Waiting time figures highlight need for urgent action to tackle child mental health crisis

• The NHS in Scotland failed to meet a maximum 18-week waiting time target for children and young people to receive treatment from mental health services
• More than 3 in 10 are waiting more than 18-weeks for treatment.
• 12 out of 14 health boards failed to meet the 18-week waiting time target:
  • NHS Fife, NHS Grampian, NHS Highland, NHS Lanarkshire, NHS Lothian, NHS Tayside, NHS Borders, NHS Ayrshire and Arran, NHS Orkney, NHS Greater Glasgow and Clyde Valley, NHS Shetland and NHS Forth Valley
• 151 children and young people waited more than a year prior to being seen for treatment, three times that for the same quarter of last year.
• More than one in five referrals for treatment are rejected.
• Figures show only 0.53 per cent of NHS expenditure is spent on CAMHS, less than 7 per cent of the mental health budget.
• Coalition calls for fundamental rethink and renewed focus on prevention and early intervention, including embedding mental health within education.

Latest waiting time figures have reinforced the call by a coalition of leading independent and third sector children and young people’s service providers for dramatically increased investment in mental health services to address the current mental health crisis.

It has also called for an urgent need to focus on prevention and early intervention in order to tackle what is one of the greatest public health challenges of our time.

The call from the Scottish Children’s Services Coalition (SCSC), which campaigns to improve services for vulnerable children and young people, comes as the latest waiting time figures from the Information Services Division, part of NHS National Services Scotland, highlight that thousands of children and young people are failing to treated within a Scottish Government waiting time target. ¹ 

With an increasing number of children and young people being identified with mental health problems they also highlight a postcode lottery for mental health treatment across the country.

Covering the quarter March to June 2019, the figures highlight that 4,010 children and young people started treatment at specialist child and adolescent mental health services (CAMHS) in this period. The NHS in Scotland, including 12 of the 14 regional health boards, failed to meet the Scottish Government 18-week waiting time target for children and young people to receive treatment from CAMHS. This target should be delivered for at least 90 per cent of patients.

While 69.7 per cent in the NHS in Scotland are being seen within this 18-week waiting time, still in itself far too long, more 3 in ten (30.3 per cent) are failing to be seen within this period.

Individual health boards failing to meet this target are: NHS Borders (target achieved for 80.7 per cent), NHS Fife (71.0 per cent), NHS Ayrshire & Arran (76.0 per cent), NHS Grampian (51.2 per cent), NHS Greater Glasgow & Clyde (76.4 per cent), NHS Highland (77.8 per cent), NHS Lanarkshire (60.9 per cent), NHS Lothian (58.6 per cent), NHS Tayside (61.3 per cent), NHS Shetland and NHS Forth Valley (87.8 per cent).

The figures also indicate that 151 children and young people in the quarter had been waiting for more than a year prior to being seen for treatment, an increase from 118 in the previous quarter (January to March) and three times that from the  same quarter of last year (52). ² 

In addition, more than 1 in 5 (21.3 per cent) are having their referrals for treatment rejected, with no real understanding of what is happening to them after this.³ 

It should be noted that a mere 0.53 per cent of the NHS budget is spent on specialist CAMHS, amounting to £61.074 million.⁴   In addition to this, only 6.34 per cent of the overall mental health budget is spent on CAMHS.

These very low figures are despite the fact that mental health services are creaking at the seams due to greatly increasing demand, as evidenced by these waiting time figures. Research indicates that 10 per cent of children and young people (aged five to 16) has a clinically diagnosable mental health problem (around three in every classroom), with 50 per cent of mental health problems established by the age of 14 and 75 per cent by the age of 24.

While acknowledging the great efforts the Scottish Government is making, such as an additional £250 million of funding announced in the Programme for Government of 2018, the SCSC has called for the Scottish Government to greatly increased investment in CAMHS and for a more consistent approach to delivering these services across Scotland.

It has also called for a renewed focus on prevention and early intervention for those with mental health problem, reducing the need for referral to under-pressure specialist CAMHS.

This includes embedding mental health within education from an early age in order to strengthen knowledge and awareness of mental health, as well as reducing the stigma associated with mental health.

Emotion and resilience classes should be provided to all students from primary one to teach students how to work through their emotions in a healthy way and there should be a whole-school approach, with training for all staff involved in education and providing counselling support.

A spokesperson for the SCSC said: “These latest waiting time figures highlight that fact in this mental health crisis we are continuing to fail thousands of children and young people with mental health problems. The great efforts the Scottish Government is making is to be welcomed, but more clearly needs to be done to address this epidemic.

“These newly released figures highlight that the NHS in Scotland, including twelve of our health boards, is failing to meet what is already a lengthy waiting time. Yet we know that three children in every classroom has a clinically diagnosable mental health problem.

“There must be a radical transformation of our mental health services, with a focus on preventing such problems arising in the first place and intervening early, especially when we know that half of all mental health problems begin before the age of 14.  This includes embedding mental health within education from an early age as well as providing training for all staff involved in education.

“With mental health and the issues associated with it representing one of the greatest public health challenges of our time, we must ensure that children and young people are able to get the care and support they need, when they need it. This includes investing in greater community support and support at school, reducing the need for referral to specialist CAMHS.”

Scottish Conservative Health Spokesperson, Miles Briggs MSP, said: “Almost a quarter of children and teenagers under the age of 18 are having to wait over a year to be seen by Children and Adolescent Mental Health Services (CAMHS) in Edinburgh and the Lothians.

“There is a mental health crisis for young people in the Lothian’s that is only getting worse due to SNP complacency over the issue.

“For a parent to be told that their child has to be wait over a year to be seen by a mental health specialist is extremely distressing and has become the norm in Lothian.

“As a Lothian MSP I am simply not willing to stand by and watch the CAMHS crisis further descend into an emergency.

“I have therefore again written to Jeane Freeman demanding action over these unacceptably long waiting times for children and young people’s mental health services waiting times in Lothian.

“Parents and guardians want urgent action to turn this totally unacceptable situation around and we have simply not seen SNP Ministers showing the leadership needed.”