Change of a lifetime

The Community Care Changing Minds campaign was launched last August
against a backdrop of some shocking statistics.

Our survey of 1,500 care professionals found that almost 80 per
cent believed services were in crisis, with a massive 97 per cent
highlighting lack of resources as a key issue. It found that a
fifth of young people referred to specialist services were turned
away and two-thirds of them ended up receiving no service at all.
It also emerged that mental health problems were being
under-diagnosed in young people because staff were aware that
services were not available and were reluctant to diagnose a
problem they knew could not be dealt with.

The campaign aims were drawn up from what readers said was needed:
a national strategy, ring-fenced resources, a proper focus on
prevention, improved joint working and more support for carers. The
Mental Health Foundation, YoungMinds and the Royal College of
Psychiatrists endorsed these objectives.

Although the government appears to have taken on board many of the
campaign messages, the forthcoming Mental Health Bill offers a once
in a lifetime chance to address some of the outstanding issues. It
is vital that it includes children and young people and Community
Care will continue to lobby for that to happen.

Though much remains to be done, much has been achieved too. The
Changing Minds campaign received a boost in October with health
secretary Alan Milburn’s announcement of an extra £140m over
three years for services promoting young people’s mental health,
and additional NHS money. Both funding streams will include
conditions about joint working and possible use of flexibilities in
the Health Act 1999.

Guidance on how the new money should be spent is to be issued
shortly. Bob Jezzard, senior policy adviser for child and
adolescent mental health services at the Department of Health,
offered the Changing Minds conference in London last month some
hope on ring-fencing resources when he said: “This money is going
to local authorities and people are going to have to work together
to determine how the money is going to be used based on their local
strategy…But it must go on children’s mental health care and not
on anything else.”

He added that a lack of hard information about the gaps in CAMHS
had been a problem in the the past but that now the DoH was
compiling a database to help inform future policy.

Other encouraging developments include the Children’s National
Service Framework, to be published next year, which will set out
standards for child and adolescent mental health services pledging
year-on-year improvements in access to services.

The Department of Health has also set a target of increasing CAMHS
by 10 per cent each year across the service. All CAMHS teams must
also provide a comprehensive service in mental health promotion and
early intervention by 2006.

Meanwhile, the National Institute for Clinical Excellence and the
Social Care Institute for Excellence have started work on
guidelines in the treatment of depression in children and young
people. The two organisations are also working together looking at
the appropriateness of parenting programmes.

So these are exciting times and change is happening. But much
remains to be done. For example, preventive services such as
Connexions, Sure Start and projects funded through the Children’s
Fund have targets for areas such as reducing teenage pregnancy and
youth crime but not for addressing the emotional and mental health
needs of young people. That needs to change. We also need to see
more details on how the new children’s trusts will fit into the
jigsaw.

Increased efforts are needed to encourage those working in
education to play a greater role. Education will not be covered by
the new national service framework but behind the scenes attempts
are being made to build links with the Department for Education and
Skills to try and ensure that those involved in educating young
people are aware of the moves afoot to tackle mental health issues
among their client group.

Among other issues highlighted by our campaign was research on the
gross neglect of young people in prisons and young offender
institutions. Ninety per cent have a mental disorder or are
substance abusers. The lack of regard to their mental health
remains a national disgrace

Changing Minds also called for action to improve mental health
services for children in secure accommodation, homeless young
people, children in care and schoolchildren with emotional and
behavioural difficulties.

Community Care editor Polly Neate says that the campaign has built
up a momentum for change. “We need to maintain that pressure
because it is clear that as far as the policy makers are concerned
we are pushing at a door that is unlocked – it might even be
opening.” She added that with the shape of children’s services
about to change radically, there was an ideal opportunity to put
the prevention, assessment and treatment of children’s mental
health problems at the centre of services, where they belong.

“One in five children have a mental health problem with one in 10
needing professional help because it is so serious. With massive
numbers like this it is ridiculous that child and adolescent’s
mental health should be seen as marginal. We believe our campaign
really has changed minds and helped put this issue firmly at the
centre of the agenda where it belongs.” 

Soundbites

“I welcome the contribution Community Care is making to the debate
on the provision of child and adolescent mental health services…
The CAMHS external working group of the Children’s National Service
Framework has been established and it is addressing many, if not
all, the points raised by the campaign.”

Health minister – Jacqui Smith

“The campaign has brought the attention of a wider audience to this
much neglected issue. It has also helped demonstrate that the
social work profession has a key role to play in promoting young
people’s mental health. It’s not just about psychiatrists – it’s
everyone’s business.”

Peter Wilson, director Young Minds

“I share the concerns about the availability of mental health
services for children, adolescents and their families… it is of
grave concern that adolescents are being put off seeking help,
because of the varying standards of support services.”

Liam Fox MP, shadow health spokesperson

Parliament

In October, David Hinchliffe, Labour MP for Wakefield, tabled an
early day motion in support of the Changing Minds campaign, which
has drawn wide support from MPs. It stated that the House of
Commons welcomes the launch of Community Care magazine’s Changing
Minds campaign to expand and improve mental health services for
children and young people. The early day motion:

Calls for increased funding for these services. 

Is alarmed that there is almost no specialist provision and few
community-based services available to this group; notes that such
services were specifically called for by the predecessor health
committee.

Recognises that young people are ending up back in the mental
health system as adults with more severe and enduring
difficulties;

Further notes there is no national policy on where young people
with mental health problems should be treated.

Calls on the government to convene a task force to draw up a
national strategy for England covering all mental health services
for children and young people.

Campaign highlights

The campaign was launched in August with a survey of social care
professionals that found that almost 80 per cent believed services
were in crisis. A total of 97 per cent believed they were
under-resourced. 

More than 5,000 people have signed our petition calling on the
government to ensure improvements in CAMHS.

Hundreds of readers have written to their MPs using letters
distributed in Community Care.

At the national social services conference in Cardiff in October
health secretary Alan Milburn announced funding of £140m over
three years for CAMHS. 

In November, David Hinchliffe MP chaired a campaign parliamentary
briefing and declared there was still “everything to play for” when
lobbying for a specific section on young people in the new Mental
Health Bill.

The Changing Minds conference held in London last month was sold
out and participants heard that although the task ahead was
daunting, a panoply of new developments on young people’s mental
health were now under way.