We, as a group of child mental health professionals, academics, campaigners and politicians, agree with the sentiments expressed in your front-page article (Shortage of mental health care is putting children at risk, GPs warn, 31 December).
The slogan of requiring “a parity of esteem” between physical and mental health in society, often used by ministers and others, needs to become an urgent future reality if we are to stem the emerging epidemic of mental health problems among young people. Some of us believe it would be wise to redirect 20% of current reactive spending on this area towards focused preventive programmes such as mental health first aid and other evidence-based interventions. We think this would ameliorate the current reliance on clinic-based and psychiatric medication-based interventions and reap rich rewards and results.
We support the rapid expansion of proven approaches such as whole-school wellbeing programmes, cognitive behavioural therapy and mindfulness to tackle underlying anxieties, along with other evidence-based psychological, talking, physical, art and family therapies to identify the mental distress caused possibly by earlier life trauma. Now is the time for our government to show some new year resolve on this issue.
Dave Traxson Chair of Calm (Child-friendly Alternatives to Labelling and psychiatric Medications), Professor Peter Kinderman Vice-chair of Calm, and chair of clinical psychology at the University of Liverpool
• Your article about failing NHS provision for adolescent mental health made distressingly familiar reading. It will soon be the first anniversary of my son’s exposure to child and adolescent mental health services (Camhs). He has been on a large dose of antidepressants since January. The medicine’s instructions say it is not to be used on children without talking therapy; he has had only five sessions of talking therapy.
He shows some symptoms of depression, his only diagnosis. He has become verbally and physically violent; his schoolwork – already poor – went off a cliff, as did attendance. He has started to self-harm. His unsupportive school showed him the door; and in the period of having no school, Camhs offered us no additional support despite pleas to manage a crisis. They also seem unwilling to screen for any other conditions, despite various indications that he has conditions other than depression. Never in my professional or personal life have I encountered a service as abject and incurious as that imposed by Camhs. My beautiful and clever son seems a shell of who he once was and I have gone from being fearful for him to being afraid of him.
Name and address supplied
• Your article says NHS England played down the findings on which you report, saying that the survey was based “on the view of a tiny fraction of GPs – roughly 3%”. The margin of error in similar random samples is related to the number of responses, 1,000 in this case, rather than on the fraction of the population. The figures presented are so stark that small sampling errors cannot put the conclusions in any doubt.
Seaford, East Sussex
• Re your article (A doctor’s perspective: ‘Youth services are at breaking point’, 31 December), until austerity measures were implemented from 2010 onwards, the term “youth services” referred to a wide range of provision, including Camhs, professional youth services, drug and alcohol outreach programmes, and all-year-round activities including diversionary programmes that help young people to build up confidence, resilience and access to multi-agency support.
The decimation of most of these services can only have contributed to the escalation of child mental health concerns, now at unprecedented levels. A significant percentage of vulnerable young people have little or no contact with their GP, and often the GP surgery is perceived as a last resort for young people who are striving to cope with depression or suicidal thoughts. Therefore the survey of GPs on which you report reveals only the tip of the iceberg in terms of inadequate child mental health provision, and this problem can only be meaningfully addressed by reinvestment in youth services as a whole.
• The concern about mental health care for children is longstanding. In 2013 I was overseeing child protection in several areas of England. I wrote to the secretaries of state for health and education about young people with mental health difficulties who were profoundly distressed at being held on paediatric wards, because of the national shortage of child and adolescent psychiatric inpatient beds. It was and is a disaster waiting to happen. The ambulant adolescents, whose disturbance increases while confined on an inpatient paediatric medical ward, are among very ill young children who are, for example, being tube-infused with medication. The secretaries of state (Michael Gove and Andrew Lansley) in 2012 did nothing to mitigate the dangers then, and they still continue today.
Dr Ray Jones
Emeritus professor of social work, Kingston University
• As a former governor of an NHS mental health trust, I am not surprised that the promised increase in mental health staff is unlikely to be achieved (Report, 2 January). My trust relied heavily on locum doctors and agency and bank staff to cover vacancies, which in the area of mental health is not conducive to effective patient care – continuity of care is essential in building trust between patients and practitioners. The effect of Brexit, with EU staff leaving, the withdrawal of nurse training bursaries and NHS pay restraints are major factors in the failure to recruit more permanent staff – all directly caused by the government’s policies.
• In the UK, Samaritans can be contacted on 116 123 or email firstname.lastname@example.org. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org.