Access to mental health for young children
Urgent reforms are required in order to protect our children’s mental wellbeing
The NSPCC’s report “How safe are our children? The most comprehensive overview of child protection in the UK 2016” revealed that in 2015/16, there were over 93,000 Childline counselling sessions with children and young people involving mental health and wellbeing issues. Of these, over 50,000 related to suicidal feelings, self harm, mental health or depressive disorders. These staggering statistics highlight that young people are increasingly trying to reach out and seek help for a range of issues.
The NSPCC also highlighted that 90% of children who suffered abuse at an early age, will go on to develop mental health issues by the time they are 18. As a solicitor working with survivors of abuse, I see everyday how childhood abuse can have a detrimental impact on a child’s development and psychological well being, as well as their day to day lives, education, employment and relationships as they transition into adulthood. Many mental health conditions in adulthood show their first signs in childhood and, if left untreated, can develop into conditions which need regular care.
But, can our children easily access mental health support when they need help the most?
In May 2016, the Children’s Commissioner published her report entitled “The Lightening Review – Access to Child and Adolescent Mental Health Services”. The Children’s Commissioner approached 60 NHS Trusts to obtain information about Child and Adolescent Mental Health Services (CAMHS). Data was received from 80% of the NHS Trusts that were approached.
The Children’s Commissioner’s findings highlighted some serious concerns about the stark reality faced by young people trying to access mental health services across the country.
Summary of The Children’s Commissioner’s findings
1. Being turned away
The report highlighted that sadly, children and young people are being turned away when vital support is needed. 28% of children and young people referred to CAMHS were not allocated to a service or provided with treatment, despite being identified as having a mental health need that required a referral. At least 79% of CAMHS confirmed that they imposed restrictions and thresholds such as age, severity of mental health, specific conditions and duration of symptoms.
No follow up was arranged for those who were discharged, and shockingly, no one checked to see if the child needed any further support following discharge.
Worryingly, of the 3,000 children and young people who were referred to CAMHS with a life threatening condition (such as self harm, suicide, anorexia nervosa or psychosis), 14% were not allocated to any provision, 51% went on a waiting list and some waited over 112 days to receive services.
2. Long waiting times
Once a child or young person has plucked up the courage to seek help, they are faced with long waiting times. In some areas, the average waiting time was around 200 days. Early intervention is vital when children are facing mental health issues. A child should not be left to suffer in silence and worsen their mental health, for help to only arrive when they are on the verge of suicide.
3. Penalised for missing appointments
There are a number of reasons as to why children or young people may not be able to attend appointments such as lack of support or travel issues. Even social isolation could derail their ability to attend the appointment. This does not mean that they no longer need any help.
Yet, the report highlighted that many children and young people are falling through the net, due to missing appointments and facing restrictions. 35% of CAMHS confirmed that restrictions are imposed if appointments are missed. 29% clarified that this means that children and young people are prevented from accessing CAMHS. Some of those who fall out of the system need to be re-referred and face increased delays.
4. Postcode lottery
There is a variation of practice across the country with regard to the likelihood of being referred to CAMHS, the likelihood of receiving treatment and waiting times. For example the average waiting time ranged from 14 days (in the North West) to 200 days (in the West Midlands). In addition, the likelihood of receiving treatment in various regions ranged from 18% to 80%.
Impact of report
The above findings are not only morally unacceptable but also go completely against the ethos of early intervention. We all know that talking about our problems or having someone to just listen to us can be life changing but it disheartens me to see that many children are not receiving the professional support they desperately need, particularly given the traumatic nature of childhood abuse and the damaging consequences this can have on a child’s life. The report makes clear that fundamental change needs to be implemented to CAMHS as soon as possible to ensure the users of the service are receiving proper support.
What is being done to improve CAMHS?
In 2015 the Government pledged an extra £1.4 billion over five years to “transform” and improve children’s mental health services. Unfortunately, the Government is already failing to deliver and in the first year, of the expected £250m funding, only £143m was released. Many mental health professionals fed back that the money failed to reach frontline services.
In November 2016, the Education Policy Institute’s Independent Commission on Children and Young People’s Mental Health, released a new report, entitled “Time to Deliver” which calls for a new “Prime Minister’s Challenge” on children and young people’s mental health. The report makes a number of recommendations for the Government, including:
- funding research into understanding mental health and new treatments;
- providing web based parenting guides for all parents;
- encouraging early intervention by creating a national programme on mental health and wellbeing within schools; and
- creating an ambitious goal that no one should wait more than 8 weeks for a routine appointment
I wholeheartedly welcome these recommendations as Government pledges are not enough. We need action and some benchmark targets against which to measure results. We need to make sure our children are able to access support before reaching crisis point. The Government’s failure to prioritise this issue and provide funding is appalling and is failing the most vulnerable people in our society. Children are our future and if we better look after their mental health then all our futures will be brighter.
Siobhan Crawford is an associate solicitor in the Abuse team at Bolt Burdon Kemp. If you or a loved one have a claim, contact Siobhan free of charge and in confidence on 020 7288 4886 or at siobhancrawford@boltburdonkemp.co.uk. Alternatively, complete this form and one of the solicitors in the Abuse team will contact you. Find out more about the Abuse team.