Children waiting too long for mental health treatment

The Sunday Times has recently published disturbing results of an investigation they conducted on long waiting times children must endure for mental health assessments at their local CAMHS unit. 

Waiting times varied from under a week to more than a year. One child waited for four years for help and another child committed suicide whilst waiting to be assessed by their local CAMHS. Following the Sunday Times investigation, CentreForum (an independent think tank that develops evidence-based research to influence both national debate and policy making) conducted their own report chaired by former Mental Health Minister Rt. Hon. Norman Lamb MP on child and adolescent mental health that addresses the ‘treatment gap’ faced by children today.

CentreForum uncovered that the median of the maximum waiting times for all providers was six months for a first appointment and nearly ten months for the start of treatment. Some providers did not measure waiting times at all, meaning that some patients could even be waiting longer than this. Additionally, it seems that children are essentially being treated under a postcode lottery system. For example, a child living in Kensington and Chelsea could be seen at their local CAMHS unit within two months, while a child living in Brent could wait for six months. One service informed CentreForum: “waiting times have grown within the service due to a significant increase in demand without an increase in resource/capacity to meet demand in a timely way”. 

CentreForum discovered that despite the fact there has been a significate rise in mental health issues amongst children in the last five years- in 2012/13 only 6 per cent of the mental health budget was spent on CAMHS, or around 0.7 per cent of the whole NHS funding, and only 16 per cent of this funding is on early intervention.* As Sarah Brennan, Chief Executive of YoungMinds, has stated the truth is that years of underfunding have left the whole system overwhelmed. The government has pledged extra money towards children’s mental health, but this money must be protected and spent where it’s needed most. Mental health problems are ruining the lives of families across the country every day, and that’s why urgent action is needed now.”  Heather Stewart, Chair of the ACP, said, “In my experience as a Consultant in a local CAMHS team, services were significantly reduced in the last five years and my fear is that the promises of increased funding will not necessarily result in the equivalent level of service that was available in 2010. As Chair of the Association, it has been painful to watch the downgrading of posts, the forced redundancies of senior and experienced clinicians with a corresponding reduction of choice for patients and the loss of the more in-depth relationship-based treatments, which might help the most vulnerable and ill children in our society.”

On average, CAMHS are turning away nearly a quarter (23 per cent) of children referred to them for treatment by concerned parents, GPs, teachers and others. Due to the inadequate funding and higher demand, CAMHS have had to implement tougher guidelines on admitting new patients. The stipulations of referrals in some CAMHS units have come to dictate that possible patients would have to be suffering from more than one condition and have higher risk factors in order to be seen. One CAMHS unit recommended that those “hearing voices in the context of mild anxiety, low self-esteem or low mood” should see their GP or voluntary sector counselling service and only be referred to CAMHS if they “heard voices that command particular behaviours”. 

The report says that to allow children to suffer severe effects from their mental health problems before they are treated, is counter-productive and stressed the need for more access to early intervention services. Financially, it is also counter-productive for the government to under fund early intervention services because the estimated long term cost to our economy of mental health problems is £105 billion a year. Research mentioned in the report, indicates that early intervention with social and emotional learning programmes for children has a return on investment of £84 for each £1 spent. While the government has pledged to invest £1.25bn over five years in improving the services, the funding provided at the moment is simply still lacking.

ACP media and comms lead and senior child psychotherapist working in a CAMHS service said, "Waiting times are only part of the problem. It's not enough to "front load" services, so that waiting times come down, we also need to make sure that there are the resources and specialists in mental health services to do thorough assessments and provide the right treatment at the right time. Also, previously there has been help available through services in the community, these once provided a safety net for children and families prior to a CAMHS referral. Many of these services no longer exist."  For the full report, read here

 

* Please note that figures for 2013/14 and 2014/15 have not been made available.