‘Transformational change’ needed to tackle child mental health crisis, says SCSC

  • 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 third are waiting more than 18 weeks for treatment.
  • 9 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 Ayrshire and Arran, NHS Greater Glasgow and Clyde Valley and NHS Forth Valley
  • 204 children and young people waited more than a year prior to being seen for treatment, double that for the same quarter of last year.
  • More than one in five referrals for treatment are rejected.
  • Figures show only 0.56 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.

The Scottish Childrens Services Coalition (SCSC) 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 coalition, which campaigns to improve services for vulnerable children and young people, call 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 July to September 2019, the figures highlight that 3,901 children and young people started treatment at specialist child and adolescent mental health services (CAMHS) in this period. The NHS in Scotland, including 9 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 64.5 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 third (35.5 per cent) are failing to be seen within this period.

Individual health boards failing to meet this target are: NHS Fife (75.2 per cent), NHS Ayrshire & Arran (78.1 per cent), NHS Grampian (50.8 per cent), NHS Greater Glasgow & Clyde (71.2 per cent), NHS Highland (64.1 per cent), NHS Lanarkshire (51.9 per cent), NHS Lothian (55.9 per cent), NHS Tayside (54.2 per cent) and NHS Forth Valley (63.8 per cent).

The figures also indicate that 204 children and young people in the July to September quarter had been waiting for more than a year prior to being seen for treatment, an increase from 151 in the previous quarter (April to June) and more than double that from the  same quarter of last year (93). 2

 In addition, more than one in five (21.9 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 0.56 per cent of the NHS budget is spent on specialist CAMHS, amounting to £67.248 million.4   In addition to this, only 6.61 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 24.5

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. 6

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, with more clearly needing to be done to address this epidemic.

“These newly released figures highlight that the NHS in Scotland, including nine 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.”

Scottish Conservative Health Spokesperson, Miles Briggs, didn’t miss the opportunity to comment. The Lothian MSP said: “In Scotland we are facing a child mental health crisis and over 10,000 children and young people are being failed by this SNP government.

“There is a postcode lottery across health boards for whether you child will get mental health support when they need it, with my own region of Lothian being particularly bad.

“I am regularly contacted by parents who are worried about their children and it is heart-breaking for them when they are told their child can’t be seen for over a year.

“A greater focus must be given to prevention and early intervention by having mental health on the curriculum for all schools in Scotland.”

NHS Information Services Division, Child and Adolescent Mental Health Services Waiting Times in Scotland (PDF link), 3rd December 2019, Table 2, p. 7. Available at: https://www.isdscotland.org/Health-Topics/Mental-Health/Publications/2019-12-03/2019-12-03-CAMHS-WaitingTimes-Report.pdf? (accessed 3rrd December 2019).

Ibid., Table 1a in background tables, p.6.

Ibid., Table 4 in background tables, p.6.

5 Mental Health Foundation, Mental Health Statistics: Children and Young People. Available at:  https://www.mentalhealth.org.uk/statistics/mental-health-statistics-children-and-young-people (accessed 25th January 2016).

BBC online, Sturgeon announces boost for mental health services, 4th September. Available at: https://www.bbc.co.uk/news/uk-scotland-scotland-politics-45395739 (accessed 5th December).

Thrive Edinburgh to explore mental health matters across the capital

Organisations across Edinburgh have joined forces to start an ‘open and honest conversation’ about the future of citizens’ mental health.

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Dedicated counselling service for all secondary school pupils

Professional counselling services will be available to all secondary school pupils who require it by September next year.

Agreement has been reached between the Scottish Government and COSLA on the detailed allocation of £60 million over four years. This funding will build or expand high quality counselling services for children and young people.

Counselling services currently delivered by qualified and registered counsellors through Pupil Equity or Scottish Attainment funding will continue, enabling local authorities to reallocate those funds to other priorities to help close the attainment gap.

School counsellors help support young people’s emotional, behavioural and mental health. Importantly, pupils will also have access to counsellors during school holidays, providing vital continuity of care.

Mental Health Minister Clare Haughey said: “Children and young people can face many issues growing up and must have the right support available at the right time.

“Providing every secondary school with access to at least one counsellor by next year is a significant step forward in our package of measures to improve the mental health support available for children and young people.”

Commenting on the announcement, a spokesperson for the Scottish Children’s Services Coalition said: “This is very welcome news and is a vital step in improving the mental health of our children and young people through early intervention.

“School counsellors help support young people’s emotional, behavioural and mental health. Importantly, pupils will also have access to counsellors during school holidays, providing vital continuity of care.

“It has been estimated that the cost of five sessions of counselling is equivalent  to just one contact with child and adolescent mental health services (CAMHS).

“Therefore, investing a fraction of the mental health budget on school-based counselling services helps to keep the individual in school and avoid an unneccesary and often stigmatising mental health diagnoses, as well as reducing the burden on stretched and costly CAMHS provision.”

 

 

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