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Access to mental health services for children and young people

Background

Improving access to and engagement with mental health services is a central tenant of the Children and Young People’s Improving Access to Psychological Therapies (CYP IAPT) programme, which commenced in 2011. The Education Policy Institute (EPI) published their third report on mental health services for CYP on the 7th October, with the current report focussing on access to services. The report is timely, as the CYP IAPT programme will become self-sustaining from 2019.

Which methods were used to obtain data for the report?

The EPI sent Freedom of Information requests to service providers (Child and Adolescent Mental Health Services; CAMHS) across England. In 2018, 90% of services and 73% of local authorities (e.g., county councils) returned information requested (Service: 54/60 providers contacted; Local authorities: 111/152). However, the data returned varied in terms of quality and extent (e.g., missing data points). The Institute also analysed data from the Mental Health Forward View Dashboard, which highlights performance against targets for Clinical Commissioning Groups (e.g., responsible for planning and funding health services for the local area that they look after).

What did the report find?

 

 

 

 

Access to mental health services for CYP

  • The number of referrals have increased in the last five years by 26%.
  • 2% of referrals were rejected or were described as inappropriate – common reasons including the CYP did not meet the thresholds for treatment (i.e. the condition was not serious enough), or the condition was not suitable for intervention.
    • Of the referrals rejected, most services signposted CYP to a more appropriate service.
    • However, there was limited, or no follow-up after a referral was not accepted into CAMHS.
    • 27/111 local authorities reported no longer providing services based on supporting early help (e.g., support for CYP with mild-moderate mental health problems), or support in schools.

Waiting times (2017-18)

  • The average median waiting time (maximum number of days in brackets) was 34 days (267) to assessment and 60 days (345) to treatment.

What were the limitations of the report?

The Education Policy Institute highlights that the quality of the data received, as well as official published data, should be treated with caution, due to the lack of standards for reporting data and missing data from CAMHS providers. The report also emphasised that it is also unclear how the Government is currently progressing on its commitment to increasing the CAMHS workforce, which is an important foundation to consider when analysing access to treatment for CYP.

In sum, the report highlights that CYP continue to experience difficulties in accessing treatment (e.g., referrals accepted, waiting times) and emphasise that greater attention needs to be paid to early intervention and prevention – to take ‘demand out of the system’ (p.30). To do so, policy makers could focus on a child poverty reduction strategy and ‘whole school’ (p. 31) approach.

Blog post written by Dr Rachel Moss (Twitter: @DrRMoss), Research Associate on the PGR Wellbeing project at the University of Portsmouth (School of Education and Sociology). 

Today is World Mental Health Day

History of the day

The 10th October each year marks World Mental Health Day, which has been observed since 1992. Each year, the day focusses on a particular issue surrounding mental health. In 2018, the theme for #worldmentalhealthday is Young People and Mental Health in a Changing World. It is hoped that the theme focus will demonstrate the importance of addressing the prevention, early intervention and adjusting the information and services available to support the mental health of young people (CYP; defined as those between 15-24 years old).

Why focus on Young People and Mental Health?

Worldwide, between 10-20% of CYP experience mental health disorders. Of those 10-20% of children, more than half of the disorders start before the age of 14, and up to three quarters by the mid-twenties. Within the UK, current efforts to further support the mental health of CYP are being addressed within a national programme to transform existing mental health services (the Children and Young People’s Improving Access to Psychological Therapies programme). Early intervention and prevention have also received an increased focus within the Green Paper for CYP mental health.

Resources to support your general wellbeing

A number of online resources are available to support your general wellbeing today, and beyond:

What to do in a crisis

If you or someone that you know is experiencing a life-threatening medical or mental health emergency:

  • Call 999 and ask for an ambulance (or ask someone else to call for you)
  • Go to A & E (or ask someone else to take you)

Urgent care, but not life-threatening

  • Call 111 (England)
  • Book an emergency GP appointment

Use the ‘I need urgent help’ tool offered by Mind.

Further information on what to do in a mental health crisis or emergency is provided by the NHS. Help for suicidal thoughts can also be found on the NHS website.

 

Blog post written by Dr Rachel Moss (Twitter: @DrRMoss), Research Associate on the PGR Wellbeing project at the University of Portsmouth (School of Education and Sociology). 

Self care for Schools

Increased Expectations

With the start of the new academic year it has become clear that expectations and demands placed on schools in terms of mental health support have increased. More responsibility is being placed on schools to deal with mental health issues faced by their pupils. This has been justified by claims that mental health training for teachers will be provided but as demonstrated by the headteachers march on Friday 28th September 2018, schools are struggling enough already to provide the resources their children and staff need.

Mental Health First Aid Training

Many are praising the provision of Mental health first aid training in schools but is this really an appropriate solution? Placing more responsibility on schools due to a lack of resources in the NHS when schools are already facing a fall in their own resources doesn’t bode well the for future of our children. Dr Wendy Sim’s Schouten’s Conversation article discusses the implications that this might have long-term.

A GCSE in Wellbeing

The impact that this has on teachers and their own mental health is apparent. Teachers have more than enough to cope with already with increased demands placed upon them and many teachers report working in excess of fifty hours per week. So, placing the responsibility of pupils’ mental health on them in addition and justifying this by saying they have been provided training is perhaps a burden they shouldn’t have to bear.

Teachers’ mental health is paramount. If they do not have good mental health themselves this will reflect on their pupils. Many teachers have expressed concern that by not looking after their own mental health, they are putting their pupils’ progress at risk, with many claiming,

“I just want to get through the day,”

And others stating that they find it difficult to care as much when they are feeling depressed themselves or that the impact this has on their concentration and fatigue affects their teaching. #perhaps to support the mental health of pupils’ it is time for teachers to lead by example and attend wellbeing workshops to then provide a GCSE in Wellbeing.

Kids in Crisis

On Monday 24th September BBC One Panorama aired ‘Kids in Crisis’ which looked at the harsh reality of the mental health system in Britain today and the impact that long waits and high thresholds have on our children with some parents being told their child would have to attempt suicide before they would be seen. This is not in line with the ‘prevention and early intervention’ policy we have been led to believe as touted in the governments February 2018 paper, Looking to the Future – Improving Mental Health Outcomes for Children and Young People.

For the Future

The Mental Health First Aid England’s Supporting Organisation is Family Links, who strive to achieve mental and emotional wellbeing of families through the provision of support programmes for parents, children and schools. They strive for a family life utopia of balance between everyone who is involved with family life. Through the provision of education and training it is hope that this can be achieved. However, the key message here is to look at the provision and utilisation of resources. With troubling times ahead. Perhaps the government needs a new strategy.

 

Blog post written by Kayleigh Rivett, Support Officer (Themes) for the Research and Innovation Services at the University of Portsmouth (@uopresearch).