Baroness Tyler: End this battle to access children’s mental health services

Posted On: 
28th January 2019

While the NHS long term plan made some welcome promises on funding, critical questions over staffing, referral and waiting times remain unanswered, says Baroness Tyler

With a shrinking workforce and Brexit on the horizon, the prospect of finding the staff needed to treat all young people with mental illness seems unlikely, writes Baroness Tyler
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There is a growing consensus that children’s mental health services need to improve radically to address the ever-growing incidence of children’s poor mental health. The case for investment is clear. Over half of life long poor mental health starts before the age of 14 and three quarters by the age of 24.

By intervening early, we can provide vital support which will shape children’s’ wellbeing for the rest of their lives. It is totally unacceptable that many children and young people are receiving treatment far too late, or not at all. According to a recent report by the University of Birmingham’s Mental Health Policy Commission, the average wait for children between their first symptoms developing and being able to access support is ten years. The impact of these delays on the wellbeing of children and young people is not only unfair but incredibly harmful.

In a recent Guardian article, over a thousand GPs were surveyed across the country about their views on children’s mental health services. A staggering 99% of them feared that under-18s will come to harm as a direct result of delays in their mental health care. This is a particularly pressing issue given the sheer number of children with mental health problems: one in ten children has a diagnosable mental health disorder and demand for services is rising rapidly. Many of the GPs interviewed felt Child and Adolescent Mental Health Services (CAMHS) have simply not been able to respond to this increased demand for care.

As well as battling lengthy waiting times, many children get lost in the gap between primary care and CAMHS, which is supposed to treat only the most severe cases. Many children who need mental health support are too ill to be dealt with by Primary Care but are not ill enough for CAMHS. This means that many GPs end up having to refer patients to CAMHS despite knowing they will be rejected as ineligible.

Far too many young people are left caught in this gap with little way out. For many of these children, the only way to access the care they need is to either let their mental health deteriorate to crisis point or turn to private care. In fact, almost two-fifths of GPs would recommend patients whose families can afford it to go private.

This is an intolerable situation which creates an invidious divide between those who can pay to go private and those who cannot. Seventy years after the creation of the NHS, families should not be forced to pay for the mental healthcare their children so desperately need.

What is being done to rescue this situation? While there are clearly things to welcome in the recently published NHS long-term plan, such as increased spending on some mental health services including in schools, it also leaves many unanswered questions.

The long-term plan makes no mention of the current thresholds that children need to meet before CAMHS will treat them. Big questions also remain over the workforce and timescale. The number of Child and Adolescent Psychiatrists working in the NHS in England has decreased by over 3% in the last few years.

With a shrinking workforce and Brexit on the horizon, the prospect of finding the staff needed to treat all young people with mental illness seems unlikely. And while there is a long-term plan, the time frame for expanding access to children’s mental health services are simply too long.

What happens to those experiencing a mental health crisis here and now? Clearly more needs to be done, and quickly, to tackle this growing mental health crisis.

Baroness Tyler of Enfield is Liberal Democrat Lords Spokesperson for Mental Health