Mental health and safeguarding are deeply interconnected. Poor mental health increases vulnerability to harm, whilst abuse and neglect damage mental wellbeing. Yet many organisations still treat them as separate issues, missing critical opportunities for early intervention and protection.
Why is Mental Health a Safeguarding Issue?
The Links Between Mental Health and Vulnerability
Children with mental health difficulties are:
- More likely to experience abuse and exploitation
- At increased risk of self-harm and suicide
- Vulnerable to online grooming and manipulation
- More susceptible to peer-on-peer abuse
- At risk of criminal and sexual exploitation
- More likely to go missing or run away
Mental health concerns aren't just wellbeing issues—they're safeguarding red flags.
How Abuse Impacts Mental Health
Trauma from abuse causes Anxiety, depression, PTSD, attachment difficulties, emotional distress leading to self-harm, suicidal ideation, substance misuse, eating disorders and dissociation and complex trauma responses.
Safeguarding responses must address mental health impact, not just immediate safety.
Recognising Mental Health Concerns as Safeguarding Issues
What Are The Warning Signs That Require Safeguarding Response?
Behavioural changes:
- Sudden withdrawal from activities or relationships
- Significant changes in eating or sleeping patterns
- Increased risk-taking or reckless behaviour
- Substance use or experimentation
- Running away or going missing
- Self-isolation or school refusal
Emotional indicators:
- Persistent low mood or hopelessness
- Excessive anxiety or panic
- Anger outbursts or aggression
- Emotional numbness or detachment
- Expressions of worthlessness
- Suicidal thoughts or statements
Physical signs:
- Self-harm injuries (cutting, burning, hitting)
- Unexplained weight loss or gain
- Deteriorating personal hygiene
- Physical complaints without medical cause
- Fatigue or lethargy
- Signs of substance use
Social changes:
- Friendship group changes, especially to older peers
- Online relationships with unknown adults
- Secretive behaviour about activities or contacts
- Exploitation by peers or adults
- Involvement in risky or criminal activity
This is a lot to comprehend and keep an eye out for! Discussions with mentors, colleagues, can help you learn from others and equally help you identify any issues. Naturally, anonymise the information initially but this could help identify a moment or situation that requires escalation and action.
When Does Mental Health Becomes a Safeguarding Matter?
Always consider safeguarding when:
- Self-harm is present or disclosed
- Suicidal thoughts or plans are expressed
- Mental health deterioration is rapid or severe
- Child is at risk of exploitation due to vulnerability
- Family circumstances contribute to mental health crisis
- Child is engaging in risky behaviour
- There's evidence of abuse, neglect, or trauma
Mental health concerns don't automatically mean safeguarding referrals, but they always require safeguarding assessment.
Identifying At-Risk Children
Vulnerable Groups
Particular attention to:
Children in care as they have higher rates of mental health difficulties, trauma from separation and adverse experiences and attachment challenges through the impact of an unstable environment.
Children with SEND as they often have communication barriers to expressing distress. They've increased vulnerability to abuse through social isolation and peer rejection.
LGBTQ+ young people have higher rates of anxiety and depression, bullying and discrimination. Coupled with family rejection or conflict can leave them truly isolated.
Young carers have stress from caring responsibilities, which can create educational and social isolation. Parentification and role reversal means they worry about family member's health above their own.
Children experiencing poverty might have stress from financial insecurity, housing instability and overcrowding. Malnutrition can play as well as limited access to support services.
Children affected by domestic abuse or witness violence and coercive control can be living in fear
Early Intervention Strategies
Creating Mentally Healthy Environments
Promote emotional literacy:
Teach children to recognise and name emotions which in-turn normalises talking about feelings. Model healthy emotional expression, creating a vocabulary for mental health.
Build resilience:
Develop problem-solving skills and encourage healthy coping strategies. Foster positive relationships and celebrate effort and growth, not just achievement.
Reduce stigma:
Talk openly about mental health and challenge stereotypes and misconceptions. Share stories of recovery and support, ensuring seeking help is seen as strength.
Create safe spaces:
Trusted adults children can approach are helped by quiet spaces for private conversations. Peer support systems with accessible information and support can make a child more comfortable to open up.
Recognising and Responding Early Via a Tiered Model
Universal support (all children):
- Mental health education
- Wellbeing activities
- Safe, predictable environments
Targeted support (children showing early signs):
- Check-ins with trusted adults
- Small group interventions / peer mentoring
- Parental engagement and support
Specialist support (children with significant needs):
- Referral to CAMHS or mental health services
- Multi-agency support
- Safeguarding involvement if needed
Early intervention prevents escalation and protects children.
Working with CAMHS and Mental Health Services
Understanding the Referral Process
When to refer to CAMHS:
- Persistent mental health difficulties impacting functioning
- Self-harm or suicidal thoughts
- Eating disorders
- Severe anxiety or depression
- Trauma symptoms
- Psychosis or severe mental illness
Referral requirements:
- Evidence of need and impact
- Parental consent (usually required)
- Completed referral forms
- Supporting information from school/setting
- Previous interventions attempted
Supporting Children Whilst Waiting
Many children wait months for CAMHS support so what can you do?
Staff experiencing mental health difficulties:
Maintain regular check-ins and provide in-house support where possible. Signpost to alternative services (charities, online support) but do so with the involvement of parents in support planning to ensure everyone is comfortable, including the child. It's important to give them a say and feel heard.
What's a Trauma-Informed Environment?
Understanding What Trauma Responses Can Occur
Trauma affects behaviour:
- Fight responses: Aggression, defiance, anger
- Flight responses: Avoidance, running away, school refusal
- Freeze responses: Dissociation, compliance, shutdown
- Fawn responses: People-pleasing, over-accommodation
Behaviour is communication—what is the child trying to tell us?
Practical Trauma-Informed Strategies
In daily practice:
- Regulate before expecting regulation from children, offering opportunities for control and autonomy
- Understand behaviour as communication
- Respond to need, not just behaviour, following through on commitments
- Provide co-regulation and emotional support
- Avoid re-traumatisation through responses and develop coping skills
- Build relationships with transparency and honesty before demanding compliance
Always take suicidal thoughts seriously—asking about suicide does not increase risk.
Conclusion
Mental health and safeguarding are inseparable. Recognising mental health concerns as potential safeguarding issues, intervening early, working collaboratively with mental health services, supporting staff wellbeing, and creating trauma-informed environments are all essential for protecting children.
In 2026, effective safeguarding means understanding that a child's mental health is central to their safety, and their safety is fundamental to their mental health. Organisations that integrate these approaches create environments where children are truly protected and supported to thrive.
Strengthen your trauma-informed practice. Our training resources help organisations recognise the intersection of mental health and safeguarding, creating safer, more supportive environments for vulnerable children.