'Everybody hurts […] sometimes' - How has the provision of mental health services for children and young people changed, and what will the future look like?
Ellie Tobin, Junior Analyst
Changing times are challenging the status quo
On average, one in ten children experience mental illness every year in the UK and these numbers are steadily increasing. The NHS, local authorities, schools and organisations from the voluntary and community service work together to provide Child and Adolescent Mental Health Services (CAMHS), which helps children and young people who are struggling with their mental health. Referrals to CAMHS have shot up by more than 26% in the last five years and they are now unsurprisingly overstretched.1 This can result in arduously long waits (of up to 18 months in some cases) from referral to first contact.
CAMHS work with children and young people to prevent and treat mental illness. It is estimated that half of all lifetime cases of diagnosable mental health illness begin by the age of fourteen. Early intervention can therefore mean that the risks of long-term mental ill health in adulthood are greatly reduced or even prevented.
Despite their crucial role and the wealth of evidence to support interventions earlier in life, CAMHS provision is fragile in many areas and varies in quality from region to region. This issue was recently highlighted by a BBC Panorama documentary, Kids in Crisis (aired 24/09/18), which emphasised in particular the disparity of mental health provision in different regions across the UK. Significant and sustained investment is necessary to overcome much of this discrepancy.
Nevertheless, we see cause for hope
Given recent negative press and challenging circumstances, I wanted to highlight ways in which CAMHS teams are striving to improve the current provision and future prospects for young people with mental health issues.
Since 2015, local and central government and healthcare commissioners have been prioritising CAMHS. The services received a £1.4 billion funding boost following the publication of the NHS report ‘Future in Mind’ in 2015. In order to guarantee their funding, each Clinical Commissioning Group (CCG) must now submit a yearly report to demonstrate how funding for young people’s mental health is being spent on young people’s mental health rather than other priorities. This is intended to help services improve rapidly and develop visions for improvement. One of the other major benefits of the yearly reporting is that local areas can focus on gaps in their individual systems and shift their spending to address these accordingly. Additional services now provided in local areas include eating disorder services and 24-hour hotlines.
Some services are already making significant changes, helping to turn hopes for a better future into reality. Lambeth has made early intervention a major priority by working with local charities, schools and the community to provide support for children who have displayed worrying changes in their behaviour for more than six months but less than one year. This is part of a wider Lambeth Made campaign focusing on the health and wellbeing of children and young people.
In Surrey, The Hope Service is an award-winning provider of CAMHS. Their speciality is in coping with crises in the community. They bring together social workers, nurses, teachers, psychologists, art/drama therapists, psychiatrists, a family worker and activity workers. This dedicated team provides support to young people in the community through day programmes. Their support reduces the need for hospital admissions for people with long-term mental health conditions which in turn creates better outcomes for children and their families.
Whilst there is unquestionably a long way to go in terms of developing a more comprehensive and more suitable CAMHS that fits the needs of young people, we are making positive steps in the right direction. The press has a tendency to highlight the unfortunate cases when the system does fail but there are many thousands of children who are being helped by changing and improving services. In addition, the public narrative surrounding mental health has shifted radically over the past five years, becoming increasingly open and accepting. The rise in demand is therefore in part a positive change. It indicates that more and more young people are calling for help rather than suffering in silence. The next challenge will be to tackle the drivers of demand and support wellbeing for young people to prevent mental ill-health in the first place.
- EPI report quoted in: https://www.bbc.co.uk/news/health-45748562