Worst on record: More than 2,000 children have been waiting over a year for mental health treatment

The Scottish Children’s Services Coalition (SCSC), an alliance of leading providers of children’s services, has called on Scotland’s political parties to make this new session of the Scottish Parliament a “Parliament for Mental Health”.

The call comes as new figures from Public Health Scotland indicate that at the end of March 2021, 2,012 children and young people had been waiting over a year for treatment from specialist child and adolescent mental health services (CAMHS) provided by the NHS.

These figures are the worst on record and represent a near tripling from March 2020 (696).They also represent more than 18 per cent of those waiting for specialist treatment.

With already under-resourced and overstretched services facing overwhelming pressure due to increased demand, the SCSC has raised concerns over a potential “lost generation” of vulnerable children and young people whose mental health is being impacted by Covid-19. 

Even prior to the pandemic cases of poor mental health were at unprecedented levels and there are a growing number of vulnerable children who cannot access adequate support.

While 4,089 children and young people were treated over the period January to March 2021 by CAMHS, only 72.5 per cent were seen within the Scottish Government’s waiting time target for the NHS of 18 weeks from referral to treatment (met for at least 90 per cent of patients). Only two out of 14 health boards met this target.

In addition to increased investment in mental health services, the SCSC has called for a renewed focus on prevention and early intervention, reducing the need for referral to costly specialist CAMHS. It has also called for greater partnership working between the public, private and third sectors as well as greater awareness of the services on offer, especially those at a community level.

A spokesperson for the SCSC commented: “These frightening statistics highlight the challenges ahead and a commitment by MSPs to focus on mental health, increasing investment in support services and intervention strategies, must be a priority for this parliament.

“We have for some time raised concerns over a potential lost generation of vulnerable children and young people, whose mental health is being impacted even further by the Covid-19 pandemic.

“This is a crisis we can overcome, but it will require a similar energy and commitment to that demonstrated for Covid-19 if we are to achieve this and prevent many young people giving up on their futures.”

Call for Scottish ‘Budget for Mental Health’ for children and young people

  • Figures show only 0.56 per cent of NHS expenditure on CAMHS and less than 7 per cent of the mental health budget
  • Varying figures across Scotland, with 0.75 per cent of NHS expenditure on CAMHS in Tayside and 0.08 per cent in NHS Orkney
  • Call comes as Children’s Mental Health Week takes place

A coalition of leading independent and third sector children and young people’s service providers has called on the Scottish Government to deliver a ‘Budget for Mental Health’ on Thursday (6th February).

The call from campaign group, the Scottish Children’s Services Coalition (SCSC), comes in week which also marks Children’s Mental Health Week (3rd-9th February).  It has urged greatly increased investment in mental health services for children and young people to tackle a current mental health ‘crisis’.

In a letter to Finance Cabinet Secretary, Derek Mackay, it has called for a significant proportion of the Barnett consequentials coming to the Scottish Government from the additional £34 billion a year the UK Government has pledged to go to the NHS to be spent on mental health.

The letter highlights figures indicating that a mere 0.56 per cent of the NHS budget is spent on specialist child and adolescent mental health Sservices (CAMHS), amounting to £67.248 million. In addition to this, only 6.61 per cent of the overall mental health budget is spent on CAMHS, a drop from 6.68 per cent on the previous year.

This is equivalent to just over 50p in every £100 of the NHS budget being spent on CAMHS.

These figures vary considerably across Scotland, ranging from 0.75 per cent of expenditure in NHS Shetland on CAMHS, 7.44 per cent of total mental health expenditure, to 0.08 per cent in NHS Highland, 2.92 per cent of total mental health expenditure.

These very low figures are despite the fact that mental health services are literally ‘creaking at the seams’ due to greatly increasing demand. 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.

The SCSC has also called for a renewed focus on prevention and early intervention for those with mental health problems. This includes on-demand counselling services in GP surgeries and greater community support generally, reducing the need for referral to under-pressure specialist CAMHS.

Latest figures on waiting times to access CAMHS, covering the period July to September 2019,  indicate that of the 3,901 children and young people who started their treatment, only 64.5 per cent had been treated within an 18-week waiting time period. This is short of the 90 per cent target set by the Scottish Government.

In addition, 204 children and young people have been waiting for over a year to be seen.

A spokesperson for the SCSC said: “As we mark Children’s Mental Health Week we are urging the Scottish Government to make the forthcoming Budget a ‘Budget for Mental Health’ for our children and young people.

“With three children in every classroom having a clinically diagnosable mental health problem, no longer can mental health be viewed as a ‘Cinderella’ service and we must put money behind the rhetoric to address the current crisis.

“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 are established by the age of 14.

“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.”

Young people dealing with mental health issues are to be guaranteed access to high quality support wherever they live, Mental Health Minister Clare Haughey  announced yesterday.

Health boards will receive new Child and Adolescent Mental Health Services (CAMHS) guidance which outlines the level of provision that children, young people and their families can expect to receive when they are referred for help within the NHS.

The first national CAMHS Service Specification, which has been developed in partnership with young people and their families, includes a number of aims such as reducing both the waiting time for a first assessment appointment and the waiting time for any subsequent treatment.

Ms Haughey said: “We are determined to ensure that any young person who is identified as needing support with mental health issues can get services that are appropriate to their needs.

“An important step towards ensuring consistent high standards is the development of agreed referral criteria and definitions and this Service Specification, developed in partnership with young people and their families, will help to ensure everyone gets the right treatment, at the right time and in the right place.

“All health boards are being provided with this specification and will be expected to set out plans on how they will implement it, with a formal review of how it is working across Scotland to take place after six months.

“In 2018/19 our investment in mental health reached £1.1 billion and over the life of this Parliament will exceed £5 billion – investment which will help deliver the best support available for children and young people dealing with mental health issues.”

Development of the service specification has been overseen by the Children and Young People’s Mental Health and Wellbeing Programme Board, which is jointly chaired by the Scottish Government and COSLA.

COSLA Children and Young People spokesperson, Cllr Stephen McCabe said: “We are grateful to the Children and Young People’s Mental Health and Wellbeing Programme Board for their work on the specification.

“This is part of a whole system approach and COSLA will continue working with partners to drive a national conversation on prevention and early support for children, young people and their families.”