After qualifying as a clinical psychologist in the early 2000s, I spent much of my early career working with children and young people in NHS Child and Adolescent Mental Health Services (CAMHS).
It was a pivotal time. Sure Start rolled out across the country. The Time to Change campaign launched, aiming to eliminate mental health stigma. Increased investment in CAMHS sought to address postcode lotteries by standardising support into tiers – from universal prevention through to specialist care.
I quickly understood just how messy mental health really is. There was rarely one neat presenting issue, and symptoms were shaped and understood by wider conditions: family dynamics, school, friendships, poverty, sexual identity, culture and physical health.
It’s tempting to feel nostalgic about the Noughties. More services, more funding, more awareness. Things can only get better?
Sadly, there have always been flaws in the youth mental health system. Many of the gaps we could see in the 2000s have persisted and widened, particularly among groups often labelled “hard-to-reach”.
We knew even back then that many children were falling through the cracks. Effects increasingly showed up in schools, workplaces, prisons and labour market statistics. The young people that reached us were only ever a fraction of those needing support, but they had navigated the gateways: their distress was noted, a referral made, eligibility criteria met and attendance facilitated – there was a bus route, a parent to drop them off, a clinic within walking distance. We could keep them safe and help them feel better. But there were plenty of other young people that never made it anywhere near CAMHS.
By the start of the 2010s, everything was different. The internet and smartphones were now ubiquitous, and social networking mutated into a tech platform rather than a fundamentally human activity.
Young people now routinely arrive in CAMHS having researched their experiences online. Digital services like Kooth (where I have led clinical services since 2018), leaned into the opportunity to attain those we’d previously categorised as hard-to-reach.
And now, thankfully, improving the lives of young people is firmly back on the government’s agenda. The Prime Minister has promised more mental health support to young people, in part to improve their job prospects, and a raft of government reviews on youth participation, mental health and neurodiversity are informing a new cross-government mental health strategy.
These reviews recognise that young people (and the not-so-young, me included) no longer distinguish between lives led online and offline. But for all this recognition, the “great rewiring of the state” has yet to reshape our approach to supporting today’s young people to thrive.
A raft of well-intentioned policies apply the logic and rose-tinted glasses of the early Noughties to the young people of 2026, focusing on delivering more mental health support in neighbourhood or community settings.
These are sensible, well-intentioned ideas, and will no doubt benefit communities; rebuilding spaces of belonging and connection has intrinsic value beyond extending access to mental-health services.
But we must not simply relocate the limitations of the existing system into new buildings. Like CAMHS, hubs and school-based mental health support teams are already struggling to meet demand. Waiting lists are now commonplace, with care prioritised for those with more severe needs.
Not everyone who needs support will engage with these services. But they are not hard to reach – they are just not reaching for the services we would like them to.
These days, before talking to a parent, friend, teacher or GP, young people will search Google, scroll TikTok, ask an AI chatbot or end up in an algorithmic rabbit hole. It’s often the most vulnerable young people that rely most on online sources of support while remaining under-represented in traditional services.
Much of the advice available online is at best questionable and at worst actively harmful – whether it’s a TikTok diagnosing ADHD or content that can push a struggling teenager further into distress at 2am. We should be ambitious about making the online world safer for young people, and it’s right that policymakers are now taking this seriously.
But again, we should be wary of nostalgia-based policy. A desire to recover what was better about childhood before the smartphone risks discarding the crucial role that new technologies can play in reshaping routes to connection and support for young people in 2026.
Shout, which provides crisis support via text message, has seen an influx of texters signposted from Gemini, Claude and ChatGPT. These texters are twice as likely to be male, Black, or Asian – exactly the communities that have historically been underrepresented in traditional services.
We are seeing similar patterns emerge at Kooth, reinforcing 20 years of evidence that open-access support online can reach those underserved elsewhere.
When Cory sought out support from Kooth after being bullied, we didn’t need to “discharge” him when he missed a number of sessions with his mental health practitioner. Instead, we could support him to recognise his strengths and address sleep issues at his own pace. Cory’s confidence grew, and so did his participation in school and social activities.
Like Cory, many of the young people that use Kooth have goals and support needs that don’t neatly fit into traditional care pathways – they fall between the cracks. Their needs reflect their circumstances and change over time.
Take Meera, whose stammer means she values messaging a Kooth counsellor via text, and who now has the confidence to attend group speech therapy. Or Sophie, who now feels able to speak to her parents about her feelings, and is accessing additional support from her GP and school. For these young people, accessing support online connected rather than displaced other parts of their life, acting as a stepping-stone to “real-world” participation.
None of this means lowering the bar for safety, evidence or clinical governance. Quite the opposite. From the smartphone to AI, as new technologies dismantle traditional gateways to information and support, our job is to build better guardrails – including clear routes back into local communities.
The Noughties taught us that the government can change the fortunes of a generation when it chooses to invest in them. But today’s young people don’t live in the Noughties.
We have the opportunity to expand our vision for young people, not simply recreate it. That means preserving what works, learning from what doesn’t and designing for the world they actually inhabit. They deserve more than nostalgia.
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