New report on the state of Children’s Mental Health Services

13 Apr

On 30 January 2020, Anne Longfield, the Children’s Commissioner for England, released a report on ‘The state of children’s mental health services’. She mentioned that the National Health Service (NHS) improved provision for children’s mental health services.  However, it is still very much the Cinderella of the NHS – meeting the needs of only 12.8% of children in England, who have mental health problems.  While Longfield welcomed the progress that the Children and Young people’s Mental Health Services (CYPMHS), she warned of the chasm between children’s needs and the availability of services.

With the extra £60 million invested in special mental health services, an additional 53,000 children began treatment.  There was an improvement in tackling eating disorders, where the number of youngsters accessing services increased by nearly 50% since 2016/17.  However, much more needed to be done.  Only 3% of children were referred to the services – which was one in four with a diagnosable mental health condition.

The headline data in Anne Longfield’s report were as follows.

(1) Children were waiting just under eight weeks – i.e. 53 days on average – to enter treatment.  A year ago, the wait was 57 days.  For eating disorders, waiting times were much shorter.  About 80% of children with eating disorders accessed services within four weeks.

(2)   Treatment across the country was hugely variable.  In four Clinical Commissioning Groups (CCGs), more than 90% of children referred were being treated by the Children and Young People’s Mental Health Services (CYPMHS).  These CCGs were Southwark, Croydon, Corby and Lambeth.  However, there were 10 CCGs where more than half of children referred to CYPMHS were not receiving treatment.  These included Knowsley, where 64% of the referrals were closed before the youngsters accessed treatment.

(3) Children account for 20% of the population.  However, they received 10% of the total spent on mental health in the country. The NHS, on average, spent £225 on an adult but only £92 for a child.

(4) Out of 195 CCGs in England, 161 increased spending on CYPMHS (per child) in 2018/19.  On average, spending increased from £54 per child to £59 in real terms.  Overall, an additional £50 million (in real terms) was spent on children’s mental health in England.

(5) To maintain the current rate of expansion will require a significant commitment and resources beyond 2024/25. Anne Longfield found that more could be done in the next five years.

(6) She sent formal statutory notices to several areas where national data indicated they lagged behind provision made for these children in the rest of the country.

Commenting on her report, Anne Longfield said:

“There has been welcome progress on children’s mental health services over the last couple of years, and more progress is promised over the next few years. Nevertheless, there is still a chasm between what children need and what is being provided. More children are seeking help for their mental health and the Government needs to make sure that help is available. We are still a decade away from a decent mental health service for all children.

“It is still not clear whether national and local government and the NHS is facing up to the scale of problems in children’s mental health services and the devastating impact this has on children. The Government doesn’t have a plan for a comprehensive service in every area and there is still no commitment to a counsellor in every school, which would make a huge difference.

“After years of Government announcements on children’s mental health, children’s mental health remains the poor relation of NHS spending, receiving a fraction of the money invested in adults. Most areas are still spending less than 1% of their budget on children’s mental health services, and the postcode lottery of care means some areas are years ahead of others in improving services.

“It is important to recognize and welcome the real progress that is being made. More children are receiving the help they need and even more will in the future. But the Government urgently needs to commit in the next Spending Review to providing help for 100% of children, not just 20%. If not, thousands of children with mental health problems will continue to suffer and become adults without getting the help they need.”

Commentary

Since September 2019, Ofsted has been assessing how well schools and academies are supporting children with mental health and promoting their well-being. The inspectorate has woken up to the realisation that one in 10 primary-age child (three per class) suffers from mental ill-health.  At secondary level, one in seven children has an identifiable mental health condition.

School and academy staff have been pivotal in identifying mental ill-health among their pupils and providing them with succour – either directly, referrals to the NHS or drafting in organisations like A Place2Be, the Anna Freud Centre and Young MindsThey have often gone it alone, building close, professional and confidential relationships with them and offering strategies for dealing with their personal and family issues.

The February/March 2020 edition of National Governors’ Association’s magazine, Governor Matters, carried a report by Roger Silk and Roger Wilson, the Chair of the Governing Board and the Head of Pastoral Services respectively at Drapers Mills Primary Academy in Thanet, Kent, who are at the sharp end of mental ill-health where there is a high level of deprivation. The area has the highest level of young people under the age of 18 who use the country’s mental health services.  Altogether, 20% of adults suffer from mental ill-health.  Wilson said that one of the biggest problems that the academy has is supporting pupils, who have witnessed domestic abuse.

Both, he and Silk, offered six tips to school/academy leaders and governors, to support children who suffer from mental ill-health. These were as follows.

(1)       Get to know your children and their communities. Train and educate governors to make them aware of the context and area issues.

(2)       Research what support is there in the community and on-line.

(3)       Provide training and support for all staff on mental health and well-being.

(4)       Follow up on safeguarding referrals and utilise data collected to make changes in your school/academy. Include safeguarding and mental health on the agendas of meetings to ensure that the topic is discussed.

(5)       Give children a voice. Involve them in decisions and make it easy for them to speak to an adult if something is troubling them. Provide them with safe places where they can go and feel calm.

(6)       Encourage governors to challenge their headteachers on the provision to support children’s mental health issues and well-being.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: