Mary Hartshorne I CAN Head Of Evidence

Joining up the Dots between Mental Health and SLCN

On World Mental Health Day 2018, making sure people understand the link between poor communication and mental health is more important than ever before. Our Head of Evidence Mary Hartshorne explores the issue.


Last year, as the government’s plans to transform mental health support for young people were announced, we wrote about the link between mental health difficulties and speech, language and communication needs (SLCN).

At the time, we emphasised the well-evidenced link between children’s SLCN and mental health difficulties. Many children and young people identified with mental health needs also have speech, language and communication needs (SLCN).

Studies tell us that as many as 45% of young people referred to mental health services have underlying communication difficulties, often unidentified. As well as this, we know through longitudinal studies that children with SLCN are at greater risk of developing mental health difficulties. A recent study looking at language skills and associated factors examined a group of children aged 8-10 months, following them up at age 7. Children with low language were 2 to 3 times more likely than their peers to have social and emotional difficulties.

The relationship starts early. If these language needs aren’t identified, children won’t get the support they need. It’s also harder for them to access the talk-based support that is offered to them. Many interventions, support or recommended therapeutic techniques such as cognitive behaviour therapy rely on good ‘higher order language’ skills – the ability to discuss opinions flexibly, use language to reason and to interpret abstract concepts such as feelings. Consequently, not identifying a difficulty with language means that young people will be unable to benefit from the limited support which is available.

So, it’s a complex relationship, with more known about it every year; one study found increased risk of mental health difficulties in young adults whose vocabulary skills deteriorated after age 5. It suggested a possible reason – that mental health difficulties could constrain communication through disengagement with peers. Too little is known about causality but nevertheless, the relationship is there.

Now, a year on, young people’s mental health is no lower on the agenda. A report by the Education Policy Institute found that the number of referrals to specialist children’s mental health services has risen by 26 per cent over the last five years. The report, based on a freedom of information request, also states children’s mental health services are struggling to cope with a rise in demand and are turning away as many as one in four young people referred for support.

The question is, has the government’s response to their Green Paper, published in July this year taken on board these evidenced links?

These links were made clearly in evidence to Bercow: Ten Years On inquiry. Led by I CAN and the Royal College of Speech and Language Therapists, we recommended that training for the planned Mental Health Support Teams and Senior Leads for mental health in schools and colleges includes information about incidence of SLCN. We also made recommendations about how to identify and support difficulties with language and communication.

So far, we know about seven universities starting new courses in January 2019 to train this new mental health workforce. We know that the multidisciplinary teams working with children’s mental health will consist of a range of practitioners but it would be great to be confident that this includes speech and language therapists.

If you are in a trailblazer area, testing out the proposals, use the tailored briefing for people working in mental health services to make sure more is known about the link. Use our resources to make a strong business case for SLCN support.

If you are one of the proposed training providers or know who they are, think about using some of the existing material, resources and training available – get in touch for more information.

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