The number of children referred to mental health services has sharply risen after close to 300 children were referred last year, the Gibraltar Government has confirmed.
The three most common reasons for referrals to Gibraltar Young Minds (GYM) are anxiety, self-harm, and neurodevelopmental disorder.
The figures show a year-on-year increase, with children accessing treatment from enrolled nurses (ENs), mental health nurses, counsellors, psychologists, and psychiatrists depending on their need.
Local figures show that in 2019 there were 110 referrals, in 2020 this dipped to 48 referrals due to pandemic disruption, and in 2021 referrals returned to pre-pandemic rates to 113 cases.
In the years since, referrals have surged.
In 2022, referrals more than doubled to 283 and a year later this increased to 295 referrals.
So far, in the first six months of this year there have been 132 referrals.
Behind the numbers are children reaching out for help.
A Government spokesperson said the average wait time for a psychologist for those currently on the children and adolescents waiting list is seven weeks, ranging from two to 15 weeks.
“Whilst on the waiting list for psychology, people are likely receiving support from another member of the Gibraltar Young Minds team rather than receiving no care,” the spokesperson said.
The 2023 Mental Health Board Report was positive describing how the Children’s Centre “continues to flourish”.
“The extra staff and new protocols have dramatically changed the way mental health is responding to the needs of our youth,” the Report said.
“Whereas a few years ago there was barely a skeleton staff of two Enrolled Nurses (ENs) and a Psychiatrist who would visit Gibraltar every so often, the complement has now been increased beyond recognition.”
According to the report, two locally engaged psychiatrists now attend at regular intervals, with the possibility of remote consultations with a psychiatrist based in the UK for specialist advice.
The UK psychiatrist visits Gibraltar every three months for a week to see the more serious cases and also remotely attends the allocation meetings once a week, so he is familiar with the caseload.
A clinical psychologist and a paediatrician are also part of the team who attend these triage meetings, as well as two counsellors, who are allocated patients through the same allocation meetings. Permanently based at the Children's Centre are two ENs as well as a Registered Mental Health Nurse (RMN).
According to the report, due to the numbers involved, the ENs and RMN will see and support the children affected until a psychiatrist, psychologist, or counsellor can see them.
On average, they see about 45 children a week.
For helpline charity Childline Gibraltar, the rise in numbers is reflected in its own work.
Mental health has been the top issue raised on Childline’s Helpline for four years in a row, and the charity believes this is due to the aftermath of the Covid pandemic.
“The reality is that for the previous 12 months, 31% of all calls to Childline’s Helpline relate to Mental Health issues,” Childline CEO Caroline Carter said.
“These calls covered topics like suicidal thoughts/feelings, anxiety/stress, depression/low mood, self-harm.”
Since Covid, Childline Gibraltar has made over 80 safeguarding referrals to the Care Agency and Royal Gibraltar Police to protect a child from cruelty and significant harm.
Over 3,000 calls have also been made to the charity in this period and, at the same time, Appropriate Adult Service callouts have tripled. Through its Appropriate Adult Service, Childline provides volunteers to accompany children who have no adult guardians.
“Childline Gibraltar has been operating this service in Gibraltar for 16 years, yet this has been our busiest year to date,” Mrs Carter said.
“This is an indication that there are more vulnerable children in our community than before Covid.”
In Mrs Carter’s expert opinion, Covid has most certainly has had a long-term impact on children’s mental health.
“The fear of the pandemic which was constant at that time with constant news updates, the separation from loved ones, the isolation from friends and especially the stress placed on families at that time cannot be underestimated,” she said.
“Parents’ relationships, financial situations and the physical and mental health of parents placed many families under heightened pressure.”
“Without other significant people in their lives from family, friends, schools, and youth clubs, children were totally isolated without much external support.”
“There was no routine of going to school and this also has a huge impact on children.”
Mrs Carter also cited UK-wide research which has found the pandemic exacerbated pre-existing mental health conditions and saw children at risk spend more time locked at home in abusive conditions.
She detailed how a UK survey by Young Minds found that 80% of young people believed the pandemic had made their mental health worse.
Mrs Carter said there are indications that some forms of child abuse have increased during the pandemic.
She pointed to the recent findings by UK Children’s Commissioner that reported that 7% of children do not live with people who make them feel loved and cared for.
“There was no universal experience of coronavirus [Covid-19] and so children and their families have been impacted in different ways,” she said.
“We must also take into account that while for many children the pandemic has proved an incredibly difficult time, others have found some happiness and relief in time spent with their families or away from the pressures of school.”
Mrs Carter said that data has suggested a potential increase in the number of children exposed to domestic abuse during the pandemic.
“The Covid-19 pandemic heightened concerns for people who, during lockdowns, were trapped at home with abusive partners, with limited access to their support network and specialist services,” Mrs Carter said.
“This is why we are working alongside the Ministry of Justice and the Care Agency to offer our new Domestic Abuse Recovery Together (DART) programme.”
She added that this is a highly specialised programme, developed by the NSPCC for mums and children who have experienced domestic abuse.
Anyone who would like more information on this can contact [email protected].
In response to local need, Childline have developed an early intervention Children's Mental Health Training Programme called Resilient Minds.
Mrs Carter said the charity is currently focused on improving children’s mental health and building resilience.
“By participating in this program, children will be better prepared to handle everyday life's challenges, understand and express their emotions healthily, and foster a proactive and positive attitude towards future challenges,” she said.
“Ultimately, our goal is to nurture a generation of children who are not only academically prepared but also emotionally to face the ups and downs of life with confidence and courage.”
“It is Childline Gibraltar’s mission to end all forms of cruelty to children in Gibraltar.”
“At a time when our work has never been more important and in demand, we are appealing to companies and individuals who would be able to make a donation.”
“This funding will enable us to continue supporting children, young people and families in Gibraltar and make an impact that will last a lifetime.”
Mrs Carter said Childline Gibraltar is here to support children, young people and their families cope with a wide range of issues every day of the year.
“Childline’s services operate daily community mental health and safeguarding services, available to every child and young person, offering free, confidential, professional support,” she said.
“These early intervention services will build on developing resilience, skills and knowledge to navigates life’s challenges effectively.”
She added if any adults are concerned about a child, or want to encourage a child to access free, confidential one-to-one support, they can contact Childline’s Helpline.
Mrs Carter said the charity’s counselling model, which is adopted from the NSPCC and Childline UK, allows callers to seek information, advice, and support through professionally trained Childline Listeners.
The Gibraltar Mental Welfare Society highlighted their concern regarding the increase in referrals, but added there has been much more awareness on the importance of good mental health.
The society said that, in the past, children with problems were “often ignored” unless they were troublemakers, and in this case, they were “usually not dealt with appropriately either”.
They added that there is far less stigma attached to mental health issues so “therefore much more of a demand for the service, added to much better diagnoses than in the past”.
The society added that the figures could be that children with mental health issues are being recognised and dealt with, rather than an increase in the number of children with issues.
“The GMWS believes that in order to try to make inroads into tackling these problems effectively, there needs to be an in-depth analysis of the underlying factors causing these symptoms,” Conchita Triay from the society said.
“We need to find out what, if any, are the recurring issues having a negative impact on our young people.”
Contact Childline, between the hours of 5pm-9pm, 365 days a year: Phone: 8008, Live Chat: www.childline.gi, E-mail: [email protected], WhatsApp: 58008288