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Improving the Emotional Health and Wellbeing of Children and Young People

Improving the Emotional Health and Wellbeing of Children and Young People

Adolescence is a critical period for mental health and brain development. The Oxwell Study is an annual survey which asks school pupils how they experience school life and health-related issues. We hope to better understand what is happening to the mental health of young people, and to inform schools, the local council and their partners, how to provide pupils with the best support and guidance to keep them safe and happy.

Kings Fund Report suggests that in the aftermath of any disaster, 3-4% of people will experience severe mental health problems and a further 15-20% will experience moderate disorders. Most of the population, around 75%, will experience symptoms of poor mental health such as stress, worry, fatigue and depleted resilience – this is an ordinary response to an extraordinarily difficult situation, but these needs are extremely damaging when they are prolonged, as we have seen with the COVID-19 pandemic.

Many people will have the physical, emotional and social resources to recover without requiring additional support. However, families and individuals who are disadvantaged, unsupported or vulnerable are less likely to recover unaided, less likely to seek support and may find that their needs are below thresholds for existing specialist mental health support.  The most vulnerable are also most likely to feel the impact of ongoing pandemic related risks such as the end of the furlough scheme. 

Liverpool Public Health Team delivered evidence-based interventions across the life course, focusing on improving local mental wellbeing and tackling low level mental health needs, self-harm/suicide risks and building resilience in our community. 

  • Perinatal support – Enhancing existing therapeutic services, breastfeeding provision and support to all women, specifically targeting vulnerable groups, to manage increasing levels of poor mental wellbeing and health within the perinatal period 
  • Early years – Enhancing existing service capacity and further developing skills and expertise for wellbeing and resilience in early years settings, universal services and community settings 
  • Schools – Enhancing and quality assuring existing whole schools approaches, supporting prevention and early intervention, including bullying prevention
  • Community based model for prevention – Provided funding for community based services to deliver an all age and families appropriate mental wellbeing support, suitable for people without a mental health diagnosis 
  • Liverpool Community Voluntary Sector – a 3rd Sector Grants Programme to enhance the capacity within communities to address the significant rise in lower-level mental health problems 
  • Domestic abuse mental health support – Vulnerable families – targeted specialist support for families vulnerable to children becoming looked after

Key Findings: 

  • Almost 1/3 of pupils don’t feel they get enough help with emotional needs; 
  • Just over 1/4 of pupils worry about going to school
  • Most indicators of poor mental health (e.g. low wellbeing, loneliness, anxiety and depression) increased overall with age 
  • 6.7% of pupils admitted self-harming within the last month 
  • 51.6% of pupils know where to go for mental health support in school 
OxWell Student Survey logo
Happy primary pupil walking down corridor
Senior school boys interacting and happy outside school

School pupils with social, emotional and mental health needs

Graph showing school pupils with mental health needs in Liverpool compared to England

Summary: The graph shows the percentage of school pupils with social, emotional and mental health needs is 3% in Liverpool and the England average is 2%. Between 2015 and 2021 percentages for both Liverpool and England increase gradually to 4% for Liverpool and 3% for England

Transformation of 0-19 Public Health Services

Children and young people have not been immune to the wide-ranging effects of the COVID-19 pandemic, and whilst children were less likely than adults to have been hospitalised with the virus, their access to health care, education and social support has been badly disrupted and their mental health has been disproportionately affected. 

Often forgotten or overlooked during the COVID-19 response, we know that children and young people have been negatively impacted by the pandemic and the measures taken to control it with a potential for long-term consequences. As a result, we as a city are committed to a journey of improvement and transformation in the services that we provide and commission to ensure that every child can have the best possible start in life and grow into healthy and happy adults. 

The 0-19 Public Health Service in Liverpool, (comprising Health VisitorsFamily Nurse Partnership (FNP) and School Health) is provided by Mersey Care NHS Foundation Trust and aims to maximise the opportunities to improve the health, social, educational, and emotional outcomes for all babies, infants, children, young people, and their families. The service supports a strong partnership commitment to ensure that all children in Liverpool can have the best possible start in life and can develop into happy children who grow and learn to their full potential. 

Health Visitor with mother and smiling baby

The Health Visitor Service seeks to work with families and partner organisations to: 

  • support transition to parenthood and the early weeks    
  • support maternal and infant mental health ​
  • support breastfeeding (initiation and duration) and infant feeding 
  • support healthy weight and healthy nutrition ​      
  • improve health literacy, reducing accidents and minor illnesses  
  • support health, wellbeing and development and help children to be ready to learn    
School nurse weighing pupil

School-aged services build on early identification of children in need of support and  focus on key priority areas, including

  • supporting resilience and wellbeing
  • improving health behaviours and reducing risk taking 
  • supporting healthy lifestyles 
  • supporting vulnerable young people and improving health inequalities 
  • supporting complex and additional health and wellbeing needs 
  • supporting self-care and improving health literacy

Public Health and its partners have commenced a process of service transformation and improvement to learn from the lessons of COVID-19 and to develop a modern service that is resilient and focused on the needs of local families. We want to ensure that the modern service can work with families and other organisations to address known modifiable risk factors for ill health and to ensure parental mental health, infant mental health and parent infant attachment are prioritised.

We want to deliver a service that can support an improvement in children’s readiness to learn with a specific focus on communication, speech, and language skills from birth, and to increase early help and reduce the number of care entrants. We are committed to reducing childhood obesity and addressing the modifiable risk factors that can lead to child poverty. 

Only by working together can we develop a local system that promotes positive health, tackles inequalities, and provides opportunities for children, young people, and families to thrive and grow well and enjoy the best possible start in life.

Unicef Child Friendly Cities and Communities logo

Child Friendly Cities

The Child Friendly Cities Initiative (CFCI) is a UNICEF-led initiative that supports local Councils in realising the rights of children at a local level using the UN Convention on the Rights of the Child as its foundation. It is also a network that brings together government and other stakeholders such as the private sector, academia, media and, importantly, children themselves who wish to make their cities and communities more child-friendly.

Liverpool is committed to achieving ‘Child Friendly’ recognition and has developed a city plan to deliver and measure progress in six CFC priorities or ‘Badges’. Liverpool’s children and young people chose Healthy as one of those priorities. The public health team is supporting the Healthy plan, where key outcomes are:

  • Easier to access health and wellbeing services for CYP, with a focus on mental and emotional health and wellbeing 
  • A health workforce trained and using a child-rights based approach
  • Health and wellbeing services across the city working together
  • Better access to healthy food, with a focus on early years and the Healthy Start Scheme
  • Better access to healthy leisure activities, including being physically active.

Children and Young People Profile

Children and Young People Profile: Liverpool 2022

A comparison between Liverpool and England.

Liverpool facts

There are 161,600 children and young people in Liverpool representing 32% of the total population aged 0-24 years.

This is above England’s average of 29.2%

Children and young people in Liverpool face a difficult start in life, with significantly higher levels of deprivation, child poverty and lone parent families compared to the national average.


Liverpool’s statistical significance compared to England:

  • Better
  • Similar
  • Worse

Significant trend:

  • Improving
  • No change
  • Getting worse

Pre-birth and early years

Cigarette icon

Smoking at time of delivery



Pregnant woman icon

Under 18 conceptions



Icon of baby

Infant mortality


Icon less than 37 weeks

Premature births


Icon weight scales

Low birth weight (term babies)



icon baby bottle

Babies first feed breast milk


Needle icon

6-in-1 vaccine (age 1)


Getting Worse

Needle icon

MMR one dose (age 2)


Getting Worse

School age children

Person with arm in sling

Admissions for injuries (age 5 and under)



School teacher pointing at board and row of pupils

School readiness



Tooth icon

Tooth decay (age 5)


Foot prints on weighing scales icon

Obese children (age 4-5)


No Change

Mother and infant icon

Children in care


Getting Worse

Brain inside head icon

Pupils with SEN



Clip board icon

Persistent absentees


Wine glass icon

Alcohol admissions (age 18 and under)


Office block with employers outside

Not in education, training or employment (16-18)



Scroll and seal icon

Attainment 8 score


Scales representing Justice icon

First time entrants into Youth Justice system



Young people

Heart beat icon

Self-harm admissions (15-24)


No change

Pill bottle and pill icon

Substance misuse admissions (15-24)


Car skidding warning triangle icon

KSI road traffic accidents (age 25 and under)


Person with arm in sling icon

Admissions for injuries (15-24)


No change

Icon of magnify glass

Chlamydia detection (15-24)


No change

Wider determinants

Pound sign icon

Average income

Getting worse

Stack of coins icon

Child poverty

Getting worse

No change

Dinner plate, knife, fork and spoon icon

Free school meals

Getting worse


Building and people icon


Getting worse

Broken heart in speech bubble icon

Domestic abuse

House icon

Rented accommodation

Getting worse


Updated: January 2023

Sources: Average (Median) Income is extracted from CACI England average = £33,820 Liverpool average = £23,476. All other data from Office for Health Improvement and Disparities. Public Health Profiles. https://fingertips.phe.org.uk © Crown copyright 2023

Contact: Sophie.Kelly@liverpool.gov.uk