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Comprehensive mental health service for children still a long way off

On 30 January 2020, Anne Longfield, the Children's Commissioner released her third annual report into the state of children and young people's mental health services.

In her introduction, the Commissioner estimated that England was over a decade away from a comprehensive mental health service for children and found that although there have been successive announcements for improvement to children's mental health services, implementation plans were limited to:

  • Delivering a joined up mental health service via schools to 20% of local areas in 2024/5
  • Expand specialist services so they meet demand by 2028

The report went on to focus on three areas:

1. Specialist NHS mental services in the community for children and young people (known as CAMHS or CYPMHS)

There has been some improvement in the provision of these services and cash investment has increased by £60 million. An additional 53,000 children entered treatment in 2018/2019 with a 50% increase in the number of children accessing eating disorder services.

However, NHS spending on children paled in comparison with per head spending for adults. There was also significant variation in spending on children's mental health services between different areas.

Waiting times to enter treatment varied from 3 weeks to 4 months. In some areas less than half of the children and young people referred for treatment actually entered it and in others 90% did.

2. Universal or low level help for children and young people – generally provided by schools, local authorities, voluntary sector and NHS

These type of services are not clearly defined but cover children with mild or low level needs which haven't been diagnosed with a mental health problem, but are at risk of developing one. They would typically be provided in schools and are provided by a range of public bodies and charities. There is no single standard model of what they encompass and no national data is collected on these services.

The Children's Commissioner found that the current system meant that responsibility for these lower level services were simultaneously everyone's responsibility and nobody's.

3. The Government's plans to meet the mental health of all children and young people

The Children's Commissioner estimated that in order to have a mental health service that met the needs of all children and young people, it would need to:

  • Enable 900,000 children to access specialist NHS services a year (roughly treble its current size)
  • Provide universal or low level help for 1,200,000 children and young people a year

The Commissioner said that provided the NHS continued to commit to the current level of expansion, it would be able to provide the recommended specialist services by 2028. However, her recommendation for universal/low level services would not be reached unless the Government created a clear plan for their provision and committed to funding them.

The Commissioner made a variety of recommendations including:

  • NHS England should speed up its expansion of children and young people's mental health service
  • There should be a basic benchmark for the type of services children and young people in respect of universal and low level services
  • There needs to be much clearer information on who is providing what to children and young people in respect of universal and low level services
  • There should be clear expectations of what each organisation in a local area will provide to collectively meet the needs of children and young people

Mind's comment

Early intervention and prevention are crucial for reducing the number of young people needing specialist services as well as reducing the number of young people reaching crisis. These types of services are likely to be provided as part of the universal/low level services identified by the Commissioner, so we welcome their recommendations on increased funding and greater accountability and transparency on responsibility for providing these services.

For children and young people who do need crisis services, specialist multi-agency Crisis Resolution and Home Treatment Teams should be developed, to bring together clinical staff and social workers to support young people quickly and prevent hospital admissions.

Mind would like to hear from people who have used crisis or inpatient children and young people's mental health services. If you would like to speak to us about your experiences, or your child's experience of using those services, please contact us on [email protected].

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