BRIDGING THE GAP IN MENTAL HEALTH SERVICES
Why this is urgent right now
The current crisis in mental health services affects all of us. Current figures reveal that one in 10 children now have a diagnosable mental health condition yet waiting lists for an initial appointment with CAMHS in Kent can be up to 18 months and for private mental health services, up to a staggering six months. Who is helping the families and children during this period?
At a time of intense anxiety, many parents are really struggling, trying to manage very challenging behaviours with limited knowledge and skills and the overwhelming sense that no-one is available to help them.
And yet, research shows that parents can successfully support their children during this period if they are given a little practical support. 1
“Good quality parenting programmes can make a real difference…they also potentially contribute to substantial cost savings in the public sector. Despite these opportunities, only a small minority of children and families get the help they need to protect their children’s life chances.”2
The struggles and failings of CAMHS are frequently in the headlines. Dr John Goldin, Consultant Child and Adolescent Psychiatrist at Great Ormond Street Hospital in an interview on BBC’s Panorama, September 2018, said “The trouble is the services are very stretched, we’re not meeting the need, so in that sense it’s not fit for purpose.” CAMHS has been accused of “rationing services in favour of those who have attempted suicide”. 3
2017 Figures from Mental Health of Children and Young People in England,4 state that 1 in 8, 5 to 19-year olds had at least one mental disorder when assessed in 2017 and of those Emotional disorders were the most prevalent type of disorder4. Yet figures from CAHMS gained by the Panorama investigation show that one in four children have been rejected from being offered help and a total of 55,800 children did not meet CAMHS criteria.
Before I founded my Family Relationship & Parenting Coaching practice, I worked as Support Worker at a local homeless hostel for vulnerable youth, where I personally witnessed cases of CAHMS “rationing services” because clients were not “in crisis”.
A BBC News report following the BBC’s Panorama programme listed how the service criteria has been rationed, stating reasons for excluding under-18s from service involvement including:
- Self-harm referrals only accepted if accompanied by another mental health condition
- Weight loss of less than 15% of an ideal weight for an eating disorder (against NICE recommendations)
- Must have already engaged with early intervention and waited a specified length of time
NICE Guidelines recommend providing parenting skills support to parents and carers but in my experience here in Kent, this isn’t on offer. Rather, parents are being encouraged to ensure their children fit the criteria for support. One mother I’ve spoken to who wanted to explore alternative treatment options rather than medication for her son, was told that unless he took the recommended medication, she would be discharged from services and would not be offered any support. This advice left her feeling intimidated into accepting medicating her son, and raises the question of where is the person-centred care?
This piece is not written with the intention of undermining CAMHS, which is working with overwhelming demand. CAMHS is working in a context where child mental health referrals have risen by 26% in the last 5 years, and referrals in 2017-2018, for under-18s rose to 198,280, (compared with 157,000 in 2013-14)5.
- Nearly 19,000 children were admitted to hospital after harming themselves in 2015 – a 14 per cent rise over three years5
- Between 2013/14 and 2014/15, referral rates increased five times faster than the CAMHS workforce5
- The average waiting time for children and young people to access mental health services ranges from 14 to 200 days5
- Once through the referral process and finally able to get specialist support, even young people with life-threatening conditions can wait more than 100 days before receiving any form of treatment.5
This rise in demand may be attributed to more mental health awareness, which can only be a positive. But in a climate where 1.5 million children live in areas with no 24/7 crisis care, and 27 out of 111 local authorities who were consulted, said they had SCRAPPED services3 related to the mental health and wellbeing of children over the last 8 years, it is no wonder that we use the words ‘crisis’, and ‘failing’ because we are failing the families involved and I am advocating that we have an obligation to ‘bridge the gap’, because waiting for children to reach crisis point can have devastating consequences.
Nick Waggett, Chief Executive of the Association of Child Psychotherapists said: ‘We do hear stories of children and young people having to have attempted suicide on a number of occasions actually before they are seen within the service. The problem is that then they’re very ill and it actually becomes increasingly difficult to offer them an effective treatment.’ 6
There are professionals who can help parents understand a diagnosis of a neuro-biological condition, and provide practical implementable tools, strategies and techniques that will make a difference. At The Weller Way, we work with parents and teenagers daily
At a time when negative behaviours can dominate, we can help remind you to focus on what your child does well, show you how to effectively praise positive behaviours, how to notice and record triggers and so much more. We believe that parents have strong intuition, know their children better than anyone else and, equipped with the right tools and skills really can make a positive difference.
You can make contact with us here
- Parenting and Outcomes for children: Thomas G O’Connor/Stephen BC Scott for Joseph Rowntree Foundation 2007. (www.jrf.org.uk)
- A chance to change: Delivering effective parenting programmes to change lives: Brown/Khan /Parsonage 15 October 2012 www.Centreformentalhealth.org.uk
- BBC News24/9/18 https://www.bbc.co.uk/news/health-45607313