The Prime Minister devoted her first speech of 2017 to mental health. May promised to use the power of government to transform the way we deal with mental illness not just in our hospitals, “but in our classrooms, at work and in our communities”. But of course there was a catch. No new money.
NHS England’s guidance on transforming child and adolescent health services makes clear:
“More of the same is simply not an option. Unless we make some real changes right across the whole system,.. opportunities to build resilience in our children and young people, promote good mental health and intervene early when problems first arise will continue to be missed…”
NCB’s research last year with the Association of School and College Leaders showed a rising tide of school children with mental health problems. More than half of educational leaders said there had been a large increase in anxiety or stress over the last five years, and over 40 per cent reported a big increase in the problem of cyberbullying. Nearly eight out of ten (79 per cent) reported an increase in self-harm or suicidal thoughts amongst students. Schools and colleges had access to a variety of support, but over half of leaders (53%) who referred students to CAMHS thought these service were ineffective.
Recent research by NSPCC confirmed how widespread mental illness is amongst the young: almost 19,000 children were admitted to hospital last year after self-harming – a 14% rise over three years. Peter Wanless, NSPCC Chief Executive, emphasised the constant pressure felt by young people, connected 24/7 by digital technology, which means they can never switch off and are always in competition with each other. This is a valid indication of the general causes of mental illness, but specific groups are particularly at risk: those who suffer abuse or trauma, those in the care system, those who have been bereaved, in the criminal justice system or those with learning disabilities. (More than 40% of people with a learning disability will experience a significant psychiatric disorder, compared with just 10% of the general population).
The Government has promised to invest £1.4 this Parliament to deliver the Future in Mind strategy, designed to improve services for children and young people. Local Transformation Plans enable local services and commissioners to work together to ensure that children’s needs are at the centre of service design.
The intent is clear, and to be welcomed, but it is not yet providing adequate services to meet growing needs. A report by Young Minds last year showed that in the cash-strapped NHS, the money intended to improve mental health services for children and young people wasn’t getting through. Over half of England’s clinical commissioning groups used their share of the funds for other purposes.
The frontline staff we speak to have said that Government’s extra funding, when it does get through, is making a difference. But after years of neglect, there is still a long way to go before CAMHS services do more than provide crisis support for children and young people in the most acute need, and reach out to those with emerging problems in the early stage of poor mental health.
Initial findings from our survey of the sector, which will be published later this year, show that improvements at a strategic level and consultation activity are yet to lead to real change in support for individual children and young people.
Those working at various levels of the system reported having to turn children away. This echoes findings from the Children’s Commissioner last year, that out of 3,000 children and young people suffering from life threatening mental health conditions, 14% were not allocated any provision and some waited over 112 days to access services.
As well as promoting children’s emotional wellbeing, and being ready to support them when they are in crises, we also need to secure proactive support, present at the times when challenges to mental health are most likely to arise. For children in care, this problem is particularly pressing. The child’s journey is very likely to have undermined their mental health, and yet they do not have routine access to an assessment by a qualified professional, let alone access to the therapeutic support they need.
Thankfully, the Government has now committed to piloting an improved approach to assessment, following work over many years by NCB and others through the Alliance for Children in Care and Care Leavers. But piloting an assessment is only the first step.
Rhetoric matters, and the PM’s intervention may well help tackle stigma, raise awareness, and galvanise decision-makers around the country to take action. But the Government must go further to ensure that £1.4bn is used to help those who need it most. The stakes are high. If we don’t act now, CAMHS will continue to fail children and young people.
This article was originally published online in Children and Young People Now. You can read the original article here>