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Time To Lock-in Children And Young People's Mental Health As A Political Priority

01/03/2017 15:35
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We've all heard and seen the truth in the declaration that children and young people's mental health services are treated as the Cinderella of the NHS.

A lack of accountability in devolved health commissioning structures has meant that even when decision makers with the best of intentions try to change things, the increased funding they assign to children's mental health services doesn't make it to the front lines. Instead, it has been absorbed and used to plug other gaps in diminishing local healthcare budgets.

Last week it was revealed that under new plans, mental health trust leaders must sign off their commissioners' spending for mental health. The shake up is part of new plans to ensure cash is reaching its intended final destination.

This much welcome and needed response pushed through by NHS England, will mean that all Clinical Commissioning Groups will have to send a letter to NHS England's regional teams, jointly signed with their main mental health provider alongside an update of their financial plans.

The letters will need to confirm that "mental health finances are an accurate reflection of health economy investment in mental health". The plans are an acknowledgement of the national scrutiny the government's recent commitments to mental health will be under. And rightly so, Children's mental health services have been a "last amongst equals" ‎as the system has moved to bring parity of esteem between physical and mental health services. But, let's be clear, this response is about ensuring that the money promised for children and young people's mental health is actually used for that purpose.

When 50% of mental health problems have established themselves by the time a child reaches 14 and 75% by the age of 24, a large part of delivering an overall sustainable health service for the future is ensuring that we get children's mental health services right.

The problem now is that even with this renewed push, Child and adolescent mental health services (CAMHS) are one part of the picture, and the rest of the picture looks bleak. There have been unprecedented cuts to local authority funded services - social care, public health, youth work; as well as huge pressures on the NHS generally and schools budgets. It is a perfect storm. When you collapse one part of the system, pressure naturally amasses elsewhere.

We need to embed the mental health of our nation's children as a priority across all parts of the system, so that the systemic overlooking of children and young people cannot happen again. This will require money up front that is not tied to the NHS or any other designated pot. That's why the Coalition has suggested a Prime Ministers Mental Health Challenge. Along the lines of the successful dementia challenge, this would see money coming from the Cabinet Office or Number 10 - rather than NHS - which has cross government and arm's length body support.

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