THE BLOG

Teenagers Going Absent From Mental Health Care Is A Red Flag That Mustn't Be Ignored

27/09/2017 10:46

Mental health problems among Britain's teenagers are reaching epidemic levels.

Feeling the strain of exams, 24/7 social media, being selfie-ready or worried about their own personal safety, teenagers are coming under pressure like never before. The fallout is undeniable: last week shocking figures showed that 1 in 4 girls aged 14 are showing signs of depression. These girls, and many other young people like them, need help. But new research from The Children Society out today has found that the help on offer is failing some of the most vulnerable.

Our research reveals that alarmingly high numbers of teenagers who are referred for mental health treatment aren't making it to the appointments they're offered. Data we collected from Freedom of Information requests, found that more than 150,000 Child and Adolescent Mental Health Service (CAMHS) appointments were missed in 2016, at a cost to the NHS of around £45m.

That means thousands of teenagers not getting the help they desperately need and precious NHS funds misdirected. To have been referred to CAMHS for help these will be teenagers in real need and it's vital that we understand why they aren't making it to appointments and what can be done to get them through the door and on the path to getting better.

Playing the blame game here doesn't work - we all know the NHS is stretched and that these are vulnerable young people. There are many reasons why teenagers are missing treatment appointments, perhaps most importantly their mental health condition. Imagine being a teenager - already trying to cope with a serious condition such as anxiety or depression - having to make the journey to an unfamiliar, intimidating setting, like a hospital, and open up to a stranger whose questions may seem blunt, intrusive and unhelpful. Some of the teenagers we spoke to who missed appointments simply didn't trust that the system would help them.

Too often, opportunities to engage young people with mental health services are missed because of long waiting times. Our research has found that children are waiting on average almost 2 months (58 days) to be assessed and then almost 6 weeks more (41 days) for their first treatment, which we believe is another driver behind missed appointments.

In the end, the outcome is the same for many of the young people we talk to: those who drop out of CAMHS end up being referred again later down the line, with deteriorating mental health, needing more intensive support.

If a teenager doesn't show up at school, concerns are raised and staff follow up, but when they miss their CAMHS appointment, all too often all that happens is another appointment is scheduled and the cycle continues until that young person is discharged, without them getting the treatment they need. This isn't good enough, multiple Serious Case Reviews have highlighted that when a teenager missed a CAMHS appointment it should be treated as a warning sign and acted upon. Simply put: lives are at stake.

It's a complex issue and there are no easy fixes, but the figures from our research are unavoidable: too many teenagers with mental health problems are struggling to engage with the system, aren't getting the help they need and it's costing them their health and the NHS vital funds.

We should be doing everything we can to make sure that teenagers dealing with mental health issues find CAMHS appointments welcoming, easy to go to and flexible enough to cope with their fluctuating health. Too often it seems like the demands of the system come above the needs of the patient, and that must change.

Three key changes need to take place: shorter waiting times so children don't give up and drop out of the system; stronger national guidance on how CAMHS services must follow up when a child misses their appointment; and children and young people having their views reflected in the way services are designed and delivered.

A missed appointment should never be seen as just a bureaucratic burden but always as a red flag that a young person may be at risk. Where health trusts get it right it saves time and money, but when systems fall down, the cost of failure can be a price no child or their family should have to pay.

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