5 Nov 2014

‘Serious problems’ in children’s mental health services

In today’s report on children’s and adolescents’ mental health there is one particularly shocking paragraph. It says:  “In some areas, it has been reported that Children and Adolescent Mental Health Services (CAMHS) will not see any young person unless they have attempted at least one suicide.”

Imagine being the parent of that young person? All you would want to do is protect them and help them and make it all OK. Yet all you can do is stand by because the help they need is not there.

It is not difficult to find examples of this. One father we spoke to said that after  his severely depressed daughter ended up in A&E three times without any referral on for psychiatric or psychological help, he put her in the car and went to the CAMHS office.  He refused to budge until they saw her.

Another mother rang the mental health crisis team in the hope that they would miraculously find her a psychiatrist after her daughter started self-harming.  They referred her back to the CAMHS team who said that it would be another month (they had already been waiting three months).

She said when her daughter first showed signs of becoming ill, she had done everything right:  she took her to the doctor, got her a referral to an eating disorder clinic, took her to the dietician appointments.  She had intervened early but the crucial, most vital piece was missing because they could not get her into therapy.  And so her daughter’s condition deteriorated.

The health select committee report describes young people’s mental health services as having “serious and deeply ingrained problems”.  It says it runs through the whole system from prevention and early intervention through to inpatient services for the most vulnerable young people.

For those involved in this area, none of this will come as any surprise.  There has been warning after warning.  As one person describes it, children’s mental health is a Cinderella of a Cinderella service.

Children’s services receive just six per cent of the overall mental health budget.  There is no decent data.  The last ONS data collection was in 2004 but it was cancelled for 2009.

So the committee had to rely on anecdotal evidence.  And that evidence was that referrals to CAMHS teams are going up 20-25 per cent.  Some said year on year, some said in the past year.

The crux of the report, of course, is that early intervention is critical.  The last place a child should be, unless absolutely necessary, is in an in-patient bed.

But if they do end up as an in-patient, the chances are it may be hundreds of miles from home.  There is a promise to open another 50 beds but that has not happened yet.

And it costs £25,000 a month so for those worried about NHS finance’s there is added value to intervening early.

But who can put value on a child’s mental well-being.  One psychiatrist said to me that we forget these are tomorrow’s workforce, tomorrow’s innovators, tomorrow’s carers.

We need them to be happy, confident and resilient.

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