Population-based observational study of mental health service use among children and young people using English National Health Service dataset

Abstract

To assess the methodological robustness and research utility of the Mental Health Services Data Set (MHSDS) for investigating patterns and determinants of mental health service use among children and young people (CYP) in England between 2016 and 2023. Population-level observational study evaluating data completeness, consistency and the impact of missing data on analytical validity. Mental health and emotional well-being services across England. All CYP (≤25 years) with records in the MHSDS between 2016 and 2023 (n>4.7 million). Completeness and consistency of key sociodemographic variables (gender, ethnicity, location and socioeconomic status); patterns of referral to services and attended contacts and the influence of missing or conflicting data on models of attendance likelihood. From 2016 to 2023, over 4.7 million CYP were in contact with mental health services, of whom 62.4% had at least one attended contact. Missing data were substantial, persistent and often co-occurred in subpopulations with distinct attendance patterns. Analytical estimates varied depending on how missing or conflicting data were handled. The proportion of CYP referred to services increased from 1.9% (n=371 655) in 2016 to 9.7% (n=1 699 899) in 2023, while attendance rates remained broadly stable around 60%. Spatial analyses highlighted regional variations, with higher attendance rates in Northern England. Data completeness influences the validity of research using the MHSDS. Addressing this issue may support more reliable and reproducible evidence in CYP mental health research.