Position paper: Mental health and speech and language challenges in children and young people in the UK

Introduction 

In the UK, the intersection between mental health and speech and language challenges in children and young people has widespread implications for education, social development, health, and long-term wellbeing. Approximately 2 million children in the UK (1 in 5) experience some form of speech and language challenge. This is a difficulty in producing or understanding spoken language, impacting their ability to communicate effectively. Many of these children and young people are at greater risk of developing mental health difficulties. Addressing these challenges is essential to ensure fair access to services, academic success, and healthy social development. 

The link between mental health and speech and language challenges  

Children who struggle with talking and understanding words are likely to experience frustration, social isolation, and academic challenges, which contribute to emotional distress. This can manifest in anxiety, depression, and behavioural problems. Research has shown that 81% of children with emotional and behavioural difficulties also have significant language difficulties, often unidentified. In addition, between 45% and 64% of young people referred to mental health services have a language disorder.   

In both mental health and speech and language challenges, some children are disproportionately affected, such as children from some racialised communities. At the intersection of mental health and speech and language challenges, they may therefore be more likely to fall through the gaps for support. 

The ability to recognise and manage emotions is an integral part of good mental health. Children with speech and language challenges struggle particularly with language for emotions, and this in turn impacts on their ability to process and manage their thoughts and feelings.    

Barriers to effective support 

Despite the clear connection between speech and language challenges and mental health, the UK faces significant gaps in service provision. Waiting times for speech and language therapy (SLT) are often long, and mental health services, such as NHS Children and Young People’s Mental Health Services (NHS CYPMHS), are stretched. Most mental health assessments and interventions are delivered through talk, making access difficult for children with speech and language challenges. The lack of integration between speech and language therapy and mental health services contributes to fragmented care, delaying early intervention, which is crucial for preventing the escalation of difficulties. Additionally, many professionals working in schools and nurseries, such as teachers and teaching assistants, lack sufficient training in identifying and supporting children with both needs.   

Policy and practice recommendations 

  1. Early identification and intervention: Investment in early identification, such as tracking tools in nurseries and schools, can help mitigate the long-term effects of speech and language challenges and associated mental health difficulties. Early interventions which focus on language for emotional regulation would help prevent later problems and support identification of children likely to be at risk in the longer term.    
  2. Access, adjustments and adaptations: Mental health services for children and young people should assess how accessible they are for those with a range of speech and language challenges. This may include exploring ways to adapt existing service offers to ensure equitable access to effective support. 
  3. Workforce training: Mental health practitioners should receive training in recognising and supporting children with speech and language challenges and mental health needs. Mental health support teams in schools should also receive training to enable them to adapt their practice to support children with speech and language challenges.  
  4. Young people’s involvement: Young people with mental health problems and speech and language challenges and their families should be involved in the development and evaluation of interventions that work for them. This must include young people from marginalised and minoritised groups and communities, whose experiences of mental health support are often poorer. 
  5. Research: Funding should be made available to support the development measures of mental health for children with speech and language challenges; to fund research into the effectiveness and adaptability of mental health interventions; and to explore how they can be delivered in real world settings such as schools, NHS CYPMHS and early support hubs.  

Conclusion 

Mental health and speech and language challenges in children and young people are little understood, creating a cycle of disadvantage. Children with speech and language challenges are more likely to have poor mental health but less likely to be able to access support than their peers. By working together, Centre for Mental Health, Speech and Language UK and the Speech, Language and Communication Alliance are determined to tackle this inequity. We are committed to improving and equalising this diverse group of children’s wellbeing and life chances.    

Further reading