A “complete overhaul” of children’s mental health services is needed to address systemic failings that are preventing acutely unwell young people getting the help they need, council leaders have said.
The current “fragmented” system is overly complex and cuts to services are leading to long delays in children getting help, the Local Government Association said. The LGA, which represents more than 370 councils in England and Wales, called on the government and NHS England to back up their commitment to creating a more ‘joined up’ system with resources for councils to invest in preventative services.
The ‘fragmented’ system
Since April 2013, there has been a split in the commissioning of children’s mental health services.
Community (tier 1 to 3) services are commissioned by local GP commissioners, often with input and funding from local authorities. Hospital care (tier 4) is commissioned by NHS England.
Councillor David Simmonds, chair of the LGA’s children and young people’s board, said: “Councils have worked hard to protect the many services they provide for vulnerable children but in the face of 40 per cent cuts to local government, this has becoming increasingly challenging.
“Local authorities need the resourcing and flexibility to be able to invest in prevention and universal services in order to tackle mental health problems. Councils are committed to change and are already playing their part, but there are vital changes to the system that need to be made. It is absolutely crucial that the whole system is properly funded, resourced and joined up to ensure young people receive the very best services available.”
The LGA said there was “an urgent need” to fund community services so that children can receive help before their mental health deteriorates to crisis point. They pointed to research that found young people’s services received just £0.8 billion in funding in 2012, just under 6% of the overall mental health budget.
The LGA also said that current system does not link up issues that impact on children’s mental health as a result of their parents’ mental health issues which could relate to domestic violence, drug and alcohol abuse.
Campaigners described the current system as a “national disgrace” and said cuts to local authority and NHS teams meant thresholds had risen to the point that only severely unwell children got help.
Sarah Brennan, chief executive of mental health charity YoungMinds, said the charity’s helpline was inundated with calls from parents struggling to access services.
“They either cannot access services or they are stuck for months on a waiting list. Clinicians tell us that their services are at breaking point,” she said.
Data obtained by YoungMinds under the Freedom of Information Act found that more than three-quarters of NHS commissioning groups had cut or frozen their investment in children’s mental health services in 2014-15. Almost half of the local authorities that provided data had cut or frozen their funding for the services.
Brennan added: “Local services providing much needed mental health services should not have to operate in crisis. We have to get this right for children, young people and their families who are in desperate need of support.”
These delays have been there for a decade or more and the situation is not helped by the way CAMHS does not work.
I work in CAMHS in a specialist team. Our team is in a unique position where our waiting times are very low. In comparison, the generic and neuro teams have extensive waiting lists.
The people that work in these teams are extremely dedicated, but the pressure on them is unbelievable.
Commissioners need to provide us with the resources in order to do the job. There have been so many reshuffles in the organisation as a result. The result is huge waiting lists, and redirecting the less risky cases to charitable organisations who do amazing work, but have also had their funding cut. It is a vicious circle!