The government has repeatedly acknowledged the crisis facing mental health services for children and young people. Theresa May has often spoken about the “burning injustice” of inadequate treatment, while her Health Secretary Jeremy Hunt has described Child and Adolescent Mental Health Services (CAMHS) as “the biggest single area of weakness” in NHS Provision.
But while some improvements have been happening, they simply aren’t happening fast enough. We need to see real action to accompany the rhetoric. In the next few weeks, the government will publish a Green Paper setting out its plans on children’s mental health. Here’s what it should include:
First and foremost, the government must acknowledge that specialist services are still badly underfunded. As a nation, we spend less than 1% of the NHS budget on children's mental health. According to NHS England, even with the extra £1.4 billion that was committed in 2015, only one in three young people with diagnosable mental health problems will get the help they need. This simply isn’t good enough.
We need to see sustainable, long-term investment in CAMHS, and the government must ensure that this money goes where it is intended.
Access to CAMHS
The government needs to do more to recruit new staff to CAMHS, and to ensure that those professionals who are already working there feel valued and incentivised. They should ensure there are waiting time and access standards for CAMHS and that data is published showing progress towards meeting targets.
There also need to be improvements in the way that A&E departments support people with mental health problems, who often report that crisis care isn’t good enough. Related to this, we would like to see a dedicated 24 hour ‘Crisis Hotline’ for children and young people, which could be reached through the existing NHS 111 service, offering advice, emotional support and providing referrals.
We need to ensure young people who require inpatient care receive appropriate treatment and understand what their rights are. It is scandalous that restraint is being used so often on children in mental health hospitals – NHS research suggests you are seven times more likely to be restrained in children's mental health services than in adult services – and this needs to be addressed urgently.
The government also needs to make sure that young people and families are treated close to home wherever possible and that the right support is available in the community wherever possible.
Promoting good mental health
While it’s crucial to improve specialist services, the government must do more to tackle the root causes of mental health problems among children. That’s why we would like to see a high-profile emotional literacy campaign, aimed at children, to help them understand their feelings and what causes them, and to help them know what to do if they’re struggling to cope.
We would also like to see an NHS-led ‘self-management hub’, which would provide advice and resources to young people and parents, helping them to manage emotional distress and mental health conditions, and guiding them to help when they need it.
The role of schools
Schools have a crucial role to play in promoting good mental health and intervening quickly when there are problems. But at the moment, most teachers agree that the education system is unbalanced, with a far greater emphasis on academic performance than the wellbeing of children.
Schools need much greater recognition for the work they do on mental health, through improvements to the Ofsted framework, and through a change in the law to make it clear that promoting wellbeing is a fundamental part of their remit. Schools should also receive designated funding for wellbeing initiatives. All teachers should be trained about mental health as part of their Initial Teacher Training. And all children should learn about mental health from a young age through PSHE or RSE lessons.
Growing up in the online world has many benefits for children, but also creates pressures that simply didn’t exist 20 years ago. The young people we work with talk about the pressure of constantly being available, of comparing their own lives to the ‘perfect lives’ they see on social media, and of dealing with bullying and harassment online. Every child should learn to cope with the pressures of the internet age as they grow up, and social media companies should be forced to take more responsibility for what happens on their platforms.
Adversity and trauma
One in three mental health problems stem from adverse experiences in childhood – including domestic violence, neglect, bereavement or taking on adult responsibilities at a young age. These experiences can result in psychological trauma, which can have a lasting effect on the way a young person behaves and manages their relationships with others.
But too often professionals working with children don’t fully understand the effects of trauma, and see ‘difficult’ behaviour by people who have had a bad start in life as a problem rather than a symptom of what they’ve been through. That’s why the government should raise awareness of the impact of trauma and adverse experience among commissioners, providers and everyone who works with children.
For more information about what we think needs to change, read our manifesto.