One third of areas make cuts in preventative mental health services

Children's commissioner report reveals postcode lottery for early help mental health services for young people

Published on 16th April 2019

Over a third of areas around England saw a real-terms fall in spending on preventative mental health services for children and young people in 2018-2019, the children's commissioner for England has warned.

A report by Anne Longfield discovered that while the total reported spend on low-level mental health services across all areas in England increased by 22% between 2016/17 and 2018/19 in cash terms, and by 17% in real terms, over a third of areas around the country still saw a real-terms fall in spending – with nearly 60% of local authorities seeing a real-terms fall.

Given the focus on improving access to children’s mental health, Ms Longfield slammed the reductions as "concerning".

Anne Longfield, the Children’s Commissioner for England, said: "This report reveals for the first time the postcode lottery facing the increasing number of children suffering from low-level mental health conditions like anxiety and depression. It is extremely worrying that a third of local areas in England are actually reducing real terms spending on these vital services.

"The children I speak to who are suffering from conditions like anxiety and depression aren’t asking for intensive in-patient therapeutic treatment, they just want to be able to talk to a counsellor about their worries and to be offered advice on how to stop their problems turning into a crisis.

"The NHS Ten Year Plan has made children’s mental health a top priority, but it won’t succeed unless children with low-level mental health problems are offered help quickly and early. Local authorities are under huge financial pressure and many are doing a good job, but those who are spending barely anything on low-level mental health cannot continue to leave children to struggle alone," she added.

The report looked into the amount spent on “low-level” mental health support for children in England such as preventative and early intervention services for treating problems like anxiety and depression or eating disorders, such as support provided by school nurses or counsellors, drop-in centres or online counselling services. These services are vital for offering early help to children suffering from mental health problems and can often prevent conditions developing into much more serious illnesses.

The analysis revealed that local areas, which included both local authorities and NHS spending, allocated a total of £226 million for low-level mental health services in 2018/19, just over £14 per child.

The report also unearthed discrepencies between areas in how much funding is available. While the top 25% of local areas spent at least £1.1 million or more, the bottom 25% spent £180,000 or less. This postcode lottery comes against a backdrop of the government making more funding available for children’s mental health nationally as the number of children in need of support and treatment from children’s mental health services has increased over the last decade.

It also follows the NHS Long Term plan, published in January, which revealed that less than a third of children with a mental health problem are accessing treatment and support. While this figure demonstrates an improvement as only a quarter of children were seen in 2015/16, and more money is being spent on children’s mental health services than in the past, with new targets set, many children who currently seek specialist treatment are not receiving it.

Indeed, the rate of improvement is highly variable across the country and the increase in capacity is not keeping pace with increased demand.

The report also shows that where spending has fallen it has often been driven by reduced spending by local authorities. In 2018/19, spending per child was higher in London and the North East but lower in the East Midlands, the East of England and the South East. In London, local authority spending per child on low-level mental health services was £17.88 per child, compared to only £5.32 per child in the East of England.

Charlotte Ramsden, Chair of the Association of Directors of Children's Services Health, Care and Additional Needs Policy Committee, said: “Poor mental health and wellbeing can have a devastating and lifelong impact on the lives of children and their families so it’s crucial that they receive the right support, in the right place, at the right time. Yet all too often children experience difficulties in accessing services, wait months for support and reach crisis point in the process. This report fills a gap in what we know about how much is being spent by local areas on mental health support for children and young people who don’t meet the threshold for statutory services.

"However, this is not the whole picture and the report itself acknowledges data limitations. The report finds that total reported spend in this area has increased each year between 2016/17 and 2018/19, but this masks local and regional variances in spend per child – more work is needed to understand the reasons for this. The report states that a greater proportion of the total spend across all three years came from local authorities, via children’s services and public health budgets, as opposed to CCGs despite councils facing huge reductions in our funding and rising need for services. This is simply unsustainable.

"We welcome the government’s focus on improving children’s mental health and wellbeing but if we are to truly transform the system in the way that vulnerable children so rightly need and deserve there must be investment in both specialist services for children and young people as well as services that prevent mental health problems from escalating and becoming entrenched in the first place," she added.

Chair of the Local Government Association’s Children and Young People Board, Cllr Anntoinette Bramble, said: “Significant funding pressures mean many councils are being forced to cut some of the vital early intervention services which can support children with low level mental health issues and avoid more serious problems in later life.

“Children’s services face a funding gap of £3.1 billion by 2025 while public health services, which also help children get the best start in life, have seen cuts of £700 million. If we are to improve provision of preventative and early intervention services then it is vital the government adequately funds these in the forthcoming Spending Review.

“But we also need the NHS to work more effectively with councils. In addition, the government promised £1.7 billion for children’s mental health, and it should make certain that all of this is received by children’s mental health services, and not diverted elsewhere. Where it has been spent on other services, government should make up the shortfall.”

Early access to mental health support

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