The Knowledge

Why speech and language matter to mental health

We risk failing another generation of children if we do not join the crucial dots  between mental health and speech and language challenges

We risk failing another generation of children if we do not join the crucial dots  between mental health and speech and language challenges

17 Mar 2025, 5:00

Last week brought news that government-funded trials of interventions designed to boost mental health literacy largely failed to yield lasting benefits. Some were in fact linked to worsening emotional difficulties over time.

This week brings news that teachers are grappling with increasing numbers of children starting school with poorer-than-expected language and communication skills.

While both findings are concerning, the unacknowledged link between them could be empowering for schools and yield huge benefits for young people.  

When we talk about the causes of poor mental health, we tend to focus on poverty, neglect and attachment issues – all factors that teachers have little to no ability to prevent.

Yet over the many years I’ve worked in mental health, I can’t remember a single discussion about the one factor schools can affect: language.

Once you see the links, they are hard to deny. Language helps us to name and identify our emotions It allows us to engage in self-talk and reasoning about what is happening to us and how we are feeling. And ultimately, language allows us to participate in talking therapies if they are necessary.

Most school-based mental health interventions are verbally mediated; they assume children possess the language skills required to understand, articulate and engage with complex emotional concepts.

Yet a significant (and evidently growing) proportion of pupils have speech and language challenges that undermine this very assumption.

Robust and disquieting studies indicate that around 45 per cent of young people referred to mental health services struggle with core language skills, such as making inferences, interpreting ambiguity and understanding figures of speech.

Once you see the links, they are hard to deny

Meanwhile, longitudinal research reveals that children diagnosed with developmental language disorder (DLD) face a 1.8 to 2.3-fold increased risk of poor mental health by adolescence compared with their peers.

Language is far more than a tool for communication.  It is the medium through which children learn to understand, regulate and express their emotions. It underpins social interaction and is crucial for developing the emotional literacy needed to navigate interpersonal relationships.

Struggling with speech and language compromises these fundamental processes, with predictable consequences for the individual, the people around them, and any attempt to bolster their mental health through traditional interventions.

Compounding the issue are broader social and economic factors. Research by Speech and Language UK finds that 1.9 million children (and rising) are behind in talking and understanding words, with one million living with the lifelong condition of DLD, which is hardly talked about in the education sector.

Alarmingly, government statistics show over 20 per cent of children in reception already lag behind expected communication levels. In disadvantaged areas, that rises to nearly half. And as child poverty reaches record highs, it’s sadly unsurprising to see teachers’ perceptions foreshadowing worse figures in YouGov’s new poll.

The evidence is clear. Without robust support for speech and language development, any intervention aimed at improving mental health risks falling short.

Redirecting resources and policy so that speech and language challenges are tackled more thoroughly is not a luxury but a necessity if we are to ensure that children have better mental health.

But investing in speech and language support requires more than hiring extra therapists. It demands a comprehensive approach.

This must include training teachers to identify speech and language challenges early, integrating spoken language skills into the curriculum and ensuring that there is guidance for teachers on how to adapt their teaching for children with lifelong speech and language challenges.

Such measures would have a double pay-off. They would help enhance children’s educational outcomes, and they would bolster children’s ability to identify and regulate their own emotions.

This would improve their mental health and their behaviour. Better still, improved communication leading to increased social interactions and higher self-esteem can be the bedrock of inclusive environments where all children feel they belong.

In short, it is only by fortifying foundational speech and language skills that can we ensure our children are given the chance, as Bridget Phillipson put it so well, to achieve and to thrive.

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