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    Home » Urgent call to fix ‘missing middle’ in youth mental health care
    Health

    Urgent call to fix ‘missing middle’ in youth mental health care

    Rhys GregoryBy Rhys GregorySeptember 11, 2025No Comments
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    Credit: Mind Cymru
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    Children and young people in Wales are not able to access mental health support when they need it, leaving them feeling ‘isolated and hopeless’, Mind Cymru has found.

    In 2018, the Welsh Government’s Children, Young People and Education Committee identified a critical gap in mental health support for young people, described as the ‘missing middle’.

    New research from Mind Cymru suggests that this issue persists, with many still falling into a space where their needs are too complex for universal services but don’t meet the threshold for specialist support.

    Young people* have told Mind Cymru that limitations of school-based counselling and other available services have also left them feeling stigmatised and reluctant to ask for help.

    One young person said: “I felt like I wasn’t unwell enough to receive the support I needed but was too bad to receive the baseline support that was being offered. It made me feel alone and like a burden.”

    Another said: “I don’t know if accessing specialist support will show up on my GP record and that could affect future job and education applications. I don’t want using such services to reflect negatively on me.”

    Mind Cymru is calling on the Welsh Government to allow young people to shape future mental health services delivered under its new strategy for mental health and wellbeing, published in April this year.

    And, having piloted its own guided self-help programme for 11–18-year-olds to help support the ‘missing middle’, the charity is also calling for enhanced services and a targeted mental health stigma programme in schools.

    Almost 700 young people in Wales accessed Mind’s Missing Middle service, a free, six-week, guided self-help model adapted specifically for their needs.

    An evaluation of the programme found 71% of those who took part experienced improvements to their wellbeing – and every person said they would recommend the service to others.

    The programme was delivered by Cwm Taf Morganwg Mind, Swansea Mind and Neath Port Talbot Mind in partnership with Specialist Child and Adolescent Mental Health Services (SCAMHS), community youth services, GPs and schools**.

    Lisa Thomas is Deputy Head at Dwr Y Felin Comprehensive School in Neath, where more than 100 students completed Mind’s Missing Middle programme through Neath Port Talbot Mind.

    Lisa said: “We strive for equity for all and to do this we will build an army of support services who work with us at school to fulfil our goals. Mind has been integral and have got to know our children so that the support offered is bespoke. They have advised pupils on the best way to support their friends, and they have spent time with parents offering guidance on how they can best support their own children.” 

    “Mental health is a vital area that needs support in school so children are able to learn, establish meaningful relationships and be happy and healthy so that their childhoods and adolescent years become the foundations on which they can build the rest of their lives,” Lisa added.

    “Mind does this in our school community. They are from the community, supporting the community and we are so very grateful for all they do.

    Mind Cymru has also previously expressed concern at the ‘all age approach’ of the new mental health strategy and is reiterating its call for the needs of children and young people to be heard.

    The charity also recommends more general advice, information and a safe space to explore mental health issues within the educational setting.

    Sue O’Leary, Director of Mind Cymru said: “Wales has made significant developments in tackling the issue of the ‘missing middle’, including through school based counselling and a whole school approach to mental health. And yet young people still tell us that they aren’t getting the right level of support at the right time.

    “Whilst the reasons for this are complex, we do know that by offering a better range of support, tailored to young people’s needs, can work. And, it can make a huge difference to their mental health at a crucial time in their lives.”

    “The Welsh Government’s commitment to open access mental health support will enable much more personalised help – but only if the development is guided by the voices of young people as well as adults, and their concerns around stigma are tackled at the same time.”

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    Rhys Gregory
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