Report highlights ‘serious gaps’ in mental health crisis care for children

There are “serious gaps” in crisis care for children with mental health problems, a new report has warned.

One in 10 local health areas has no plan to improve crisis care for young people, according to the Education Policy Institute.

This is despite acknowledgement from the Government for clinical commissioning groups (CCGs) to improve in this field.

Less than a third (31.6%) had an operational improvement plan in place.

“The provision of services for young people in mental health crisis is in many areas inadequate, a situation which has led to children being held in police cells, on adult wards, or moved to inpatient care out of their local area,” the authors wrote.

One of research organisation’s previous reports highlighted that some mental health services across England only offer care for those in desperate need during office hours.

It also stated that A&E departments often lack specialist expertise and young people can end up in police cells due to a poorly coordinated crisis response.

The Education Policy Institute analysed data taken from NHS England’s “dashboard”, which assesses a CCG’s improvements in children and young people’s mental health care.

The authors found that the number of children with mental health problems being treated on adult wards rose slightly last year – despite Government recommendations that no one under the age of 18 should be treated on an adult ward.

Between July to September last year, 90 youngsters spent a total of 2,654 days on adult wards, a rise from 79 children spending 1,938 days on adult wards between April to June last year.

The report also found that some local health bodies are spending twice as much on mental health care for children and young people than others.

Each CCG was asked to state their planned annual spending on children’s mental health and the EPI compared this data with child population estimates for each health region.

“There is wide variation in these levels of planned investment in children’s mental health care per capita across the country,” the authors found.

“CCGs in the top quarter spend over £52 per capita. Those in the bottom quarter spend £23 or less per capita.”

The report concludes that almost three quarters (73.2 %) of CCGs failed to meet NHS England’s benchmark for improving services.

Emily Frith, director of mental health at the Education Policy Institute, said: “This report highlights the extremely wide variation in funding and performance across the NHS on children’s mental health.

“It demonstrates that the Government still has a long way to go to drive up standards.

“Our analysis illustrates the need for further national scrutiny of local transformation plans and funding so that the much vaunted improvements to services are actually delivered.”

Natalie Perera, executive director of the research body, said: “The Government have invested £1.25 billion into children’s mental health. The fact that, two years in, almost three quarters of CCGs still fail to meet NHS England’s benchmark for performance demonstrates the need for urgent service improvements.”

Commenting on the report, Javed Khan (pictured), chief executive of children’s charity Barnardo’s, said: “This deeply alarming report shows what a postcode lottery children’s mental health treatment is in England.

“It is simply unacceptable that three quarters of local clinical commissioning groups (CCGs) failed to meet NHS England’s own targets for service improvement, which include having 24/7 access to mental health crisis care.

“Without support mental health issues can escalate having a deep impact on the lives of children and those around them.”

Peter Hindley, chairman of Royal College of Psychiatrists’ Child and Adolescent Faculty, added: “It is wrong that a postcode lottery can decide whether a seriously ill child receives good care or not.

“Commissioners must revisit their spending commitments in this chronically underfunded area.”

A Department of Health spokeswoman said: “Every child in crisis should get the support they need – that’s why we are investing £1.4 billion in children and young people’s mental health care and are holding CCGs to account for how this is used.

“We know change won’t happen overnight but improvements to services are on track – there are a record number of CAMHS (child and adolescent mental health services) beds and there will be liaison mental health services in every A&E by 2020.”

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