Across the UK, schools and community organisations are running more mental‑health and wellbeing programmes than ever before. From pastoral care and anti‑bullying workshops to art, sports, dance, mindfulness, and school‑based counselling, there’s no shortage of activity. Often activity involves short term government and grant funding. Project staff may be lacking experience in evaluation and clinical support.
Yet fundamental questions are rarely asked:
Do these interventions actually help?
How many children get better?
How many don’t?
Which children benefit and who do not?
How many sessions are required to create sustained change?
What are the conditions for success?
How does the intervention compare to others and what are the cost-benefit comparisons?
How trained do providers of the intervention need to be to optimise benefits?
How individualised are interventions to meet the specific goals and needs of participants?
The Focus on Volume Over Outcomes
Much of the reporting around children’s mental health services emphasises what was delivered, not what was achieved. Typical metrics include:
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Number of sessions run
- Cost per session
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Number of children attending
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Hours of staff time spent
- Feedback, usually on enjoyment of sessions by the participants
But these are outputs, not outcomes. They tell us how busy a programme is, not whether it works or who it works for and for whom it does not work. Even more clinical services, such as school‑based counselling or mental‑health support teams, often lack robust outcome data available publicly.
Example 1: The School‑Based Provision Study
A UK study of secondary schools across two large regions found that while schools reported a wide range of mental health support services, there was no significant correlation between the level of provision and pupil mental health scores. PMC
In other words: schools doing more did not automatically have pupils with measurably better mental health. This suggests that more provision does not guarantee more benefit.
Example 2: The „Trailblazer” Mental Health Support Teams (MHSTs)
Under the national programme Children and Young People’s Mental Health Trailblazer programme (now expanding as MHSTs), over 600 support teams are in place in England, covering over 50% of the pupil population. Centre for Economic Performance+3NHS England+3GOV.UK+3
But an early evaluation of the first wave (25 sites) found that while setup and implementation progress was good, there is still limited evidence about long‑term outcomes, how many children improved, and which children benefited most. NCBI+1
This illustrates the challenge: large scale programmes, significant investment, high visibility—but evaluation lags behind the investment.
Why Evidence Matters — Especially when Costs Are High
When we invest in mental health support for children, we cannot assume that more programmes equals better outcomes. The cost of large‑scale provision is substantial. Consider: what if £1 million is spent on “wellbeing sessions” in schools without measured outcomes, while the same amount could support a small counselling service with rigorous evidence of symptom reduction and long‑term improvement?
Without evaluation, we cannot know:
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Which children actually improved
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Which programmes had no effect (or even adverse effects)
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Whether money is being diverted away from more effective interventions
These are not abstract risks—they are very real. As expansion accelerates, the risk of resource mis‑allocation grows.
Another risk of this approach is that we get everyone talking about mental health, increasing the problematisation of frequently occurring emotional issues with less recourse and access to robust solutions. The young people in schools become the next generation of students, workers preoccupied by mental health thoughts but not as well versed in the best ways to support themselves.
Conclusion
Expanding mental health services for children and young people is both urgent and necessary. But expansion without evaluation risks building a system that is costly, and ineffective and short term funding and less clinically supported projects may be part of the problem.
Until we consistently ask:
“Do children get better? How many?”
…we cannot know whether our investment truly improves lives.
Good intentions are not evidence. And good children’s mental health is the future for us all.
