Future in Mind Leeds: Health Needs Assessment November 2016 Report v1.0 Prepared by: Associate Development Solutions Ltd Steve Cudmore, Head of Service Development Dr Dina Gojkovic Grimshaw, Research and Evaluation Lead Dr Fiona Warner-Gale and Jane Sedgewick, Directors Table of Contents 1 Executive Summary .............................................................................................................................. 6 1.1 Introduction .................................................................................................................................. 6 1.2 Population ..................................................................................................................................... 7 1.3 Deprivation ................................................................................................................................... 7 1.4 Protective Factors ......................................................................................................................... 7 1.5 Risk Factors ................................................................................................................................... 9 1.6 High Risk Groups ......................................................................................................................... 10 1.7 Prevalence of MH Disorders and Illnesses .................................................................................. 12 1.8 Forecast Prevalence .................................................................................................................... 12 1.9 Service Provision ......................................................................................................................... 13 2 Introduction ....................................................................................................................................... 14 2.1 Context ........................................................................................................................................ 15 2.1.1 Local policy context .............................................................................................................. 15 2.1.2 Scope of the Health Needs Assessment............................................................................... 17 2.1.3 Leeds .................................................................................................................................... 17 2.1.4 Population ............................................................................................................................ 19 2.1.5 Early Years ............................................................................................................................ 25 2.1.6 Adolescence ......................................................................................................................... 26 2.2 Definitions of emotional wellbeing and mental health .............................................................. 27 2.3 International Comparison ........................................................................................................... 28 2.4 Statistical Neighbours ................................................................................................................. 31 3. Protective Factors ............................................................................................................................. 31 3.1 Overview ..................................................................................................................................... 31 3.2 Family Protective Factors ............................................................................................................ 34 3.2.1 Attachment & Parenting ...................................................................................................... 34 3.2.2 Breastfeeding ....................................................................................................................... 36 3.3 School and Community Protective Factors ................................................................................. 38 3.3.1 Early Year Education ............................................................................................................ 38 3.3.2 Early Years Foundation Stage Child Development ............................................................... 40 3.3.3 Academic Achievement at the end of Key Stage 4 .............................................................. 42 3.3.4 Education, Training and Employment .................................................................................. 43 3.4 Individual Protective Factors ...................................................................................................... 44 3.4.1 Participation in at least 3 hours of sport or PE at school ..................................................... 44 4 Risk Factors ........................................................................................................................................ 45 Leeds CYP FiM HNA Final Page 2 of 138 v1.0 4.1 Overview ..................................................................................................................................... 45 4.2 Family Risk Factors ...................................................................................................................... 47 4.2.1 Maternal smoking and low birth weight .............................................................................. 47 4.2.2 Abuse and Neglect (Brain Development) ............................................................................. 48 4.2.3 Family breakdown or loss of a parent .................................................................................. 49 4.2.4 Bereavement ........................................................................................................................ 50 4.2.6 Children in out of work families ........................................................................................... 51 4.3.7 Dependent Children of parents with no educational qualifications .................................... 52 4.2.8 Children of parents with mental disorder ............................................................................ 52 4.2.9 Domestic Violence ............................................................................................................... 53 4.2.10 Young Carers ...................................................................................................................... 54 4.2.11 Children with parents in prison .......................................................................................... 55 4.3 School and Community Risk Factors ........................................................................................... 56 4.3.1 Inequalities and deprivation ................................................................................................ 56 4.3.2 Free School meals ................................................................................................................ 59 4.3.3 Persistent absence ............................................................................................................... 60 4.3.4 Exclusions ............................................................................................................................. 61 4.3.5 Behaviour in schools – bullying ............................................................................................ 62 4.3.6 Young People who are NEET and at risk of NEET ................................................................. 63 4.4 Individual Risk Factors ................................................................................................................. 64 4.4.1 Young Offenders .................................................................................................................. 64 4.4.2 Substance misuse ................................................................................................................. 66 5. High Risk Groups ............................................................................................................................... 69 5.1 Overview ..................................................................................................................................... 69 5.2 Children Looked After ................................................................................................................. 69 5.2.1 CLA and prevalence of mental disorders ............................................................................. 69 5.2.2 Strengths and Difficulties Questionnaire (SDQ) ................................................................... 70 5.2.3 CLA and Population risk factors ........................................................................................... 71 5.3 Children in Need ......................................................................................................................... 74 5.4 Children with a Disability ............................................................................................................ 76 5.5 Children with Learning Disabilities .............................................................................................. 77 5.6 Children with Special Educational Needs (SEN) .......................................................................... 79 5.12 Black and Minority Ethnic groups ............................................................................................