CAMHS Under Pressure

Children are resorting to severe self-harm and suicide attempts to gain access to Child and Adolescent Mental Health Services (CAMHS), new evidence reveals. Pupils as young as thirteen admitted to seeing suicide attempts and threats as the only way to flag the severity of their suffering.

The Children’s Commissioner Anna Longfield described how she visited one site where five occasions of threatened or attempted suicide had taken place since January, as pupils made a desperate bid for help: “Children with life-threatening conditions”, she said, “just aren’t getting the support they need.” Also reported were high levels of self-harm, which pupils had reconciled themselves to in a healthcare system they described as ‘looking the other way’. New pressures and fears, new mediums of communication and high expectations are fuelling an increase in young people seeking help, while simultaneously the means of support dwindles.

An inquiry is ongoing into CAMHS, under the control of the House of Commons Health Select Committee. Addressing the Committee, Ms Longfield said the disturbing new trend was something sites would not have witnessed five or six years earlier and that she was horrified by the consensus amongst young people that this was the only way to secure consistent and high level care: "In my slight naivety, I thought that was quite shocking, but as I asked others it seemed to be the norm.” Funding must be ring-fenced by the NHS in order to protect frontline services, argues the Commissioner, as schools around the country suffer with rising numbers of suicidal and severely vulnerable pupils.

Similar problems pervade beyond England. Wales is the only union nation that has made it a legal requirement for schools to make counselling services available for children older than Year 6, but the National Education Union has urged the Welsh Government to also do more to bolster CAMHS. There were 19,000 referrals to CAMHS between 2015-2016 in Wales, which was 3,000 more than the previous year. One council revealed a six fold increase over three years in the amount of pupils referred for self-harming, with some as young as six.

The NHS are launching a pilot scheme in Wales which aims to provide better mental health support for pupils who are showing signs of anxiety, depression or self-harm. These vulnerable children will be able to access specialist help and it is hoped that by spotting and intervening early, they will receive the right care at the right time. The trial will cost £1.4 million over two years and be based in the North East and South East of the country. Announcing the trial, Health Secretary Vaughan Gething said: "One in four people in Wales will experience mental health problems at some point in their lives. Getting the right treatment at an early stage, coupled with greater awareness of conditions, can in many cases prevent long term adverse impacts. This will ensure children, teachers and others charged with caring for children in our schools, receive support to promote good emotional and mental health.”

Scotland is the only UK country with no national standard for school-based counselling services. Maureen Witt, the Scottish Health Minister, described how it was up to local authorities to decide how mental health services were facilitated in their schools. She acknowledged that this meant it was often a "lottery" of care and the Scottish government have also admitted they have a "long way to go" in equipping health boards to provide the right care. A lack of mental health provision is leaving the youth of Scotland in distress and at serious risk, say key children’s charities. Between January 2016 and September 2016, 30,639 children were seen by CAMHS.

Local government body Cosla (Convention of Scottish Local Authorities) cited continuous budgets cuts as the cause of a shortage in mental health workers and educational psychologists in Scotland. Almost 7,000 of the 30,639 patients waited more than 18 weeks to receive help. With research suggesting that half of mental health difficulties start before the age of fifteen, the calls from the Scottish Children’s Service Coalition for urgent action to improve support are well founded. The Scottish Youth Parliament, Penumbra, Place2Be and Children in Scotland are also supporting the call for support to be improved in all schools and in the community.

In her first health care speech as Prime Minister, Theresa May announced the party plan for a 'shared society' approach to care. This approach is supposed to rely on expanding issues like mental health beyond the bounds of the health service, creating a unified and interconnected state sponsored approach. But in a culture of severe austerity, funding remains the main issue. Without ring-fencing provision money wanders to different causes and falls short of the worsening frontline of mental healthcare. Children are most likely to disclose they are struggling to a trusted adult, meaning teachers are perfectly placed to help and the right training and resources could provide a vital lifeline for a struggling child through education. But the Conservative government has already rolled back the initial training target set to equip secondary school teachers with mental health first aid training. They have also re-affirmed their commitment to role the scheme out to primary schools, but practicalities and figures are not forthcoming.

CAMHS is “possibly the single weakest area of NHS provision” admitted Jeremy Hunt, as data from 32 NHS Trusts reveal that two thirds of children referred to CAMHS received no treatment. One in five local authorities has cut or frozen CAMHS funding since 2010, with children sent to adult psychiatric wards and even police cells as provision dries up. The government plan to impose a maximum waiting time for children seeking mental health support from CAMHS of four weeks. However, financial and staffing limitations mean this is unattainable until 2021. The average wait to receive care in the England is currently 11 weeks. A heavy influx of cash and specialist staff is essential to stem the damaging tide of ineffective provision which is impairing the health and futures of so many young people. We should not live in a nation where the calls of a child for help go unheeded to such extreme lengths, or worse, until it is too late.

By Daisy Whittingham of Handsam Ltd

Handsam Ltd is a leading provider of compliance consultancy services, online management systems, support and advice to the education sector. Visit their online resource website at handsam.education to find out more about their offering to schools.

Handsam Ltd is a leading provider of compliance consultancy services, online management systems, support and advice to the education sector.

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