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Government unveils proposals to overhaul child mental healthcare

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Specialist mental health services should have a dedicated professional in post to support local primary care providers with child mental health issues, according to proposals from a government taskforce.

There is to be a “complete overhaul” of mental health services for young people based on recommendations made in a report published today by senior officials at the Department of Health and NHS England.

Mental health support needs to become more visible for children and young people and this should in part be achieved by ensuring every local GP and school has a named point of contact by 2020 to achieve better communications, referrals and access, according to the Children and Young People’s Mental Health Taskforce.

“Crucially, we must make it much easier for a child or young person to seek help and support in non-stigmatised settings”

Norman Lamb

A total of 49 proposals have been put forward by the taskforce, which was set up last year to create a “blueprint” for improving mental health care over the next five years.

Problems with current services were identified by the taskforce, including gaps in treatment, increasing needs among certain groups – such as young women with emotional problems – and longer referral and waiting times.

Through discussions with young people, the taskforce found they had difficulties in discussing mental health problems with their GP and that schools were not an environment they felt safe to discuss these issues in either.

Significant gaps in data and information about spending and provision have also been highlighted, which had led to a “general lack of clarity about what is provided by whom, for what problem, for which child”, said the taskforce.

This lack of data has also made child and adolescent mental health services (CAMHS) “financially vulnerable” when public sector cuts are being addressed, stated the taskforce in its report Future in Mind.

“Variable” access to crisis, out of hours and liaison psychiatry services were also noted, with some parts of the country having no designated “place of safety” for people under the age of 18 – used by the police so people with mental health problems can be assessed.

“A safe, effective, available service close to home is what we want to give to families…[and] access [to this] is still patchy”

Martin McShane

The taskforce’s recommendations include rolling out the existing Children and Young People’s Improving Access to Psychological Therapies programme (CYP IAPT) across the country and training all those working in mental health services in the competencies developed from the programme.

It also suggested every local area should have a “one stop shop” service, which provided mental health support and advice for young people in the community, making use of the voluntary sector.

Meanwhile, it said, a prevalence survey of children and young people’s mental health and wellbeing should be caried out by the government every five years, and commissioners should be “fully transparent” about their investment in these services.

The taskforce was co-chaired by Jon Rouse, director general for social care, local government and care partnerships at the Department of Health, and Martin McShane, director for long-term conditions at NHS England.

Martin McShane

Martin McShane

Dr McShane said:  “A safe, effective, available service close to home is what we want to give to families and while this is being delivered really well in some places access is still patchy in others.

“The taskforce has laid the foundations on which we will now build an effective mental health service for our children and young people,” he said.

In his foreword to the report, care minister Norman Lamb said: “We musn’t think about mental health in a purely clinical fashion.

“We need to make better use of the voluntary and digital services to fill the gaps in a fragmented system,” he wrote. “Crucially, we must make it much easier for a child or young person to seek help and support in non-stigmatised settings.”

The taskforce claimed that many of the proposals are “cost-neutral” requiring a different way of doing business rather than further significant investment.

However, it also acknowledged a number will need “explicit support from the next government, in the context of what we know will be a very tight spending review”.

On Monday, deputy prime minister Nick Clegg said the government would spend an extra £250m a year for five years on child and adolescent mental health services (CMAHs).

The investment, which Mr Clegg trailed at the Liberal Democrat spring conference, is expected to be confirmed in the budget tomorrow.

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