Interview with:
Nana Owusu
Head of Clinical Services (Clinical Division)
Anna Freud
The landscape of children’s mental health services in the UK is stark, revealing a systemic crisis in accessing vital support. Wait times are up to 17 times longer than others, depending on geographical location, and the number of children referred for neurodevelopmental conditions like autism and ADHD has increased by almost 30%, with these children facing some of the longest waits.
The sheer volume of children and young people (CYP) seeking support is simply greater than healthcare services can support with current capacity and investment. Lengthy wait times for community mental health services often leave children waiting too long for help meaning that they access services when they’re in crisis and well past the point of early intervention.
“Many services are stretched beyond capacity and unable to meet growing demand”, says Nana Owusu, Head of Clinical Services at Anna Freud, a world-leading mental health charity for children and families. “Ultimately, services need sustainable funding and a skilled, culturally competent workforce to tackle waitlists and provide reliable signposting” Nana insists.
With 20 years as a registered CAMHS Clinical Nurse Specialist and Therapist, Nana is a prominent mental health leader, public speaker, and campaigner. She is currently the Head of Clinical Services at Anna Freud, where she oversees the operational delivery of programmes promoting young people’s mental health and works closely with senior leadership on the strategic direction of the Clinical Division. She also consults for Electronic Arts, supporting the wellbeing of young gamers at international eSports events. Notably, as former Director & Clinical Lead at Hammersmith, Fulham, Ealing and Hounslow (HFEH) Mind, Nana pioneered The Circle, the UK’s first high street crisis prevention café for children and young people.
With greater awareness comes a greater need for support
In our society, we have seen a great increase in awareness of mental health conditions, which is a positive shift, Nana acknowledges. “But, with greater mental health awareness and understanding, people need somewhere to turn to and, without accessible and responsive services, it can deepen the distress”, she warns.
While social media has connected young people globally, it has also increased their exposure to distressing content, from world disasters to social injustice. For some, this can amplify underlying anxiety or low mood.
“I have often seen young people internalising systemic failures as personal weaknesses”
“Social media is not the root cause, nor inherently negative. But for young people already vulnerable, the constant exposure to distressing global events can intensify existing challenges”, Nana explains. “I have also often seen young people internalising systemic failures as personal weaknesses”, she goes on.
Many parents and carers also have their own online presence. “Children’s access to their parents’ digital lives can sometimes be emotionally destabilising, especially when they are exposed to content that reflects adult stress, distress, or unresolved trauma”, Nana says.
“We talk a lot about children having easy access to harmful content online, such as gambling, self-harm or pornography”, Nana continues. “But what we don’t talk about all that often is that young people may also witness aspects of their caregivers’ lives, including emotional struggles, that they are not developmentally ready to process. This can lead to a premature sense of responsibility for adult emotions”, she says.
Bridging the gap in early intervention
The demand for mental health services is so great, and waitlists so long, that children and young people are often only receiving support when they’re in crisis. Even in early intervention, which is designed to focus on supporting individuals at risk of developing more serious mental health problems, practitioners without the appropriate training can find it hard to identify risk.
“Education Mental Health Practitioners (EMHPs) and Child Welfare Practitioners (CWPs) often enter early intervention roles directly from university”, Nana explains. “While they bring fresh perspectives and enthusiasm, they need structured ongoing training and support to confidently identify and respond to emerging risk.”
“Many early intervention services lack multidisciplinary teams with a broad range of expertise”
Nana believes that some services tend to underestimate the level of expertise that is required for early intervention. “Many early intervention services lack multidisciplinary teams with a broad range of expertise. This can dilute the clinical depth needed to support children effectively and is often linked to limited funding”, she explains.
“There is often a misconception that early intervention work is less demanding or less complex”, Nana outlines. “While some early support can be delivered by practitioners with basic mental health training, the role of EMHPs and CWPs goes well beyond this. Although they receive a year of focused postgraduate training through the CYP-IAPT programme, the presentations they support are often layered and nuanced, extending beyond the guided self-help element. To ensure safe and effective care, services need robust supervision and clear pathways for escalation to more experienced clinicians. In some areas, this level of support is inconsistent, increasing the risk of missing early signs of deterioration”.
Technology’s role in supporting care pathways
Nana believes technology has a role to play in helping to map out and support care pathways. “We need wellbeing teams embedded into schools, so they can escalate cases quickly without relying on rigid diagnostic thresholds. Services are fragmented and complex, so we really need one embedded team doing one mapping of the area, rather than 100 different services doing 100 different mappings, and this is where I think modern technology or AI can support.”
In terms of pathways, there should also be better utilisation of small, local charities, not just statutory and well known charity organisations, Nana believes. “These smaller charities better understand the needs of their local communities. However, they don’t have the capacity or ability to collect the data they need to demonstrate the impact that they’re making to secure funding”, Nana explains.
“Build equitable partnerships , offering infrastructure support where needed, so that smaller, trusted community organisations can flourish”
Anna Freud uses iaptus, a patient management system that offers customisable care pathways that support community based services to manage their workflows and easily report to commissioners. From her experience in working in a number of charities providing mental health support, Nana has seen how iaptus supports charities to deliver standardised and high quality care. There are opportunities for charities to cooperate and share expertise that Nana highlights. “This is where larger organisations could help smaller charities support more children and young people that we can’t reach”, Nana says. “We have a whole research and evaluation team that could support building capacity resilience within smaller charities for example,” she goes on.
“Larger organisations should not assume they are always the best placed to deliver every service.” Nana explains. “Instead, we can build equitable partnerships , offering infrastructure support where needed, so that smaller, trusted community organisations can flourish and continue their essential work”, she concludes.
Read more from our thought leadership series here.
Digital technologies provide promising solutions to help children’s mental health services within NHS, voluntary, private, and public health settings cope with pressures.
Written by
Louisa Clark
hi@mayden.co.uk
If you would would like to contribute to our thought leadership series, please get in touch.
