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MPs criticise poor access to young people's mental health services

  • 7 Comments

A growing number of vulnerable young people are being put at risk because of “serious and deeply ingrained problems” in children’s mental health services, a critical report by the Commons’ health select committee has found.

MPs claimed mental health services were “operating in a fog”, because essential research into the state of children’s and adolescent’s mental health in England was 10 years out of date.

Committee chair and former GP Dr Sarah Wollaston said essential data is needed to address the growing threat of sexting, cyber-bullying and graphic online content on children’s mental health.

“It is a disgrace that we don’t have provision data on children’s mental health service”

Sarah Wollaston

She demanded a “significant increase” in investment after some services in the country reported up to a 25% increase in the amount of children and adolescents seeking help.

Dr Wollaston, who is the Conservative MP for Totnes in Devon, said: “Not only do we have a shortage of prevalence data, but we have an issue around the data about the provision of services. It is a disgrace that we don’t have provision data on children’s mental health service.”

She added: “What we do have is information from all the people we’ve heard from that there has been an increase in referrals and new issues have arisen around the impact on children’s mental health with new technology and the challenges around the online environment that children face, like cyberbullying and sexting.”

Health select committee

Sarah Wollaston

Children’s mental health charity YoungMinds said it was clear that services are facing a “major crisis” which is causing daily suffering for young people and their families.

In their report on child and adolescent mental health services (CAMHS), the MPs said there were “major problems” with access to inpatient mental health services and an unacceptable variation in the quality of services, with families facing “battles” to have their children treated.

During their inquiry, MPs heard evidence from children who had spent months on a waiting list for therapy while some services admitted to being so overwhelmed that they only treat children once they have seriously self-harmed.

Children as young 12 are being held in police cells overnight when suffering a mental health episode because out-of-hours services do not exist in some areas while others are being admitted to mental health wards on the other side of the country away from their family.

The committee’s report stated: “There are serious and deeply ingrained problems with the commissioning and provision of children’s and adolescents’ mental health services.

“These run through the whole system from prevention and early intervention through to inpatient services for the most vulnerable young people,” it said.

In its evidence to the comittee, NHS England said only 6% of the mental health budget was currently spent on children and young people, despite half of all adult mental health problems starting before the age of 14.

The report urged the government to make huge investments in services, particularly in early intervention measures which can prevent mental health issues becoming entrenched in children.

They welcomed news that a taskforce will carry out a new study into the prevalence of mental health in children and adolescents, and urged for more data surrounding the provision of services.

“We have been told countless times of the intense frustration of mental health professionals”

Sarah Brennan

Many charities that work with young people said the report came as “no surprise”.

Sarah Brennan, chief executive of YoungMinds, said: “We have heard over and over again from young people and their families about the overwhelming distress caused by lack of access to mental health services.

“We have been told countless times of the intense frustration of mental health professionals, as they attempt to do their best for children, young people and their families who are suffering on a daily basis,” she said.

YoungMinds

Sarah Brennan

Ms Brennan said the new report “proves beyond all doubt” that children and young people’s mental health services are “facing a major crisis”.

“The publication of this report must be a pivotal moment in addressing this crisis, our response has got to change, no longer can we sit back and pretend this isn’t happening,” she added.

Peter Liver, director of ChildLine, said: “These findings do not come as a surprise to us – we have held over 34,000 counselling sessions with young people this year who have told us they have had suicidal thoughts.

“Children are telling us they feel unable to ask for help from anyone else and we need to ensure they know they are not alone,” he added.

NSPCC

Peter Liver

Peter Carter, chief executive and general secretary of the Royal College of Nursing, said: “It’s a disgrace that vulnerable children and young people are being let down like this. The pressure on services and lack of resources is compromising patient safety and it’s unacceptable.

“Nursing staff work across all levels of the CAMHS system, from school nurses through to specialist children’s mental health nurse consultants,” he added.

“Every day they can see the consequences of perverse commissioning arrangements and inadequately funded services making it too hard for children and young people with mental health problems to access care.”

 

  • 7 Comments

Readers' comments (7)

  • Welcome to my world!

    Before I had my job "re-structured" away in 2012 I was a Band 7 in community CAMHS. Our service, which had never been at NSF recommended minimum numbers, was being hacked apart in order to save money. One of our local in-patient units was also closed, or should I say "de-commissioned", as that was the term used and tells you where the decision came from.

    When I worked in CAMHS in-patient services (1988-98) the lack of beds was well-known to all clinicians and our complaints ignored by managers and commissioners.

    I also worked in a specific CAMHS over-dose service, which was closed by a combination of incompetent and vindictive management and commissioners thinking (thanks to a certain manager) that we were too expensive, despite an excellent clinical record.

    Years of complaint by clinicians and families about poor staffing levels have been routinely ignored by management (I was forbidden from raising the subject by one service manager) and commissioners, who by and large knew nothing about CAMHS, despite the existence of documents such as "Together We Stand" which contained specific and detailed guidance about commissioning CAMHS.

    This is NOT NEW!

    Sarah Wollaston, a former GP, who may even have been involved in GP commissioning, has no excuse for not knowing this already...

    And how many MPs on this committee voted AGAINST Lansley's bill?

    The claim that research into the state of CAMHS is 10 years out of date is also NOT TRUE! Every year there is an exercise counting numbers, grades and disciplines of staff, case load size, types of cases etc. This data exists already. Electronic record systems (ESR for staffing and the likes of RIO for clinical data) make it simple to obtain the relevant information anyway.

    Sounds more like our political masters and mistresses have, as ever, been going out of their way NOT to know...

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  • And that is before we start on the world of the "hidden waiting lists", which don't, of course, officially exist...

    And the, related, way in which models of care such as CAPA (the Choice and Partnership Approach, which is being forced on CAMHS) are being badly implemented by managers intent on using it as a kind of triage system to get people off waiting lists, the ones which DO officially exist...

    Really I can write for hours and hours about this stuff.

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  • why would MPs need access to young people's mental health services?

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  • I entirely agree with BasketPress. There is no excuse for pretending we do not know about this problem (or set of problems). I wonder when, if ever, the government will realize that addressing mental health problems effectively will reduce overall costs for the state because problems associated with mental ill health will reduce. The NHS model of care is also not the whole answer - early intervention by third sector counselors can be effective, and is a lot cheaper. We probably do need a review of the evidence, but mostly to inform a complete re-working of our approach to treating mental ill-health.

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  • Thank you, Peter!

    I hadn't even started on the cuts to school nursing services, educational welfare, educational psychology, funding for services provided by charities/not-for-profit organisations and the like which went alongside NHS cuts...

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  • Actually, related to one of Peter's points, my last job was supposed to be a service development one, looking at how to develop and support Tier 1 and 2 services (i.e. those outside more specialist CAMHS)...

    I wasted quite a lot of time coming up with various plans, drafts, potential models and the like before I found out that the rest of the money supposed to support my work of service development and expansion had been spent on a consultant psychiatrist and that I was essentially there to get people off waiting lists...

    Short-sighted was about the politest phrase I used.

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  • Well said BasketPress I agree entirely. I worked in specialist CAMHS for many years and was restructured out of my post as a cost cutting exercise. I agree totally with all you say. Why don't the people making decisions talk directly to staff in the service and get direct information too?
    Hope you enjoy your role now. I eventually took voluntary redundancy but am still passionate about these services and keep up to date.

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