Hannah Richardson :
A total of 28% of children referred for mental health support in England in 2015 were sent away without help, some after a suicide attempt, a report says.
The Children’s Commissioner’s review of mental health services also found that 13% with life-threatening conditions were not allowed specialist support.
This group included children who had attempted serious self-harm and those with psychosis and anorexia nervosa.
A government spokesman said no-one should be sent away in need.
The commissioner obtained data from 48 of England’s 60 child and adolescent mental health service trusts.
One trust in north-west England said it focused resources on the most severe cases.
‘Russian roulette’
There have been concerns in recent years about the patchy nature of services offered by child and adolescent mental health trusts (CAMHs), with many seemingly unable to cope with local demand.
And school teachers and heads in some areas have highlighted the growing mental health need amongst pupils which are having to be met within schools.
‘Frightened the living daylights out of me’
Ellie Fogden, now 19, sought help when she was 16:
I did not become ill immediately at 16. For a number of years, I felt quite down, so to speak.
It was constant worrying, pressure from school, and my own body image.
I got to a point where I had had enough. I am waking up every day and I am not wanting to be here.
I self-referred to a local counselling service and I was on a waiting list for about three months and then started sessions. The counsellor was very worried and she referred me to CAMHs.
I had to go to the doctor to get a referral and it took about three to four weeks to get a session. I was in there for about three hours and I was just bombarded with so many questions. Some of them I didn’t have the answer for because I didn’t understand what was going on in my head.
I wasn’t taken seriously enough. Some of the questions were dismissed as – it is not that bad, people have it worse. For me, it felt awful. There was no compassion which made it so much worse.
I didn’t go back for another CAMHs appointment. It frightened the living daylights out of me. I finished counselling at this independent service. I wasn’t great but wasn’t as bad.
As I have grown older, it has just gone into a downward spiral where I am currently worse than I was when I was 16, with depression.
The review, by commissioner Anne Longfield, aimed to cast light on local weaknesses so provision can be improved, and more young people’s needs be met.
She told BBC Radio 4’s Today programme that over the past year, she had heard from a “constant stream of children, parents and professionals” about their inability to get help when they really need it.
They go to their GP who refers them to specialists, but the specialists then say their conditions are not serious enough, she said.
“There is a gap emerging between the help and support that GPs can offer and the specialist services,” Ms Longfield added.
“I don’t yet know quite why they are being turned away but certainly being turned away or put on a waiting list for up to six months is clearly playing Russian roulette with their health.”
Missed appointments
The average waiting time for those accepted for support ranged from 14 days in a trust in north-west England to 200 days at one in the West Midlands.
More than a third of trusts, around 35%, said they would restrict access to services for children who missed appointments.
However, the report notes that children and young people are known to have difficulty in attending appointments for many reasons.
Ms Longfield said trusts have told her there was “too much demand” for their services.
“There is more awareness, more people coming forward for help,” she said.
“But actually this is about recognising the terrible conditions children are in and looking at how their local systems can respond. Clearly in some parts of the country, they are doing the job much better than others”.
Natasha Devon, formerly the government’s mental health champion, said in order to identify problems in the early stages, it was necessary to look at the root causes.
“Anxiety, for example, is the fastest growing illness in under-21s, and we need to look at what’s happening to young people – the culture and the society they live in, the pressures that are on them.
“Rather than medicalising what is actually just a response to what is happening to them, we need to look at the environment they are in.”
‘More compassionate’
James Morris, the Conservative MP who is chair of the all-party group on mental health, acknowledged that problems had been building up in the system over many years and a “fundamental transformation” was required.
“It is unacceptable that somebody who’s suffering from a serious mental health problem should find themselves in a situation where they can’t get access to care,” he told the Today programme.
“We do need to move towards a more compassionate system for children and young people but the transformation is going to take time. It’s going to require additional investment; it’s going to require better commissioning on the ground.”
An NHS England spokesman said: “While the data in this report does not substantiate the conclusions drawn, it is clearly the case that CAMHs services need to expand and the additional £1.4bn pledged will help us to do that.”
A Department for Health spokesman said: “This investment is just beginning and is creating new joined up plans to improve care in the community and schools to make sure young people get support before they reach a crisis point.”
A total of 28% of children referred for mental health support in England in 2015 were sent away without help, some after a suicide attempt, a report says.
The Children’s Commissioner’s review of mental health services also found that 13% with life-threatening conditions were not allowed specialist support.
This group included children who had attempted serious self-harm and those with psychosis and anorexia nervosa.
A government spokesman said no-one should be sent away in need.
The commissioner obtained data from 48 of England’s 60 child and adolescent mental health service trusts.
One trust in north-west England said it focused resources on the most severe cases.
‘Russian roulette’
There have been concerns in recent years about the patchy nature of services offered by child and adolescent mental health trusts (CAMHs), with many seemingly unable to cope with local demand.
And school teachers and heads in some areas have highlighted the growing mental health need amongst pupils which are having to be met within schools.
‘Frightened the living daylights out of me’
Ellie Fogden, now 19, sought help when she was 16:
I did not become ill immediately at 16. For a number of years, I felt quite down, so to speak.
It was constant worrying, pressure from school, and my own body image.
I got to a point where I had had enough. I am waking up every day and I am not wanting to be here.
I self-referred to a local counselling service and I was on a waiting list for about three months and then started sessions. The counsellor was very worried and she referred me to CAMHs.
I had to go to the doctor to get a referral and it took about three to four weeks to get a session. I was in there for about three hours and I was just bombarded with so many questions. Some of them I didn’t have the answer for because I didn’t understand what was going on in my head.
I wasn’t taken seriously enough. Some of the questions were dismissed as – it is not that bad, people have it worse. For me, it felt awful. There was no compassion which made it so much worse.
I didn’t go back for another CAMHs appointment. It frightened the living daylights out of me. I finished counselling at this independent service. I wasn’t great but wasn’t as bad.
As I have grown older, it has just gone into a downward spiral where I am currently worse than I was when I was 16, with depression.
The review, by commissioner Anne Longfield, aimed to cast light on local weaknesses so provision can be improved, and more young people’s needs be met.
She told BBC Radio 4’s Today programme that over the past year, she had heard from a “constant stream of children, parents and professionals” about their inability to get help when they really need it.
They go to their GP who refers them to specialists, but the specialists then say their conditions are not serious enough, she said.
“There is a gap emerging between the help and support that GPs can offer and the specialist services,” Ms Longfield added.
“I don’t yet know quite why they are being turned away but certainly being turned away or put on a waiting list for up to six months is clearly playing Russian roulette with their health.”
Missed appointments
The average waiting time for those accepted for support ranged from 14 days in a trust in north-west England to 200 days at one in the West Midlands.
More than a third of trusts, around 35%, said they would restrict access to services for children who missed appointments.
However, the report notes that children and young people are known to have difficulty in attending appointments for many reasons.
Ms Longfield said trusts have told her there was “too much demand” for their services.
“There is more awareness, more people coming forward for help,” she said.
“But actually this is about recognising the terrible conditions children are in and looking at how their local systems can respond. Clearly in some parts of the country, they are doing the job much better than others”.
Natasha Devon, formerly the government’s mental health champion, said in order to identify problems in the early stages, it was necessary to look at the root causes.
“Anxiety, for example, is the fastest growing illness in under-21s, and we need to look at what’s happening to young people – the culture and the society they live in, the pressures that are on them.
“Rather than medicalising what is actually just a response to what is happening to them, we need to look at the environment they are in.”
‘More compassionate’
James Morris, the Conservative MP who is chair of the all-party group on mental health, acknowledged that problems had been building up in the system over many years and a “fundamental transformation” was required.
“It is unacceptable that somebody who’s suffering from a serious mental health problem should find themselves in a situation where they can’t get access to care,” he told the Today programme.
“We do need to move towards a more compassionate system for children and young people but the transformation is going to take time. It’s going to require additional investment; it’s going to require better commissioning on the ground.”
An NHS England spokesman said: “While the data in this report does not substantiate the conclusions drawn, it is clearly the case that CAMHs services need to expand and the additional £1.4bn pledged will help us to do that.”
A Department for Health spokesman said: “This investment is just beginning and is creating new joined up plans to improve care in the community and schools to make sure young people get support before they reach a crisis point.”
(Hannah Richardson is a BBC News education reporter)
