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Emotional and mental health

Mental health is an individual’s cognitive, behavioural and emotional wellbeing (Mind, 2020). It’s something we all have – including every child and young person. We use the term “mental health issues” to refer to mental health problems, conditions and mental illnesses. These issues may or may not be medically diagnosed and may or may not require specialist treatment.

If you work with children and young people, you’ll know that they experience a wide range of feelings, emotions and challenges. Mental health needs can include low mood, anxiety and self-harm and are often a direct response to what is happening in a child or young person’s life.

The emotional wellbeing of children and young people is just as important as their physical health as it enables them to develop into healthy adults who are able to deal with all of life’s challenges.

Negative experiences such as abuse and neglect can adversely impact a child’s mental health and how they perceive the world. This can also sometimes lead to safeguarding and child protection issues, for example if a child’s mental health begins to put them or other people at risk of harm.

Self-Harm describes a wide range of things that people do to themselves in a deliberate and usually hidden way. It can often be used as a way of coping with difficult and distressing feelings. In the vast majority of cases self-harm remains a secretive behaviour that can go on for a long time without being discovered. Self-harm can involve:

  • Attempted hanging;
  • Overdosing of tablets or medicines;
  • Cutting, often to the arms using razor blades, broken glass or knives;
  • Burning using cigarettes or caustic agents;
  • Punching and bruising;
  • Inserting or swallowing objects;
  • Head banging;
  • Pulling out hair or eyelashes.

Self-harm can sometimes be a coping mechanism with the aim of relieving emotional distress. Sometimes this emotional distress that leads to self-harm can also lead to suicidal thoughts and actions but it is important to note that this is not all the time.

Professionals need to be able to recognise the signs that a child may be struggling. However, it’s important to remember that some mental health issues may not have visible signs. There are also factors that might make it more difficult for a child or young person to ask for help.

Some children and young people may try to hide how they are feeling or what they are doing.

As with all situations there are certain factors that may increase risks of poor mental health:

  • Parental issues (e.g. substance or alcohol misuse, mental health issues, parents in prison);
  • Loss within the family (e.g. parents who separate or divorce, bereavement);
  • Experience of abuse (physical, sexual or emotional) or neglect;
  • Experience of being severely bullied;
  • Living in poverty or experiencing homelessness;
  • Being a young carer;
  • Experiencing significant issues at school.

Common warning signs of mental health issues include:

  • sudden mood and behaviour changes
  • self-harming
  • unexplained physical changes, such as weight loss or gain
  • sudden poor academic behaviour or performance
  • sleeping problems
  • changes in social habits, such as withdrawal or avoidance of friends and family.

These signs suggest that a child may be struggling, but there could be a number of different explanations for them.

Don’t attempt to diagnose mental health issues yourself or make assumptions about what’s happening in a child’s life.

Self-Harm – the following factors should be used when considering whether a child is in need of urgent medical treatment and should be taken to a Hospital Emergency Department.

  • Has declared or is suspected to have overdosed on illegal or prescription drugs
  • Has consumed large volumes of alcohol
  • Has injuries i.e. cuts, broken bones that require specialist medical attention
  • Has declared or is suspected of attempted asphyxiation / hanging

What helps good mental health? For children to remain mentally well they need:

  • good physical health (including good diet and regular exercise).
  • to be able to explore and develop interests (through their environment, play and interaction with others).
  • to feel part of a family (feeling as though they belong, get along with others, are loved, valued and safe).
  • to be supported to learn, be optimistic and feel that they have a say.
  • to feel part of a community (e.g. school / nursery / etc.).
  • to be supported to cope when things do not go well.
  • to be supported to learn how to problem solve. If you are concerned that a child may be struggling, it’s important not to wait for them to talk to you before trying to start a conversation. Encourage them to talk with you or with other trusted adults.

There are a number of self-help resources and services available in Portsmouth to support children and young people with varying levels and complexities of need.  Professionals in Portsmouth City are encouraged to use the 5Ps formulation to help them further understand a child’s emotional and mental health needs. This can then inform any consultation and decision making.

If you are concerned that a child may be struggling, it’s important not to wait for them to talk to you before trying to start a conversation. Encourage them to talk with you or with other trusted adults.

If a child is self-harming, professionals should make a brief assessment and follow the pathway. Consider also completing a Safeguarding referral alongside calling other agencies, if:

  • Noteworthy safeguarding concerns exist
  • There are less specific, but active concerns about safeguarding, in particular relating to Child Sexual, or Criminal Exploitation

Guidance has been produced for a range of areas of concern and is tailored for children aged 5-11 and young people aged 11-16. It describes the different criteria for SEMH support services and the self-help resources available both locally and nationally. The full comprehensive guidance is available online at the following link:

111 should be contacted in the first instance if the child does not require immediate medical attention. If a child is expressing suicidal thoughts or plans, ensure their safety as much as possible and contact their GP or 111.

Worried about a child – If you are concerned that a child or young person has suffered harm, neglect or abuse, please contact

Portsmouth Multi Agency Safeguarding Hub (MASH)

If a child is at immediate risk of harm, call the Police on 999

Click on the link to view the services available within Portsmouth to support children’s mental health.

The following PDF quick reference guides have also been produced for professionals, parents and carers:

Kooth is a transformational digital mental health platform that launched in 2004, since January 2021 it has been available to children and young people aged 11-25 in Portsmouth City. It gives children and young people (CYPs) immediate access to an online community of peers and a team of experienced, accredited counsellors. Access is free of the typical barriers to support – no waiting times, no referrals, no thresholds to meet and complete anonymity. The service is open for support 365 days per year, between 12pm-10pm on weekdays, and 6pm-10pm on weekends and holidays.

HIPS Self-Harm & Suicidal Behaviour Protocol is available on the HIPS Safeguarding Children Procedures website

The NHS website offers helpful guidance on how to start a conversation with a child or young person about their feelings.

Young Minds provides resources and information on everything to do with young people’s mental health.

NSPCC has a learning resource on recognising and responding to child mental health

Wessex’s Healthier Together advice on children’s mental health

Royal Navy and Royal Marines information in helping children deal with periods of separation which can lead to increased levels of stress and anxiety

For local targeted and specialist consultation and referrals please contact –

Mental Health Support Teams (MHST) for school professionals only.

Mental Health Triage Team via 111 – 24/ 7.

CAMHS Single Point of Access (All professionals, YP and families):

  • 0300 123 6632 – office hours
  • 0300 123 6610 – urgent out of hours on call psychiatry.

CAMHS Children’s Services professional line:

  • 023 9268 8793 – office hours
  • 0300 555 1373 – out of hours (for safeguarding concerns)