Primary school-age children with mental health problems will bear the brunt of cuts to child and adolescent mental health services, experts are warning.
Young Minds and the Royal College of Psychiatrists (RCP) say that unless mental health budgets are protected, children’s services will see a sharp rise in the number of teenagers with severe mental health problems within the next decade.
As budgets are squeezed Camhs teams will increasingly target resources at “cases with most urgent need” involving older children in crisis, says Young Minds policy and campaigns director Lucie Russell.
“We are not seeing specialist clinical care being cut. It is more low level provision that those younger children in particular need to ensure problems do not escalate,” Russell says.
Dr Margaret Murphy, chair of the RCP’s faculty of child and adolescent psychiatry, describes the ebbing away of support for under-12s with mental health issues as “an inevitable and sad consequence” of budget cuts.
“The focus will increasingly be on adolescents with more tangible problems such as suicide or self harm,” she says. “School age children under 12 are less likely to exhibit these and their level of disorder is likely to be at a lower level. The problem is that without support they are more likely to go on to become the more serious cases.”
Lack of ring-fencing
Russell blames the government’s focus on localism and a lack of ring-fenced funding.
“There is no direction from government so local areas are making their own decisions. In some areas the cuts are large. The quality of care will depend more than ever on postcode,” she says.
BASW professional officer Nushra Mansuri (pictured) says the cuts and the effect on younger children’s services runs in opposition to the government “rhetoric” in support of early intervention.
“We’ve heard what has been said by ministers in support of early intervention,” she says. “But the gap between that rhetoric and the reality is getting greater.”
During the summer Young Minds carried out an investigation into the extent of Camhs cuts. Out of 55 areas analysed, 29 said they intended to reduce spending.
Dave Munday, professional officer at Unite, says members are already reporting cuts underway in London but elsewhere cuts are mainly in the planning stages.
Lewisham is among the hardest hit areas. South London and Maudsley NHS Trust and Lewisham Council have cut the borough’s Camhs budget by £500,000.
Unite regional officer Richard Munn confirmed that “our appeal against the cuts in Lewisham has failed and the cuts are taking place.”
Munday says Unite members nationwide are bracing themselves for “eligibility criteria going up, waiting times for referrals increasing and posts disappearing.”
But not all areas are so unfortunate. NHS North of the Tyne has invested more than £1m in a community treatment service to support young people with mental health problems in their home.
The Royal Free Hampstead NHS Trust is to invest in an eating disorders service and Brighton and Hove Council has told Community Care that it is to keep its Camhs budget intact.
Among mental health services for looked after children being protected in Brighton and Hove is its Clermont Unit, which assesses the mental health needs of children involved in child protection cases.
But where cuts are taking place Munday concedes relationships between Camhs workers and social workers will become strained.
“It is frustrating for social workers. When they can’t access the mental health support they think a family needs then frustration sets in,” he says.
Mansuri agrees: “I think all sides recognise cuts are happening, but that doesn’t make it easier to deal with. This frustration can lead to a fortress mentality, with social workers left wondering how to get in and access the service. Already social workers find the eligibility criteria tough.”
Mansuri believes social workers and teachers will end up having to pick up the pieces left by Camhs cuts but points out they can only do so if they receive better mental health training focused on children suffering problems.
“This would be the next best thing. If it is harder to access Camhs services then others need to be able to know what to do and be in a better position to offer support,” she says.
A focus on joint commissioning would also ease the pain of budget cuts, says Daisy Bogg, member services development officer at The College of Social Work.
She says that while Camhs, in theory, is the responsibility of both councils and health trusts, in many areas only one body will take the lead.
“Where both have an equal say in the service and are commissioning jointly then we believe the service will be far more effective. Those with mental health problems are a hard-to-reach group often with complex problems. They are not just a social care group or a health group, they are both.
“If social care and health are just looking to protect their own budgets then that will have a negative effect on services,” Bogg adds.
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