Children needing mental health care are victims of postcode lottery say experts

MENTAL health services in Wales are failing children and young people, according to a damning report published today.

Four leading public bodies produced the 109-page report, which makes 17 recommendations to the Assembly Government.

It claims children with mental health problems are falling victim to a postcode lottery, with care and support good in some areas but non-existent in others.

In some areas, children were placed on adult mental health wards while elsewhere those with drug and alcohol addictions or eating disorders were ignored.

The report also found Wales is the only place in the UK with no specialist mental health services for children under five, an age group that would benefit from early intervention.

It found young people aged between 16 and 18 were also being let down because they were dropped by children’s services aged 16 but not picked up by adult care teams until they reached 18.

In one case, a family could not get help from social services for their violent 16-year-old son who suffered from Down’s syndrome and autism. He was later arrested and taken away from the family home.

It is the first time Healthcare Inspectorate Wales (HIW), the Wales Audit Office (WAO), Estyn and the Care and Social Services Inspectorate Wales (CCSIW) have combined to produce a report.

Yet hopes it might lead to an overhaul of mental health services in Wales have been dealt a blow by Health Minister Edwina Hart’s defence of the Assembly Government’s approach, branding the report “out of date”.

Jeremy Colman, Auditor General for Wales, denied the claim, saying: “The report highlights the most up-to-date improvements. Also, the performance information included in the report is current as at August 2009.

“As part of our normal clearance procedures, this report was shared with Assembly Government officials who confirmed they were happy that the report is materially accurate and presented fairly.

“There have been some improvements in recent years in mental health services for children and young people. However, additional investment alone will not deliver the further improvements needed, and the Assembly Government should take the lead in ensuring that changes to the design and delivery of services, as recommended in this report, are fully implemented.”

Children’s Commissioner for Wales Keith Towler, said an overhaul of mental health provision for children was “well overdue”.

He said: “I welcome this latest report that draws yet more attention to the issues that my office has continued to raise about CAMHS (Child and Adolescent Mental Health Services) in Wales.

“It’s extremely frustrating to look back at every annual report since the establishment of the Children’s Commissioner for Wales in 2001 and see CAMHS highlighted as a key issue.

“The time for change is well overdue, and I will be monitoring these recommendations. This is a clear infringement of the rights of these vulnerable children and young people, and I am looking for immediate action. These recommendations must be implemented quickly and effectively.”

The Assembly Government estimates 40% of children and young people in Wales have “recognisable risk factors” for mental health problems and 25% suffer from severe disorders.

The report called on the Assembly Government to produce a detailed national plan with clear priorities and targets to be published in six months.

Among its recommendations were improvements to child and adolescent mental health services and a unified approach to training for support workers, teachers, nurses and other professionals so that signs of mental health problems in children could be spotted earlier.

It also recommended that children and their parents should be involved more fully in decisions surrounding their welfare and children aged over 16 should not be placed on adult wards.

Dr Bill Maxwell, Estyn’s chief inspector, said: “It’s evident that there is still a lot of work to be done to ensure that all children and young people with mental health problems have equal access to a good range of support from specialist educational psychology, welfare and school nursing services.”

Acting chief inspector for CSSIW Jonathan Corbett said: “Children and young people with emotional and mental health problems often have complex and wide ranging needs that require a co-ordinated response from different professionals and services in the fields of health, social care and education.

“This report should help those tasked with meeting these challenges”

HIW chief executive Peter Higson said: “There is still a considerable challenge ahead for those providing mental health services to children and young people.

“We hope that this landmark report will assist them in meeting this challenge and Healthcare Inspectorate Wales, along with the Wales Audit Office, Estyn and CSSIW, will continue to monitor the progress made across Wales in developing comprehensive, effective and safe services.”

Health Minister Edwina Hart said: “The findings of this report are well out of date and do not reflect the wider improvements to children’s mental health services.

“In addition to the improvements that the report highlights, both speed of access to services and staff numbers have increased in the last two years.

“Waiting times for specialist services have fallen by almost 10%, with nine in 10 new cases seen within the target time.

“Specialist nurse numbers have increased by 15%, the number of clinical psychologists has more than doubled, and the number of mental health workers in primary care have almost doubled with specialist training courses rolled out for frontline staff.

“Improvements are also being made for patients requiring specialist in-patient care, backed by more than £35m Assembly Government funding.

“A new unit has opened in North Wales and interim improved facilities have opened in South Wales ahead of a new permanent facility next year.”