Wave 2 Initial Findings  |  Comment

Inequalities in mental health and access to support services

By Erica Holt-White on November 9th, 2023.

Erica Holt-White, author of our briefing looking at mental and physical health patterns, breaks down what we found.

It certainly feels like, as a country, we have come a fair way in terms of mental health awareness since I was a teenager. For example, last month the theme of World Mental Health day was ‘mental health as a universal human right’, and it was great to see so many people engaging with the day on social media and in the workplace.

However, data on mental wellbeing from the COVID Social Mobility and Opportunities (COSMO) study’s first wave (the first time data was collected on this for the study), in which 44% of 16/17-year-olds were classified as experiencing high psychological distress, and findings published today from wave 2 (where COSMO participants were surveyed for the second time), make sobering reading. It is clear there is still a long way to go to achieving universality in good wellbeing and access to mental health services for young people.  

Our new findings could not be more timely.

A continued concerning picture

This week sees the launch of wave 2 data from the COSMO study,, covering a cohort of over 11,000 17-18-year-olds. The new data is now accessible for all researchers to use though the UK Data Service with our initial findings on mental and physical health in today’s report.

Concerningly, the proportion of students classified as experiencing high psychological distress, using the General Health Questionnaire as an indicator, remains the same as it was in wave 1, at 44%. This underscores an alarming trend of worsening mental health compared to previous generations, potentially indicating a long-running impact of the pandemic: COSMO’s 44% figure is considerably higher than the 35% with high psychological distress at age 17-18 in the Our Future cohort study from 2017 and the 23% at age 16-17 found in the Next Steps cohort study in 2007.  

We have also once again seen that non-binary+ (74%) and female students (56%) are more likely to meet this threshold compared to male students (32%), and they are also more likely to report bullying, harassment, and self-harm.

Using sexual orientation data newly available in wave 2, we found LGBQ+ young people were more likely to indicate signs of poor mental health. For instance, looking at incidence of self-harm, 47% of bisexual young people, 37% of gay/lesbian young people, and 44% of those with other sexualities reported having self-harmed, compared to 9% of heterosexual young people.

Inequalities in support

Thousands of young people have reported mental wellbeing issues in COSMO – but are they getting the help they need?

A quarter of young people had sought some form of mental health support over the previous 12 months. Of those, 35% said they are either on a waiting list or have not received some of the support they have sought.

Concerningly, those in the most deprived parts of the country were 11 percentage points more likely to say they are still waiting or have not received the support they applied for, at 39%, compared to 28% of those in the most affluent areas.  

Looking at specialist services like Child and Adolescent Mental Health Services (CAMHS) specifically, those in the most deprived areas were more than twice as likely to have not received support as those in the most affluent areas.

Moreover, as shown on Figure 1, 28% of respondents at school or college said the mental health support offered by their school/college wasn’t good enough, with those at state schools twice as likely as private school students to say so (32% vs 16% respectively).

Figure 1: Students’ rating of school/college mental health support by school/college type

Notes: N=8,079. Bar for those in special schools has not been shown due to small sample size. Labels may not add to 100% due to rounding. Analysis is weighted for survey design and young person non-response.

The pandemic’s prolonged impact

To understand more about respondents’ wellbeing, the cohort were asked whether the COVID-19 pandemic is still having an effect on any areas of their life.

31% reported that the COVID-19 pandemic was still having a negative impact on their mental wellbeing. As shown in Figure 2, gender differences were also present here. Looking at differences by sexuality, 52% of bisexual young people, 49% of gay/lesbian and 53% of those with other sexualities also reported this, compared to 27% of young people who are heterosexual.

Figure 2: Percentage reporting COVID-19 pandemic still impacts mental wellbeing by gender

Notes: N=11,089. Analysis is weighted for survey design and young person non-response.

Aside from the wider societal impacts of the pandemic, responses revealed the COVID-19 virus itself is still impacting the daily lives of young people. Today’s briefing also looks at self-reported health, long-term illness, and  long COVID (a condition where sufferers experience prolonged COVID-19 symptoms for more than 4 weeks post initial infection)– finding that 13% of young people said they had or have now recovered from long COVID, with 3% saying they had long COVID that severely limited daily life.

Those who report currently having or having had the condition are also more likely to be classified as experiencing high psychological distress (58%) compared to those who have never had long COVID (43%) or COVID at all (37%).

These findings as well as the general high incidence of poor mental health seen in COSMO show that COVID-19 and the pandemic’s impact is far from over.

What next?

There is no indication that there has been an improvement in young people’s wellbeing since wave 1 of the COSMO study, suggesting this is a significant ongoing problem for this generation. Similarly, a recent Department for Education survey found 25% of school absences in June 2023 were due to anxiety/mental health problems, 9 percentage points higher than the 16% reported in March 2022.

Mental health problems can impact on every part of a young person's life, including their ability to engage fully with their education. The COSMO cohort, many of whom are now heading to university or employment, and other generations after it, should be able to easily access high-quality support to ensure these problems do not impact their future life chances.

There is a clear need for sustainable and well-funded mental health services, including preventative and early intervention services, which recognise and deal with the continuing impact of the COVID-19 pandemic identified in this study. Such services should offer tailored support for non-binary+ and LGBTQ+ young people, delivered by professionals who have been trained to understand the needs of these individuals.  

If good mental health is to become a universal human right, change is not only needed to support the COVID generation of young people but also to support generations to come.