The British Association for Behavioural and Cognitive Psychotherapies (BABCP) is the lead organisation for Cognitive Behavioural Therapy (CBT) in the UK and Ireland. Our mission is to support the development of CBT, and those who deliver it, to improve the mental health of people across the UK and Ireland.
As the leading organisation for CBT in the UK and Ireland with over 26,000 members, we are committed to promoting the highest standards of CBT practice, training, and supervision. We hold all our members to the highest professional standards, which they commit to by adhering to our Standards of Conduct, Performance, and Ethics. Alongside the Association for Rational Emotive Behaviour Therapy (AREBT) we keep the CBT Register UK and Ireland. This is the only officially recognised register of BABCP and AREBT accredited CBT therapists, supervisors and trainers, Wellbeing Practitioners and evidence-based Parent Trainers. The CBT Register is a Professional Standards Authority (PSA) Accredited register.
Our submission will therefore be based on the areas of mental health and the impact that the lack of prompt access to evidence-based treatment such as CBT can have on young people’s mental health. We will be happy to give oral evidence to the Committee.
Executive Summary
One of the key factors leading to young people being NEET is mental health struggles with one in five children and young people aged 8 to 25 having a probable mental health condition. Data shows that almost children and young people with a probable mental health condition are more likely to miss schools and needing time off work. While demand for children and young people’s mental health services continues to increase, it has not been met with adequate resourcing, negatively impacting on waiting times and worsening children and young people’s mental health. While some of the Government initiatives such as the Whole School Approach, Youth Matters Strategy, Early Support Hubs, the 10-year workforce plan are a positive step; there is a need for the Government to invest in high-quality, evidence-based psychological therapy, such as CBT delivered by appropriately trained and accredited psychotherapists in different settings. Appropriately funding NHS Talking Therapies, ensuring a full rollout of the initiatives listed above, improving waiting times for children and young people to access treatment, and investing in culturally appropriate care are crucial to ensure children and young people can thrive, access education, employment and training.
Young people who are NEET
Question 1
What factors lead to a young person not being in education, employment or training (NEET)? Are there some young people who are more likely to be NEET than others?
One of the key factors leading to young people being NEET is mental health struggles (1) (2) and the current delays in accessing evidence-based mental health support, such as CBT though NHS Talking Therapies. In 2023, 20% of children and young people aged 8 to 25 had probable mental health condition (3). Prevalence of probable mental disorders is particularly high among older adolescents, with rates among 17–19-year-olds estimated at over 23 percent, and higher prevalence observed among young women (4). Socioeconomic disadvantage is associated with higher prevalence and poorer outcomes (5), alongside lower engagement with services. This can have an impact on lower engagement or higher dropout rates.
Demand for children and young people’s mental health services has increased substantially in recent years, with large numbers of young people in contact with NHS services annually and continued upward pressure on referrals (6). However, higher demand has not been met with adequate resourcing of mental health provision who are able to deliver the care that is needed. In 2023/24, there were 78,577 young people waiting over a year for mental health treatment from the NHS, with 44% of these waiting over two years (7). The delays in accessing evidence-based mental health support for young people can also exacerbate mental health issues, with 59% of young people reporting that their mental health worsened during the wait for support (8). This was identified by the most recent Children’s Commissioning report which clearly recommends reducing waiting times for Children and Young People Mental Health Services CYPMHS ( 9).
Children and young people struggling with mental health are more likely to be NEET and data shows that almost 30% of 11-16 year olds with a probable mental health condition missed a week or more of school in 2023 (compared to 10% of their peers without a mental health condition) (10), and 35% of 18-24 year olds in employment reported needing to take time off work due to poor mental health or stress (11).
Another factor to consider is the current and ongoing delays on assessment and diagnosis of neurodiversity conditions, as shown in Lord Darzi’s independent investigation (12). Currently waiting lists for an assessment can be as high as two years and five months for children, according to the Children’s Commissioner 2024 report (13); and adults face waiting list of up to three years (14), depending on where they are based in the country. People who are neurodivergent may face additional challenges leading to a higher risk of common mental health problems such as anxiety (15) and depression (16), so prompt access to evidence-based therapies such as CBT is crucial to ensure they get the help they need. CBT is also recommended by the National Institute for Care and Health Excellence (NICE) guidelines as a possible treatment for adults and young people with ADHD (17).
Another risk factor for children and young people becoming NEET is “risky or antisocial behaviour”. BABCP currently has a register of Evidence-Based Parent Trainers (EBPT) which are a small but very important group helping children and young people. CBT and associated social learning theory programmes can be an effective tool for treating related underlying emotional and mental health problems that contribute to antisocial behaviour (18).
Lastly, the mental health of the parents of children and young people can have an impact on them becoming NEET. A recent study in the Netherlands concluded that “individuals with precarious family circumstances (no parent in paid employment or at least one parent with mental health problems) have high school dropout and NEET rates that are up to twice as high compared with individuals with no precarious family circumstances.” (19)
Question 2
What are the long-term consequences for young people who are NEET for an extended period?
Studies have shown that NEET experiences are associated with higher risk of mortality, hospitalisation and poor mental health (20). This can of course have a negative impact not only on themselves and their families but on society and the economy as a whole, thus highlighting the benefits of investing in projects such as the Whole School Approach and NHS Talking therapies so any issues can be identified and addressed promptly. Consideration should also be given to Social Learning Theory-based parenting intervention delivered by Accredited Evidence Based Parent Trainers (EBPTs) and to parent-led CBT interventions for treating common mental health conditions as these would help to identify and tackle any issues promptly preventing children or young people becoming NEET.
Question 3
Would it be useful for the Government to set specific goals or target relating to the number or proportion of young people who are NEET? What might such a target be?
Regular attendance at school and meaningful engagement with employment and training have a positive impact on mental health. However, any targets or goals should take account of the underlying reasons for children and young people finding themselves not in education, training or employment.
Preventing young people from becoming NEET
Question 4
How can the Government, and the DWP, help to prevent young people becoming NEET in the first place?
- Embed the Whole School Approach and invest in the Education Mental Health Practitioner (EMHP) workforce
A key area to consider is to further embed the Whole School Approach (21) and to enhance access to evidence-based therapies such as individual CBT informed interventions as offered by EMHPs through Mental Health Support Teams. EMHPs work across education and healthcare to support the mental health of children and young people in schools, colleges and the community and are registered (*) by either BABCP or BPS to ensure a gold-standard of training and adherence to best practice.
* Registration for all working EMHPs and CWP was launched on 24 April 2023. On 24 April 2024 NHSE made registration a requirement for all working EMHPs and CWPs through either BABCP or BPS thus ensuring a gold-standard of training and adherence to best practice.
The Government should consider increasing the number of EMHPs and ensure it delivers on its commitment of ensuring that all schools have a Mental Health Support Team (EMHT) by 2030 if not earlier (22). The role of EMHPs should also be enhanced by putting more resources into CPD, training and supervision to ensure this model does not drift. This is also in line with the Government’s commitment to focus on prevention as part of the 10-year plan.
2. Reduce waiting times for Children and Young People Mental Health Services and fund services appropriately
According to the BMA, over half a million children and young people are currently on a waiting list for mental health support, and they are still being sent far from home in out of area placements (23).
As explored above, the number of children and young people in contact with mental health services does not stop increasing however, demand is not met with investment in capacity that can help to reduce the waiting lists (24). It is crucial for the Government to continue supporting the commissioning for NHS Talking Therapies, and to fund the expansion of the professionally trained mental healthcare workforce across health and education that can deliver evidence-based therapy, such as CBT. Earlier access to evidence-based psychological interventions could reduce progression to crisis-driven care.
Furthermore, many talking therapies services – which run from either age 16 or 18 depending on the local commissioning – have employment advisors embedded in their service which young people/adults can access alongside their evidence-based therapy. These advice sessions are separate to the person’s therapy but can be complementary helping people to reach their goals of getting back into work, retaining work, changing jobs or volunteering. They often help practically with CV development, interview skills, career planning and access to training. This is crucial not only to help young people’s mental health but also to their future education and professional lives.
3. Continue embedding mental health awareness and care in every area of society
Evidence consistently shows that around 50 percent of lifetime mental health conditions emerge before age 14, and approximately 75 percent by the mid-20s (25), underscoring the importance of prevention and early intervention beyond compulsory education. So, while primary and secondary schools are key access points, the system should ensure that young people are able to access evidence-based therapy, such as CBT outside of schools and in their community – e.g. youth services, local clubs etc. Government initiatives like Youth Matters (26) which set up Youth Future Hubs with mental health but also career support are key to ensuring young people have the care they need. However, it is crucial that the mental health support available includes evidence-based talking therapies, such as CBT, delivered by adequately trained and BABCP-accredited practitioners.
Similarly, the Early Support Hubs, which are designed to provide drop-in mental health support to people aged 11 to 25 without the need for a GP referral is a great initiative. However, currently there are only 24 hubs, so it is important to continue creating hubs in every local authority and to ensure that CBT therapy, delivered by accredited or registered Therapists, is offered, in line with current NICE guidelines.
Another key preventative measure is to embed health awareness in every area of society from early years to older adult care, and in relevance to this particular case in the transition to adulthood. This will provide young people with an opportunity to take care of their mental health by building it into school curricula, acting as a preventative tool allowing early.
4. Invest in culturally appropriate care
Research from the Children’s Commissioner highlights the prevalence of health inequalities amongst children (27). Socioeconomic disadvantage is associated with higher prevalence and poorer outcomes, alongside lower engagement with mental health services (28), which can in turn have an impact on lower engagement and higher dropout rates.
Culturally competent and accessible psychological interventions in the community are required to reduce inequalities in outcomes. Investing in accessible evidence-based community care led by and for the community could help to reach children and young people who are less likely to access statutory CYPMHS or who may already not be in education or work.
5. Improve accessibility to NHS Talking Therapies, such as CBT for young people and their families
Since the COVID-19 pandemic there has been rapid growth in remote and digitally delivered psychological therapies, including CBT, aimed at improving access. Evidence supports the effectiveness of remote CBT, outcomes vary depending on practitioner competence, intervention design and monitoring arrangements (29). BABCP will be happy to work with the Government ensuring there are clear national standards for digital CBT delivery, including competency, supervision and outcome monitoring.
Question 5
Are there any examples of Government-funded interventions designed to prevent young people becoming NEET that have been particularly effective?
As per our response above, the Whole School approach which aims to promote and support mental health and wellbeing in schools is crucial in preventing NEET. However, it is crucial that this approach is rolled out across the whole of the UK to reduce discrepancies between areas and to invest in training enough EMHPs who can deliver CBT-informed approaches.
The Youth Matters strategy (30) which sets up Youth Future Hubs with mental health but also career support is also a very important Government initiative to ensure young people have the care they need. However, it is crucial that the mental health support available includes evidence-based talking therapies, such as CBT, delivered by adequately trained and BABCP-accredited practitioners.
Similarly, the Early Support Hubs, which are designed to provide drop-in mental health support to people aged 11 to 25 without the need for a GP referral is a great initiative. Currently there are only 24 hubs, so it is important to continue creating hubs in every local authority and to ensure that CBT therapy, delivered by accredited or registered Therapists, is offered, in line with current NICE guidelines.
For young people who are not at school any longer, it is important that they are able to access evidence-based support by adequately funding NHS Talking Therapies and community care so that BABCP-Accredited CBT therapists, Children’s Wellbeing Practitioners (CWPs), Psychological Wellbeing Practitioners (PWPs) and EMHPs can continue to provide interventions both in a healthcare and in a community settings.
The 10-year workforce plan, which includes the shift to community and prevention, is also a key Government initiative that could help with allowing children and young people to get the help they need to prevent becoming NEET.
Question 6
What evidence do we have of where funding has been allocated and the effectiveness of different programmes?
No comment.
Support for young people who are NEET
Question 7
How well supported are young people as they move from school to college and into education? What impact might the transfer of apprenticeships and Skills to DWP for people aged 20+ have on these transitions?
In England, there is support for those who have used a child or young person’s service and need mental health support moving into adulthood and the CYPMHS may consider moving them to AMHS – a change that can happen between 16 to 25 (31), but this depends on availability in the local area. There are also often differing thresholds for severity and risk between adult and child mental health services, which can create gaps during the challenging time of transition to adulthood.
In Wales, this transition is covered under Transition and Handover Guidance (32). There is similar guidance in Scotland where Health Boards are expected to plan for transitions and the Scottish Government published guidance a including the Child and Adolescent Mental Health Services (CAMHS) Service Specification (33). The specification sets out an expectation that the Scottish Government’s Transition Care Planning (TCP) Guidance is implemented and it ensures that children, young people and their families will be able to access additional support which targets emotional distress through Community Mental Health and Wellbeing Supports and Services. The National CAMHS Service Specification requires a robust TCP for those children and young people who are more at risk of adversity during transitions which should allow for flexibility for those aged 18-25 to continue their care and treatment with CAMHS where this is in their best interests.
It is acknowledged that the transfer from Children and Young People to Adult mental health services could have a potential negative impact on young people who are NEET. We believe that the Department of Work and Pensions should work with the Department of Health and Social Care, NHS bodies and all of those involved in providing care to ensure they are able to understand the implications of the transition.
Question 8
What is the most effective way of delivering support to young people who are NEET? Are there any initiatives that can be learned from, domestically or internationally?
As per our above answers, there is a need to provide evidence-based mental health support in different settings, including in schools, community settings such as Youth Hubs by BABCP-accredited practitioners –EMHPs, PWPs, CWPs, and CBT therapists.
Being able to access evidence-based mental health treatment outside of schools is perhaps most important for those who are already NEET as they are not in an education or a work setting. It is also paramount for this particular group to have easy access and facility to self-refer as they won’t be in a setting where referrals are made on their behalf and they may not have positive advocates in social support systems. Currently, the Early Support Hubs provide children and young people aged 11-25 with drop-in mental health support to people aged 11 to 25 without the need for a GP referral is a great initiative. However, there are only 24 hubs, so it is important to continue creating hubs in every local authority. There is also a need to ensure the psychological interventions delivered in the Early Support Hub are in line with best- evidence and NICE guidelines, which recommend CBT as the first line treatment for the majority of common mental health conditions.
As above, the key initiatives that we can see can have a positive impact on young people who are NEET, include the Youth Matters Strategy, the NHS 10-year plan with the focus on community care and prevention. However, both these initiatives rely on the Government allocating appropriate funding and creating enough posts for accredited CBT therapists and Wellbeing Practitioners.
Question 9
How can and should DWP support young people who are not in contact with the benefit system?
No comment
Question 10
What barriers or disincentives prevent young people from taking up, or completing, apprenticeships?
No comment
Question 11
What barriers are there to employers offering and targeting apprenticeships at young people? How effectively will the Government’s current approach address these?
No comment
Question 12
How can apprenticeships and other forms of training offered by DWP, e.g. Skills Bootcamps or the sector-based work academy programme, be best utilised to support young people?
No comment
Question 13
How does support for young people who are NEET differ between the UK’s four nations? How might the transfer of Skills to DWP impact the delivery of support for young people across the UK?
Mental health support really varies across the four nations. England and Wales both have the aim to embed the Whole School approach (34) to emotional and mental wellbeing and they have EMHPs roles in NHS, education and community settings. Wales also has a CAMHS In-Reach to Schools service which has been crucial for shifting the culture in schools to recognise the importance of emotional and mental wellbeing (35).
Scotland has a similar early intervention initiative such as LIAM – Let’s introduce anxiety management, which is a CBT-informed targeted anxiety intervention for mild-moderate anxiety in children and young people (36). Scotland also has a similar role to EMHPs called a Psychological Intervention Assistant (PIA) which can work in CAMHS settings delivering evidence-based interventions for children and young people experiencing mild to moderate mental health difficulties, e.g.: anxiety, depression/low mood, and self-regulatory and behavioural difficulties.
The EMHP role is not yet formally established in Northern Ireland, but similar early-intervention children’s mental health posts may be available through Health and Social Care Trusts.
NHS talking therapies and the ability of self-referral is important for young people over 18 who may not feel comfortable discussing their situation with their families or their GP, as it facilitates access to evidence-based mental health treatment, such as CBT. Currently, people based in Scotland, Wales and Northern Ireland are at risk of a postcode lottery where some people living in a certain area belonging to a particular Health Board or NHS Trust may or may not be able to self-refer.
Employment and the labour market
Question 14
What are the main barriers to employers supporting young people into employment and how can the Government better work with employers to address these?
No comment
Question 15
How well is support for young people tailored to local labour market conditions and how can this be improved?
No comment
Question 16
What impact may developments in technologies, such as AI, have on the employment of young people? How should the Government respond?
No comment
Question 17
How can employers be encouraged to invest in Skills training?
No comment
