Many vulnerable children more likely to be rejected for mental health support, research suggests

By Aine Fox, Reporter15th August 2024News EnglandChild Protection, Childrens Services, Mental Health, News England, NHS, Social Work, Top Stories, Vulnerable Children

Some of the most vulnerable children are more likely to be rejected for mental health support than their peers, new research into thousands of records at an NHS trust has suggested.

Children from the most deprived areas are around two times more likely to be turned away from NHS Child and Adolescent Mental Health Services (CAMHS) than those from the least deprived areas, the Cambridge University and National Children’s Bureau report showed.

Those with general social work involvement are more than three times as likely to be rejected, according to analysis of more than 71,000 records from a large NHS trust in London.

Researchers have not named the trust to prevent finger-pointing at a particular service, because they said the problem is believed to be widespread across England.

The researchers said: “Findings are interpreted in light of practitioner engagement sessions and clinician interviews around the country, and work with a diverse group of experts-by-experience at every stage.

“These consultations have suggested that our findings for children with social work involvement for current concerns are generally indicative of the situation across England.”

While children who have social work help for current concerns and those on child protection plans are more likely to be rejected from CAMHS, children in care are less likely to be rejected.

The report authors suggested this is likely to be down to the fact that the NHS trust studied has dedicated services for children in care.

They also noted that experts had advised them that CAMHS can require young people to be in a “stable place” to receive therapeutic support, with the authors warning this can mean children in need miss out on help.

The authors stated it is “unjust to exclude children from mental health support if their family situation never becomes stable”.

They added: “Given that children and young people with social work involvement for current concerns or those living in poverty are more likely to face these challenges, which are often not easily resolved, such requirements may produce inequities in access for these young people.”

They have called for more “strategic investment” so that under-served groups can access mental health support, possibly including tailored support for children in poverty, and a dedicated pathway for children and young people at risk of entering care.

Anna Feuchtwang (picture), chief executive of the National Children’s Bureau, said: “Mental health services often require young people to be in a ‘stable place’ to receive support.

“But these young people’s lives can be highly unpredictable, whether that’s because of poor parental mental health or being at risk of harm or abuse, or because of more practical issues like lacking the funds to take public transport to appointments.

“The net result is that these children may never get the support they need – a system that accepts this as an answer is clearly one in need of reform.

“The Government must look urgently at removing the systemic biases within our services for children that discriminate against those who are particularly vulnerable so they get equal opportunities to benefit from high-quality mental health support.”

Professor Robbie Duschinsky, from the University of Cambridge, said: “For children who need it, mental health support is crucial. Children with current social work concerns or living in poverty are systematically more likely to be refused mental health services following referral.

“These are sad findings, and surprising to many of us. However, they may not be a surprise to children and families who need and use these services.

“Our research was prompted by discussions with people with lived experiences, who urged us to look at inequalities in access to mental health services for the most vulnerable groups of children. Their concerns have been borne out in the results described in this report.”

Julia Mannes, NIHR Three Research Schools Fellow at Cambridge, said: “Behind this data are real-life stories of children experiencing considerable psychological distress.

“They need and deserve specialist help but are too often turned away. This evidence will help policymakers shape systems that children and families can rely on for support.”

Nil Guzelgun from the charity Mind said: “This disparity in access to mental health support for children from the most deprived backgrounds is unacceptable, especially given their heightened need.

“To address these issues, the government must set out an ambitious cross-government strategy for mental health with adequate funding.

“This needs to prioritise young people’s mental health services and ensure all young people are able to access specialist mental health support when they need it, providing more targeted support in the most deprived areas and effectively addressing the link between poverty and mental health.”

An NHS England spokesperson said: “The NHS is providing mental health support to more children than ever before, with a more than 50% increase since 2019, while expanding provision as quickly as possible within the current five-year funding arrangements.

“There is more to do and that’s why plans are also in place to continue increasing access, including ensuring more than half of pupils can access an NHS mental health support team, offering early support in schools, by next spring – significantly ahead of the original target.”