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Improved training needed for professionals referring children to CAMHS

Training is needed for teachers and others who refer young people to services to avoid delays and to ensure all professionals understand their roles within the system, says EPI

Published on 19th September 2017

More than a quarter of young people referred to CAMHS services were not accepted, a report by the Education Policy Institute has found.

Following Freedom of Information requests, the EPI revealed that just over a quarter (26.3 per cent) of children referred to specialist mental health services were not accepted into those services in 2016-17.

Experimental NHS data shows that around 147,000 young people were in contact with children and young people’s mental health services in May 2017. Therefore, it can be estimated that around 52,500 children’s referrals were not accepted over the time period when these referrals were accepted.

There is wide variation between providers; some providers do not accept over half of their referrals, while for others, that figure is less than 5 per cent. The proportion of referrals not accepted, deemed inappropriate or signposted elsewhere was 64.1% in Norfolk and Suffolk and 63.5% in Hertfordshire Partnership.

There are good alternative services available in some areas to accept young people who are not accepted by specialist services, but these are not consistently commissioned in every area. The wide variation demonstrates that in many areas there continue to be significant problems for young people in accessing the treatment they need.

The most common reason for children not receiving treatment was that the young people did not meet the eligibility criteria for specialist child and adolescent mental health services (CAMHS).

The next most common reason for referrals not being accepted was mistakes in the referral process, for example, the referrer not providing enough information. The report said this highlights the need for greater training for GPs, teachers and others who make referrals to help reduce mistakes and the number of inappropriate referrals.

The percentage of referrals not accepted by specialist services increased significantly from 21.1 per cent in 2012-13 to 26.5 per cent in 2015-16 and has since levelled off.

In addition to data on access, providers were also asked to state their maximum and median waiting times to initial appointment and to start of treatment over the past five years. There appears to have been some progress over the last year in reducing median waiting times. The average waiting time for assessment has dropped from 39 days in 2015-16 to 33 days in 2016-17 and for treatment from 67 to 56 days. Over the last five years there has not been a clear trend in median waiting times, but the most recent year (2016-17) is the lowest this has been for five years.

“This report shows that over a quarter of young people referred to specialist mental health services are not accepted for treatment. Little progress has been made in reducing the high proportion of young people who are not accepted into specialist services despite having been referred by a concerned GP or teacher,” said the report. “When referrals are accepted, young people in many areas are still waiting an unacceptably long time for treatment. The case for national waiting time standards to be put in place is therefore strong. Some progress is, however, being made in reducing waiting times to treatment, which may be due to the additional funding earmarked for children’s mental health services.”

The report concluded that the forthcoming Green Paper on mental health and schools provides an ideal opportunity for the government to address these concerns and to ensure that young people can access early intervention support in every area of the country, either in school or in the community.

Training is also needed for teachers and others who refer young people to services to avoid delays and to ensure all professionals understand their roles within the system and how to get young people the help they need.

Paul Whiteman, general secretary of school leaders’ union NAHT said: “This report highlights the barriers children face in seeking access to mental health services, and backs up what school leaders have been telling us. Our survey with Place2Be in February this year revealed that more than half of school leaders in the primary phase believed that it was difficult to access mental health services for pupils. Schools have been trying to help their pupils by plugging the gap in the provision of specialist mental health services but our secondary survey revealed that funding cuts meant that nearly a third of heads were cutting the services they could offer.

“It is essential that schools are supported by properly funded health and social care services rather than making up for cuts to those services. If support and funding is inadequate, many young people could continue to get a raw deal.

“We hope the government takes notice of this report and works with NAHT and others on the upcoming mental health green paper. Schools have a vital role to play in promoting and supporting good mental wellbeing and in the early identification of pupils with mental health needs, but need to have confidence that mental health services can be relied on to provide specialist support and treatment,” he concluded.

Access and waiting times

 

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