Latest waiting time figures highlight need for fundamental shift in focus for child mental health services 
- 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 a quarter are waiting more than 18-weeks for treatment
- Ten 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 and NHS Greater Glasgow and Clyde Valley
- 118 children and young people waited more than a year prior to being seen
- 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 increased investment in mental health services with a much greater focus on prevention and early intervention.
The call from the Scottish Children’s Services Coalition (SCSC) (see Notes to Editors for members), 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 be treated within Scottish Government waiting time target.
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 January to March 2019, the figures highlight that 4,237 children and young people started treatment at specialist child and adolescent mental health services (CAMHS) in this period.
The NHS in Scotland, including ten 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 73.6 per cent in the NHS in Scotland are being seen within this 18-week waiting time, still in itself far too long, more than a quarter (26.4 per cent) are failing to be seen within this period.
Individual health boards failing to meet this target are: NHS Borders (target achieved for 40.0 per cent), NHS Fife (72.8 per cent), NHS Ayrshire & Arran (81.6 per cent), NHS Grampian (43.3 per cent), NHS Greater Glasgow & Clyde (80.6 per cent), NHS Highland (81.4 per cent), NHS Lanarkshire (76.6 per cent), NHS Lothian (69.1 per cent) and NHS Tayside (57.9 per cent)
The figures also indicate that 118 children and young people in the quarter had been waiting for more than a year prior to being seen for treatment, an increase from 108 in the previous quarter (October to December).
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. 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, the SCSC has called for the Scottish Government for 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 we are continuing to fail thousands of children and young people with mental health problems.
“The great efforts the Scottish Government is making, including an additional £250 million for mental health over the next five years announced in its recent Programme for Government, is to be welcomed, but more clearly needs to be done.
“These newly released figures highligh that the NHS in Scotland, including ten of our health boards, are 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.”
The ISD figures released yesterday show that for the latest quarter to March 31st 2019, 85 young people in NHS Lothian waited over a year to be seen out of the 118 of young people waiting over a year across all NHS health boards in Scotland.
The number of young people waiting within the 18 week target in NHS Lothian has increased to a record 540, 69.1%, which is still below the national average of 73.6% seen within the 18 week target for the last quarter.
In NHS Lothian more young people are being seen within the 18 week target, however the 85 young people waiting over a year to be seen still makes up 72% of all young people waiting over a year to be seen in Scotland for the same quarter.
The CAMHS Workforce Report states that “NHS Grampian and NHS Lothian’s child & adolescent populations are projected to increase the most by over 6.0% each” (page 8), which means that NHS Lothian CAMHS will need extra funding to meet future demand.
Scotland’s first Youth Commission on Mental Health produced a report last week that said fundamental change was needed to the way young people with mental health issues were supported. Recommendation included that mental health education be embedded within the school curriculum and for education professionals to be trained in mental health support.
The commission’s also called for waiting times to access child and adolescent mental health services to be reduced to eight weeks.
Scottish Conservative Health Spokesperson, Miles Briggs, said: “This provision of mental health services for young people in Lothian is nowhere near where it needs be.
“Hundreds of young people are waiting over the 18 week target every quarter in NHS Lothian to be seen by a mental health professional.
“There has been a mental health crisis for young people in Lothian for many years now and the complacency of SNP Ministers means that young people are suffering without the access to support that they need.
“The SNP must start taking the necessary actions to improve mental health provision for young people in Lothian immediately.”
