Shockingly poor mental health services for children highlighted

Children's commissioner sounds alarm over children's mental health services

Published on 10th October 2017

The children’s commissioner for England has raised concerns about the “shockingly poor” mental health services that children and young people are receiving.

Anne Longfield has urged the government to use the forthcoming green paper on mental health to address the issues currently facing young people needing mental health support.

Ms Longfield said she was “very concerned” that children’s inability to access mental health support leads to a whole range of additional problems, such as school exclusions or care placements breaking down and children ending up in the youth justice system.

“I believe many of these problems could be prevented if children had access to mental health support when they need it. As this briefing shows, early intervention is cost effective - but is currently a postcode lottery of fragmented support depending almost entirely on where a child grows up and which school they attend,” she said.

Progress in improving children’s mental health services has been “unacceptably slow”. Having compared the adults’ mental health system to the one designed for children, Ms Longfield found “enormous disparities” and “shocking results”.

“NHS England lays out clear expectations to local areas about what should be provided for adults, backed up by targets and benchmarks on success rates and waiting times. In contrast, there is no monitoring of how many children are seeking mental health treatment, no information on how many are accepted into treatment, how long they will wait or what outcomes they achieve,” said Ms Longfield.

“There were no children’s mental health national targets until last year – now there are nine indicators, but these are not are top priority targets. At a time when the NHS is under exceptional financial pressure, the system in place makes it all too easy for children’s mental health to be ignored,” she added.

There had been some notable, progress in children’s mental health services however, with NHS England estimating an extra 21,000 children have received CAMHS support since 2015/16. Yet nearly 60% of local areas are failing to meet NHS England’s own benchmarks for local area improvement, she warned.

The system was “even bleaker” when it comes to children with emerging problems as there is no clear guidance about  how ill a child needs to be before they should receive care. No information is collected on which local services are available, and the evidence that has been collected, by the Office of the Children’s Commissioner and a range of other bodies, reveals a postcode lottery of care.

The report highlighted:

  • Between 1 in 4 and 1 in 5 children with a mental health condition received helped last year
  • The overwhelming majority of NHS mental health spending goes towards those with the most severe needs
  • The government’s much vaunted prioritisation of mental health has yet to translate into change at a local level.
  • There is a massive discrepancy between children’s and adult’s mental health.

The report recommends that the forthcoming Green Paper brings about a system designed around three principles:

1. A mental health service that is designed for children and built to meet their needs.

2. A service that supports children in the right place at the right time.

3. High quality, evidence based services, from the classroom to hospital care

The Green Paper should set out clear expectations as to what a child can expect in terms of mental health support and needs to make it clear which bodies are responsible for providing each element of this support.

NHS England should place a clear expectation on CCGs that they should be providing a comprehensive and integrated package of targeted and specialised provision in their local area. This must include early intervention services.

The NHS should hold local areas to account to ensure they are spending all the additional funding they have received on children’s mental health, that this is not offsetting cuts elsewhere, and that this is combined with effective local transformation plans.

In 2018 when new data is available on the level of need, clear targets should be set to increase the proportion of NHS funding spent on children’s mental health.

Ms Longfield warned that a “wholesale shift” was needed in the scale of ambition across government and the NHS on children’s mental health care.

“I want to see a clear expectation as to what local areas should be providing, with transparency and accountability to ensure this happens. My message to government and parliamentarians is clear: the Green Paper is an opportunity to bring about this seismic change and it must not be missed. Be bold, be brave and do not compromise. We can transform the provision of children’s mental health care, and the rewards for doing so are enormous,” concluded Ms Longfield.

Mental Health Briefing 


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