22nd November 2018

Analysis shows children’s mental health services are showing signs of improvement – but a seismic shift in ambition still needed to meet demand

Anne Longfield, the Children’s Commissioner for England, is today (Thursday) publishing new analysis by her office looking at the provision of children’s mental health services in England. The research comes ahead of the publication today (Thursday) by NHS Digital of the first prevalence survey of children’s mental health since 2004.

The Commissioner’s briefing finds that Child and Adolescent Mental Health Services (CAMHS) are improving in most areas in the country, yet with the exception of eating disorder services, the provision of services in the youth justice system and in perinatal mental health care, the rate of progress is slow. A vast gap remains between what is provided and what children need. As a result, the current rate of progress is still not good enough for the majority of children who require help but are not receiving it.

Our main findings include:

  • Of more than 338,000 children referred to CAMHS last year, less than a third (31%) received treatment within the year.
  • Another 37% were not accepted into treatment or discharged after an assessment appointment, and 32% were still on waiting lists at the end of the year.
  • Less than 3% of children in England accessed CAMHS last year, a small fraction of those who need help. This is partly because many children who seek help are not accepted into treatment, but also because many children do not know they have a problem or do not seek help.
  • Of those children who did enter treatment, around half did so within six weeks.
  • However, nearly 80% of children entering eating disorders treatment are seen within four weeks.
  • Most areas are increasing funding for CAMHS, but parity with spending on adult mental health services remains a distant prospect. Nearly fifteen times as much is spent on adult mental health as on child mental health.
  • In cash terms this means children’s mental health services require an additional £1.7bn a year to achieve equivalent funding to that provided to adult mental health
  • Some areas are already far exceeding the existing NHS target to be treating a third of children with significant need (based on 2004 levels of prevalence) by 2021. Yet for every area exceeding what NHS England expects of them, there is an area failing to deliver.

The report does show areas of progress. In the last two years the NHS has delivered 70 new community eating disorder services for children, with a waiting time standard of one week for urgent referrals and four weeks for routine. There have also been welcome improvements in mental health care support in the youth justice system and in perinatal mental health.

The Children’s Commissioner’s Office has also compared the performance of Clinical Commissioning Groups. Using a range of indicators, our research suggests Ealing CCG to be the worst performing area, closely followed by Hounslow, Hammersmith and Fulham, Harrow and Hillingdon. In Ealing, over half of the children referred to CAMHS are not admitted for treatment after first assessment and those who do receive retreatment wait on average nearly three months. Other areas with poorly performing CCGs include Leeds, Sheffield, Nottingham, Bristol, Bradford and Leicester. The top performing CCGs are South Tees; Hartlepool and Stockton-on-Tees; Durham Dales, Easington and Sedgefield; Darlington; and Thanet.

Anne Longfield, the Children’s Commissioner for England, said:

“I welcome the progress that is being made in some parts of the country and pay tribute to hardworking NHS staff who are delivering improvements to the system. I am pleased to see an increase in workforce and the numbers of children seen by CAMHS. However, there is still a vast gap between what is provided for children suffering from mental health problems and what is needed to treat them. The current rate of progress is still not good enough for the majority of children who require help.

“I want to see the Government and NHS England dramatically increasing the level of ambition for children’s mental health services. The NHS 10-year plan needs to set out a vision for children’s mental health with clear targets and timetables. By 2023, the NHS should be in a position to ensure no child who needs help is turned away. There also needs to be a focus on early help. An NHS-funded counsellor in every school, providing a service that is accessible and child-friendly, would be transformative.

“All of this will require funding and leadership, but the prize is worth pursuing, and the NHS 10-year plan is the time to do it. We must not let this chance pass.”

Find out more in our report

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