‘Long way to go on child mental health’ as only third able to access treatment – Children’s Commissioner
There is “still a long way to go” on children’s mental health, with only a third of those with a probable mental health disorder able to access treatment, the Children’s Commissioner has said.
Dame Rachel de Souza (pictured) said increased investment is making a difference to children who are struggling, but the coronavirus pandemic has made the challenge “greater”.
She said average waiting times have decreased “substantially” since 2019-2020 – from 43 to 32 days – and NHS data also suggests more children are being accepted for treatment.
But her report found some children are still waiting too long to start treatment, many are not being accepted, and there are striking regional disparities for access and waits.
And fewer were referred for treatment in the first place – for the first time in four years – which is likely due to “disruption of the normal channels for identifying problems during the pandemic”.
This is despite NHS data suggesting the number of children with a probable mental health condition jumped to around one in six in 2020-21.
This suggests only around a third of children (32%) with a probable mental health disorder are able to access treatment, the report states.
Dame Rachel said her recent Big Ask survey, of more than half a million children, found they are not asking for “rocket science” but for someone to talk to when they need support, and earlier access so problems do not worsen.
She said: “Whilst the majority were happy with their mental health, we know some are struggling.
“Where they need support from children’s mental health services, I see improvements, and a focus on further improvements, but also there’s still a long way to go.
“Despite reductions in some waiting times, children still wait too long, even if fewer are being turned away.”
The new briefing is the Children’s Commissioner’s fifth annual report on the state of children’s mental health services in England, and the first with Dame Rachel in post.
She said the analysis, of NHS data covering the year up to March 2021, demonstrates there has been progress overall, but striking regional disparities remain between some Clinical Commissioning Group (CCG) areas.
For example, in East Sussex more than three-quarters of children accepted onto waiting lists over 2020-21 were still waiting for treatment to commence at the end of the financial year.
This compares with 14% of children in Castle Point and Rochford, in Essex.
Overall, over a third (37%) of children accepted for treatment were waiting for it to commence at the end of the year.
Children waited six days on average to start treatment in Castle Point and Rochford, but this increased to 81 days for those in Cannock Chase, Staffordshire.
Overall, 497,502 children in England were referred to children’s mental health services in 2020-21 – 4% of all children in the country.
The proportion of children whose referrals were closed before starting treatment fell to 24% from 27%, which suggests more of these children are being accepted for treatment.
National spending on child mental health services has risen for the fourth year in a row to £881 million – a real-terms increase of 4.4% from the previous year.
Eight out of 10 (82%) CCGs increased spending over the same period, and over half of CCGs (135) are spending up to 1% of their budget on children’s mental health, the benchmark set out in the NHS Long Term Plan.
However, 24 CCGs reduced spending between 2019/20 and 2020/21
Spending in some areas was as low as £16 per child (NHS Halton CCG), compared to £165 per child by the NHS Isle of Wight CCG.
Mark Russell, chief executive of The Children’s Society, said the fall in referrals in the year to March 2021 was “concerning”, and that they have since surged, including for “really severe mental health crises”.
He said: “While shorter waiting times to access treatment are welcome, the Children’s Commissioner’s analysis shows that far too many children are still being turned away.
“Our research with GPs last year found that it is common for young people to be referred and rejected a number of times, as they repeatedly fall below the threshold for CAMHS (children and adolescent mental health) services.
“We also found that, shockingly, more than a quarter of young people struggling with their mental health don’t ask for help because they ‘don’t want to inconvenience anyone’.
“It’s clear that there are still major barriers and stigma around mental health for children and young people and early support is essential.”
Imran Hussain, director of policy and campaigns at Action for Children, added: “The increased funding for mental health services is a drop in the ocean compared to the investment needed to combat the damage done to children’s mental health after almost two years of fear, anxiety and disruption.”
Lynn Perry, from Barnardo’s, said the charity was “grateful to the Children’s Commissioner for shining a light on this crucial issue”.
She added: “Being able to reach this support early at school will reduce the number of children who need specialist help from specialist mental health services.
“This is why Barnardo’s is calling on the Government to speed up the rollout of mental health support teams to help pupils and teachers get the support they need when they need it.”
A Department of Health and Social Care spokesperson said: “We recognise the impact the pandemic has had on everyone, especially children and young people who have faced disruption to their home lives and their education. That is why we have committed an additional £500 million this year to support those most affected, including £79 million for children’s mental health services.
“We are expanding and transforming mental health services in England – backed by an extra £2.3 billion per year by 2024 – to allow hundreds of thousands more children to access support. We have also appointed a Youth Mental Health Ambassador to assist us in supporting the mental health needs of our children and young people.”
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