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The Crisis In Children’s Mental Health Cannot Be Resolved With Warm Words

Children’s mental health services have reached crunch point. So why did the Government’s hyped up Green Paper offer little more than pitiful rhetoric?

07/12/2017 08:29 GMT | Updated 07/12/2017 08:29 GMT
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According to the Children’s Commissioner, there are 800,000 children living with mental health disorders - that’s the equivalent of at least three children in every classroom.

Demand for mental health support has reached unprecedented levels, and yet three in four children with a diagnosable mental health condition still do not receive the support they need.

For years, teachers and families have been left floundering, unclear as to how best to spot and tackle mental health problems among the children in their care. Many have struggled to get any help when a child is in difficulty until they reach crisis point.

And even then, a quarter of children referred to CAMHS by concerned parents, teachers and GPs are turned away by underfunded and overstretched services.

In words of the Centre for Mental Health, young people have often found help “too remote, too clinical and too stigmatising.”

Tackling this abysmal situation is at the heart of the Government’s ambitiously titled ‘Transforming Children and Young People’s Mental Health Provision’ Green Paper.

The Government rightly recognises the crucial role schools and teachers play in supporting children’s mental health. Schools can protect and promote a child’s emotional wellbeing with lifelong benefits.

For months then this joint venture between the Department of Health and Department of Education was hyped up as central to Theresa May’s promise to tackle the ‘burning injustice’ of mental health.

Sadly, though, the only injustice she’s highlighted has been her Government’s scandalous failure to provide an ambitious, fully funded solution to the mental health crisis.

The Green Paper was filled with fancy rhetoric, but lacked the meaningful action our children deserve.

Should we be surprised? The sad reality is that Theresa May’s Tories are aiming for just 35% of children with diagnosable mental health conditions to receive treatment by 2020/21. That still leaves 65% with unmet needs- an appalling reality.

The PM’s lacklustre effort is evident in the flagship announcement of the Green Paper - the creation of new Mental Health Support Teams. Supervised by clinical staff, these newly trained professionals will provide specific extra capacity for early intervention and ongoing help.

On the surface this sounds promising. Providing additional support for those with mild to moderate needs is a critical step in promoting good mental health and wellbeing.

As ever, though, the devil is in the detail.

The Government is committed to rolling out these teams to just 25% of the country by the end of 2022/23- a whole five years away. What of the other 75%? Even beyond 2022/23 there is no guarantee of a wider rollout- the Government has unhelpfully stated this “will be part of future spending review decisions.”

We also don’t know how many people will actually be recruited into these support teams. Nor have we been told the proposed ratio between teams and schools and colleges.

 

The Green Paper was filled with fancy rhetoric, but lacked the meaningful action our children deserve

 

Recruiting and retaining staff to work in the proposed new mental health support teams will be a major challenge. If the wider workforce is anything to go by, the picture is extremely bleak.

The number of NHS psychiatrists helping children and young people in England has fallen significantly despite growing demand for care, from 1,015 full-time equivalent posts in May 2013 to 948 in May of this year.

Moreover, more than 500 school nurses have left the profession without being replaced since 2010. Similarly, the number of educational psychologists employed by local authorities has dropped by 13% over five years- despite the Association of Educational Psychologists overwhelmingly reporting an increased demand for their services.

This is leaving teachers without vital training and pupils without necessary support, and significantly explains the dramatic and utterly unacceptable postcode lottery in mental health treatment: some under 18s have had to wait as long as 18 months for care- a damning indictment of Tory failure.

Accordingly, the second flagship proposal may be more promising. The Government has pledged to trial a four week waiting time target for specialist CAMHS. This is a welcome move because the longer a child has to wait for treatment, the likelier it is to impact adversely on their life and ability to go to school/college.

However, since CAMHS are increasingly overstretched, actually achieving a 4 week waiting time target requires far greater investment to ensure children and young people get timely access to the help they need.

After all, a mere 0.7% of the NHS budget is spent on children’s mental health, and only 16% of this is spent on early intervention.

Plus, even the money which is spent is failing to reach its intended target locally: 25 CCGs in England budgeted less than £25 per child on mental health services for the entire 2016/17 financial year, diverting CAMHS money to plug shortages elsewhere.

They are able to do this because the Tories have failed to ringfence mental health expenditure. This is a critical mistake by the Government and one Labour will immediately rectify in Government.

So how will the Government ensure that the waiting time target isn’t achieved by further raising the threshold for accessing services in local areas facing financial pressures?

Just last month we learnt that more than 100,000 children have been rejected for mental health treatment by NHS Trusts after being referred in the last two years. That’s the equivalent of 150 rejections a day.

There is a serious risk that without significant extra staffing and funding, hard-pressed services will meet the waiting time target by limiting who receives a service or limiting what each person can receive.

Rationing services further is entirely unacceptable.

The Government’s Green Paper was an opportunity to truly ‘transform’ children’s mental health support.

Instead, unambitious and weak proposals have been put forward, which will do little to fundamentally solve the profound funding and staffing issues afflicting the quality and quantity of mental health treatment available to vulnerable young people.

Prime Minister, this ‘burning injustice’ continues.

Jon Ashworth is shadow health secretary and Labour MP for Leicester South
Angela Rayner is shadow education secretary and Labour MP Ashton-under-Lyne