Mental Health

Campaigning to improve mental health services for children and young people

The Scottish Children’s Services Coalition is committed to improving mental health services for children and young people. We aim to achieve this through campaigning for the increased provision of a wide range of high-quality, well-resourced and quickly accessible services.

Mental health problems include depression, anxiety, eating disorders, obsessive compulsive disorder, ADHD and self-harm.

Research indicates that 10 per cent of children and young people (aged five to 16) have a clinically diagnosable mental health problem, around three in every class, and 20% of adolescents may experience a mental health problem in any given year. These problems disproportionately affect those children and young people from lower income households and areas of deprivation.

Child and adolescent mental health services (CAMHS) embrace the range of services across agencies – NHS, local authorities, third and independent sectors – that contribute to the mental healthcare of children and young people (and their families and carers).

Supporting an increasing number of people identified with mental health problems isone of the greatest public health challenges of our time.

Greater resourcing of CAMHS

Mental health must be valued equally with physical health (so called ‘parity of esteem’), when providing care and treatment to children and young people with mental health needs. We are committed to ensuring that these children and young people are able to get the help they need, when they need it, delivered in the most appropriate setting, improving their mental health and wellbeing.

In order to achieve this we are campaigning for increased investment to deliver a wide-range of high-quality, well-resourced and quickly accessible CAMHS. This will assist in the provision of adequate staffing and includes primary care, community-based support and specialist inpatient services.

Focus on prevention and early intervention

The number of those seeking treatment for mental health problems has increased significantly, including those presenting with more complex needs. However, the impact of austerity and a lack of resourcing, including staffing, means that services are overstretched and unable to adequately address this demand.

Many children and young people with mental health problems, for which an early diagnosis and treatment are essential, are therefore not receiving appropriate care and support.

In order to address this we are seeking a radical shift towards preventing poor mental health and promoting wellbeing, as well as early intervention. This includes greater investment in primary care and community support, as well as greater support within schools. This provision can reduce the need for referral to more costly specialist CAMHS, which are under considerable pressure and can result in long waiting times for treatment.

We are also seeking greater collaboration between the public sector and independent and third sector service providers, so that those children and young people with mental health problems receive the best possible care and support, tailored to their individual needs.

It is vital that there is increased investment and adequate staffing to deliver more efficient and effective CAMHS, with a focus on prevention and early intervention.

High cost to the economy and society

If a child or young person with mental health problems is left without support and access to treatment the worst their outcomes are, resulting in a potentially high cost to the economy and society.

The Scottish Association for Mental Health has highlighted the social and economic impacts of these problems if they are not treated and persist into adult life. Those affected, for example, are more likely to die younger, be unemployed, become homeless, or end up in costly long-term care.

Ensuring that children and young people with mental health problems can quickly access the appropriate treatment is vital in supporting them to reach their full potential.

Our campaigning is currently focused on two key areas of concern:

1. Waiting times to access CAMHS
2. A lack of appropriate CAMHS inpatient facilities

1. Waiting times to access CAMHS

We are committed to ensuring that for those children and young people requiring it, the waiting time target to access specialist CAMHS is being met through greater investment in these services. This will support the delivery of adequate staffing and should form part of an overall strategy to ensure that care and support is provided, when needed.

The Scottish Government has set a target for the NHS in Scotland to deliver a maximum waiting time of 18 weeks from a child or young person’s referral to treatment for specialist CAMHS. This is in itself still far too long and would not be tolerated for those with physical health issues.

Faced with a greatly increased demand on services and a lack of resourcing, including inadequate staff numbers in certain areas, the NHS in Scotland is failing to achieve this waiting time target. With a considerable variation in waiting times between regional health boards, this has led to a postcode lottery when it comes to the treatment of those with mental health problems.

Any delay in diagnosis and appropriate support for the child or young person concerned, as well as for their family, can have a devastating impact. Investment in these services will also serve to prevent longer-term social and economic costs.

We are committed to to ensuring that all health boards meet the 18-week waiting time target, with action plans that include clear, funded and measurable timetables put in place for those currently failing to meet this target.

2. CAMHS inpatient facilities

We are committed to increasing the provision of CAMHS inpatient facilities, including the delivery of these north of Dundee, as well as secure care for those children and young people with the highest level of mental illness.

Despite increasing demand there are only 48 specialist hospital beds provided within the NHS in Scotland for children and young people (aged 12 to 18) with mental health problems. These are located in three CAMHS inpatient units – Edinburgh, Glasgow and Dundee – with no provision north of Dundee. There is a further six place unit for those aged five to 12 in the Royal Hospital for Sick Children in Glasgow.

Under the Mental Health (Care and Treatment) (Scotland) Act 2003, a responsibility is placed on health boards to provide accommodation and services to meet the needs of persons under the age of 18.

However, a lack of specialist beds for children and young people who require inpatient mental health care means that they are sometimes forced to remain at home, often with the individual’s condition deteriorating and the family reaching crisis point.

Some are admitted to CAMHS inpatient units which are often far from home, leaving them isolated from family and friends, which is detrimental to their recovery.

Others are admitted to non-specialist adult mental health or paediatric hospital wards, settings often inappropriate for their circumstances. Figures from the Mental Welfare Commission for Scotland indicate that there were 118 admissions, involving 101 children and young people (under the age of 18), to such non-specialist wards in 2018/19, an increase on the previous year (103 admissions involving 90 children and young people).

In addition, there are no secure intensive psychiatric care units in Scotland for children and young people with a severity of mental health needs that require this care, and specialist inpatient facilities for those with a learning disability and/or autism spectrum disorder.

We are committed to ensuring that a child or young person requiring inpatient mental health care receives it in a timely manner, delivered in an appropriate setting.