’t use it at all who experience problems, research suggests. If a child doesn’t use social media at all then they aren’t connected to their friends, and this can lead to a feeling of isolation.’

Consultant child and adult psychotherapist Julia Mikardo, a member of the Association of Child Psychotherapists (ACP), says the current political climate is fuelling uncertainty. Julia, who is also ACP representative on Unite’s occupational professional committee of applied psychology, says: ‘We as adults are worried about what is going to happen next politically. How anxious children are about that will depend on how robust we are in helping them manage their feelings. Our heads are full of so many things at the moment that we are in danger of downplaying or ignoring the impact 
all of this is having on children.’

CP cuts

The AfC report also highlights the cuts to HV numbers in England – by 30% from over 10,000 in 2015 to 7070 at the last count (NHS Digital, 2019) – and calls on the government to properly resource the HV workforce to increase support for families in the first years of a child’s life. Its other calls to the four UK countries in early life include for Northern Ireland to urgently speed up the development of its cross-cutting early years (0 to 6) strategy, when a reconstituted assembly is in place (see Main recommendations for further calls).

‘In England, they’re back to where they were in 2009 when there was a crisis in health visiting,’ says Michelle, ‘although there is a crisis in resource provision for children in the whole of the UK.

‘The system is in crisis. The HV situation is better in some areas, but it still needs further resources across all home nations, as does school nursing, especially if we look at a preventative model. We should keep the child as the focus of everything we do.’

Carol asserts what CPs know well: ‘HVs are a very early safety net for picking up problems. Even the standard checks help build a relationship with parents, and yet their numbers have been cut back in many areas and they make fewer visits. As the first health professionals to get to know families, they are ideally placed to signpost families to support and refer onwards. Similarly, later on in school-age children, SNs are often the first health professionals to pick up on underlying problems.’

Yet SN numbers have also fallen in England, by 24% since 2015 (NHS Digital, 2019). Carol adds: ‘CAMHS is also under siege [across the UK] and it’s not necessarily appropriate to refer children with low mood and milder problems to them. There needs to be more investment in earlier support and interventions including professionals such as HVs and SNs.’

The Scottish Government seems to be leading the way by investing more in frontline staff, with a commitment to invest in an extra 250 SNs by 2022 following the increase of more than 500 extra HVs already.

Dr Ruth Astbury, programme lead of the postgraduate diploma SCPHN (school nursing) at the University of the West of Scotland, says: ‘There’s been a focus by the Scottish Government to invest in school nursing and health visiting, and this has come from recognition of the emotional health and wellbeing concerns among young people. It is also investing in more school counsellors and CAMHS staff.

‘SNs are often the first port of call for school children with anxiety and low mood - the children either are referred by teachers or can ask for help themselves. SNs can also refer more serious cases onto specialist services.

Ruth also explains that ‘HVs in Scotland make 11 home visits to families – eight of them in the first year of a child’s life – and this gives them a chance to build relationships with families. Later, they can link in with SNs if they have ongoing concerns.’

‘Every 15 minutes a child goes into care, but if that child was supported earlier, many of these cases could be avoided’

Main Findings of the Action for Children report

  • Three generations of families fear childhood is getting worse
  • Vast numbers of children worry about ‘adult’ issues such as Brexit and violent crime, while bullying offline and online emerged as the number one obstacle to a good childhood.
  • The UK’s most vulnerable children are being hit the hardest by the growing crisis in childhood.
  • AfC are calling for a national childhood strategy so governments can get a grip on these issues.

The way forward

In Scotland, Ruth says that postgraduate diploma courses in school nursing are currently delivered by three universities following a letter sent out by the chief nursing officer six years ago advising health boards that the public health nursing role (as defined in Nursing for health 2001) should be refocused, and the titles of SN and HV reintroduced (Moore, 2013).

‘The anticipation is that SNs who have completed the new postgraduate courses [in Scotland] will be able to support anxiety management in schools and avoid escalation of problems through early intervention,’ says Ruth. ‘If children are supported at the early stages by nurses and in-school counsellors, we may not need the more specialist services as much. The impact of this Scottish model will be evaluated and may influence school health in the rest of the UK.’  

Michelle says: ‘More money has to be invested in services to support families and young people, as it has been in Wales and Scotland, and that starts from birth. In Wales, we are fortunate to have a government that values HVs, and we also have the Wellbeing Future Generations Act 2015 and the Healthy Child Wales Programme, which backs up our role and considers the needs of the next generation.’

David believes a complete overhaul is needed. ‘Although there’s been a lot of political activity around children and young people’s mental health, what disappoints me is there’s been no recognition at all of what is causing these problems. The government doesn’t want to admit their policies are part of the cause.’

He continues: ‘We need a minister for children, to scrap Ofsted and school league tables and have children starting school much later as they do in countries such as Finland, where they start at seven. We also need more investment in resources such as playgrounds, children’s centres, youth clubs and health professionals such as SNs and HVs who can support families and young people.’

Consultant psychotherapist Julia also believes that ‘putting the needs of children on the political agenda is extremely important. Getting in earlier by giving frontline staff access to specialist advice and consultations with mental health professionals such as child and adolescent psychotherapists and psychologists could really help. It’s not an “either/or” situation – we need resources for crisis management and complex mental health professionals and early intervention and prevention.’

‘I wish I could just switch off the internet’

School nurse Bill Browning* works in a London borough across primary and secondary schools.

‘I’m part of a team of seven SNs covering a school population of 40,000. We see a lot of mental health problems in secondary school children, but we are starting to see them in primary school children, too. Kids today are under a lot of pressure academically and there’s also pressure from their peers to “fit in”.  Social media use has intensified this and escalates bullying. Kids tell me they don’t fit in or have fallen out with friends, or are worried about how they look. I often say I wish I could just switch off the internet because of all the problems it causes.

‘We deal with a lot of children with low-level anxiety – young people with problems not necessarily serious enough to refer onto CAMHS but who still need support – and this is the group it can be hardest to get help for. We can refer onto a counsellor working in schools or the local CAMHS, but the waiting lists are long, and we find ourselves supporting and monitoring them in the meantime. Sometimes we have to wait until they get worse before we can get them help.

‘More SNs are definitely needed; there needs to be more government investment. We could do so much more, we’re a highly skilled workforce that is being under-utilised. I don’t think the government is aware of just how highly trained SNs are, and some central direction in England would be welcomed.’

*Name has been changed

Final call

Carol of AfC says that although the charity’s report paints a bleak picture of childhood today, a crisis can be averted with investment in early support. ‘Whatever we can do to improve the access to health professionals at an early stage is the way ahead.

‘We want every child in the UK to have a safe and happy childhood with the foundations they need to thrive. We are calling for a national childhood strategy to be drawn up so that the needs of children are considered in policies across all departments. This might even mean engaging children and young people in the decision-making process.’  

She warns: ‘If we carry on sleepwalking the way we are now, we will have a crisis and a whole generation will be affected by these issues. What we have to remember is that today’s children are the next generation of adults and parents.’ 

Main recommendations of the AfC report For early childhood (forming part of the AfC’s call for a National Childhood Strategy)
  • In Scotland, the Scottish government should work collaboratively across sectors to overcome barriers and implement the Early Learning and Childcare Blueprint.
  • In Northern Ireland, a newly re-formed Northern Ireland Assembly should urgently speed up the development of the cross-cutting early years (0 to 6) strategy and the childcare strategy. 
  • In England, the government should set a clear direction for the future of children’s centres, creating long-term security for services used by millions of children each year. 
  • In England, the government should properly resource the HV workforce to increase support for families in the first years of a child’s life.
  • Across all four nations of the UK, administrations should rethink their childcare offer so that high-quality, affordable early education is available to all children from the earliest years. 

See bit.ly/AfC_crisis for the full report



Action for Children. (2019) Choose childhood: building a brighter future for our children. See: https://www.actionforchildren.org.uk/media/12029/cc-report-final-0507.pdf (accesed 18 September 2019).


Child Poverty Action Group. (2019a) Child poverty facts and figures. See: https://cpag.org.uk/child-poverty/child-poverty-facts-and-figures (accessed 19 September 2019).


Child Poverty Action Group. (2019b) The new face of child poverty. See: https://cpag.org.uk/news-blogs/news-listings/new-face-child-poverty (accessed 19 September 2019). 


Children and Families Directorate (2019). Children’s social work statistics 2017-2018. See: https://www.gov.scot/publications/childrens-social-work-statistics-2017-2018/pages/4/?_sm_ (accessed 18 September 2019).


Children’s Society. (2019) Children and young people’s services: funding and spending 2010/11 to 2017/18. See: https://www.childrenssociety.org.uk/sites/default/files/childrens-services-funding-csfa-briefing_final.pdf (accessed 18 September 2019).


Department for Education (2018). Statistics: children in need and child protection. See: https://www.gov.uk/government/collections/statistics-children-in-need (accessed 19 September 2019). 


Moore R. (2013) Public health nursing services: future focus. See:  sehd.scot.nhs.uk/mels/CEL2013_13.pdf (accessed 18 September 2019).


National Assembly for Wales. (2018) Is the Welsh Government giving a ‘Flying Start’ to all children who need it? See: https://seneddresearch.blog/2018/05/21/is-the-welsh-government-giving-a-flying-start-to-all-children-who-need-it (accessed 18 September 2019).


NHS Digital. (2019) NHS hospital and community health service (HCHS) monthly workforce statistics. See: https://files.digital.nhs.uk/70/0A4E65/NHS%20Workforce%20Statistics%2C%2... (accessed 19 September 2019).


Scottish Government. (2018) Delivering for today, investing in tomorrow. See: https://www.gov.scot/binaries/content/documents/govscot/publications/strategy-plan/2018/09/delivering-today-investing-tomorrow-governments-programme-scotland-2018-19/documents/00539972-pdf/00539972-pdf/govscot%3Adocument/00539972.pdf (accessed 18 September 2019).


Welsh Government (2018). Children on child protection register by local authority, category of abuse and age group. See: https://statswales.gov.wales/Catalogue/Health-and-Social-Care/Social-Services/Childrens-Services/Service-Provision/childrenonchildprotectionregister-by-localauthority-categoryofabuse-agegroup (accessed 19 September 2019).