Today’s report from the Care Quality Commission into child and adolescent mental health services provision makes for sad reading. The CQC, commissioned by the Government to review child mental health services, has found that whilst most specialist services provide good quality care, too many young people find it difficult to access services. As a result, they do not receive the care that they need when they need it.
One young person told the CQC that they waited 18 months to receive help. Public Health England estimates that only 25% of children and young people who need treatment for a mental health problem are able to access it and the Royal College of Psychiatrists has noted difficulties in finding specialist inpatient beds close to a young person’s home.
Two weeks ago, I gave a similar warning about the state of children’s mental health support. Like the CQC, I acknowledge there are efforts being made to change things and that the staff working in children’s mental health are doing a good job in difficult circumstances. That was never my concern. It is those not getting the care they need – and why – that worries me most.
In a briefing I wrote for MPs, I estimated that fewer than a quarter of children needing mental health support received it last year. There are severe shortages throughout the system, with the majority of local NHS areas failing to meet NHS standards on improving services.
Yet the numbers we cite on delays, expenditures and percentages can only tell you so much. The reason my office has focused so hard on children’s mental health this year is that we also hear – day in, day out – from children themselves, their carers, teachers and health system professionals about just how desperate the need is out there.
Like the senior charity worker who contacted me this week to tell me how delays in providing support for her severely depressed teenage daughter ‘totally failed’ the family, who ultimately had to pay for care themselves.
“We are convinced that the reason our child is alive today, is that we threw all our principles out of the window and paid to get our child private health care. We are the lucky ones, what about those that cannot afford it who are failed every single day? This is why is so crucial that you spoke up because the lack of care and provision is a national scandal and the nature of the illness conspires to keep us silent as our kids feel judged and ashamed.”
Or the child mental health professional who wrote to tell me how CAMHS was letting down children throughout her local area:
‘Please do not reduce the pressure that you can bring to bear. Parents have lost faith in CAMHS.’
Or the mum who forwarded me her correspondence begging for help for her teenage daughter and the dad, desperate for care for his son.
These letters come to me from all over the country, all the time.
Many will have seen from the recent coverage of our letter to the Chief Executive of the NHS that we were not satisfied with NHS England’s response to our briefing. In our view they disputed figures and our analysis without addressing the central thrust of the number of children not receiving help and the scale of improvement needed.
Their response is also quite a contrast both to the many who have contacted us saying the same things we have, and today’s CQC report.
Are all these people wrong – all these children, all these parents, all these professionals? Is the GP who wrote to myself and NHS England this week describing services for children needing mental health support as ‘terrible’, wrong? Is the CQC, the health service’s regulator, wrong as well?
My office has a series of reports in production which will show just how poor the availability is for children with mental health needs. We recognise that NHS England has started to try to improve the situation and that it’s not their sole responsibility. There are some green shoots. But the system is clearly not providing the support needed to the majority of children. Using the statutory powers my office has available to command information, we have sought data from every corner of the NHS, wherever it will reveal the extent of need and the failure of the system to meet that need.
I’ve also called for a new focus on children’s mental health from across Government and at the top of Government. We expect Ministers to publish a Green Paper on possible ways forward very soon. I would like that to contain something I’ve long campaigned for: a qualified mental health professional for all schools, connected to the CAMHS system to triage cases, who children could seek assistance from in an environment less forbidding than is perhaps currently the case.
It is my job to continue fighting for a better deal for our children. All those people who contact me begging for help, and all our children, deserve no less.