Children with mental health problems are waiting up to 18 months to be treated, a government-ordered report will reveal next week, in an indictment of the poor care many receive.
A Care Quality Commission report into child and adolescent mental health services (Camhs) will warn that long delays for treatment are damaging the health of young people with anxiety, depression and other conditions.
The NHS watchdog will conclude that when under-18s in England do get help from the NHS, it is “caring”. However, it will voice alarm that so many of them encounter much difficulty once they are referred by their GP or a teacher at their school.
Experts at the CQC who have drawn up the report, due to be published next Friday, were surprised to find that accessing care took so long and delays occurred in so many parts of England. Children can wait months after referral before their initial assessment and then further months before they start treatment.
Long delays are leading to some children starting to self-harm or fall out of education, couples breaking up and parents having to stop working so they can look after their child, the charity Young Minds said. Statistics show that one in five children referred for treatment in England cannot be seen by overstretched child and adolescent mental health services, and some families end up seeking private care.
“Improvements have been happening in some areas, but we regularly hear from parents who can’t get a referral, with their GP telling them to seek a referral via their school and vice versa. We also hear from parents who have been waiting for months for an initial assessment, and whose children’s conditions have got worse during that time,” said Jo Hardy, the head of parent services at Young Minds.
“Some parents tell us that their children have started to self-harm during the wait or that they’ve dropped out of school, which not only has a big impact on their own education, but also means that one of the parents has to give up their job to look after them.
“We hear from parents who’ve separated because of the pressure the wait is putting on the whole family, or who talk about the damaging effect it’s having on their other children,” she added.
The report’s authors learned that many child and adolescent mental health service units were struggling to cope because rising demand for care coincided with worsening staffing levels, especially at weekends, which is undermining the quality of care patients receive. It will also highlight how bed shortages are forcing the NHS to send children sometimes hundreds of miles away from their home area in order to be treated.
In August Sir James Munby, the president of the family division of the high court, said Britain would have “blood on its hands” unless the NHS found a bed for a 17-year-old girl, known only as X, who was at serious risk of taking her own life. He condemned the “disgraceful and utterly shaming lack of proper provision in this country” for young people struggling with mental illness.
“I welcome the CQC’s focus, including highlighting the very long waiting times and difficulty accessing care that too many children and young people endure,” said Dr Bernadka Dubicka, a psychiatrist and chair of the child and adolescent faculty of the Royal College of Psychiatrists.
Shortcomings in child and adolescent mental health services care mean some children end up experiencing a full-blown mental health crisis, she said.
“Although there has been some additional investment, money is not reaching the frontline, demand is increasing and children are being pushed into crises. Every day children and young people are being let down by the current inadequate provision across the system.”
The report was due to come out last week, but publication was delayed until next Friday after Downing Street intervened. No 10 asked the regulator to look into the state of mental health care for children and young people and made clear Theresa May’s keenness for the regulator to analyse an area of NHS care in which weaknesses have been causing acute concern to MPs, medical groups and families. The number of under-18s – especially girls – ending up in hospital as a result of self-harm has risen sharply over the past 10 years.
May has taken a particular interest in children’s mental welfare as part of her focus on mental ill health as one of the “burning injustices” she has pledged to tackle. It was a key element of her “shared society” speech in January, which was the first detailed exposition of her beliefs and philosophy since she entered No 10 in July last year.
Jeremy Hunt, the health secretary, last year claimed that child and adolescent mental health services were “possibly the biggest single area of weakness in NHS provision at the moment” and said “we are letting down too many families and not intervening early enough when there is a curable mental health condition”. Anne Longfield, the children’s commissioner for England, last week said there was “shockingly poor support” for children with mental health problems.
The CQC’s review of the evidence comes as the government prepares to publish a green paper on children’s mental health, which is intended to lead to what ministers, mental health experts and children’s campaigners say are overdue major improvements in care.
A CQC spokesperson said: “We have been tasked by the government to identify the strengths and weaknesses of the healthcare system to support children and young people’s mental health and help improve understanding of the pathways that they follow and the obstacles that they face. We will publish the first stage of this thematic review next week.”
Claire Murdoch, the mental health director for NHS England, said: “It is factually unarguable that after years of underinvestment, NHS funding for young people’s mental health services is now going up. In the past year alone, the figures show young people’s mental health spending has gone up by £100m.”
But she added: “But NHS England has also been explicit about the scale of unmet need, which recent improvements have inevitably only been able to begin to tackle.”
