Latest waiting time figures have reinforced the call by a coalition of leading independent and third sector children and young people’s service providers for the Scottish Budget on 12th December to be a ‘Budget for mental health’, with dramatically increased investment in mental health services, delivering services for children and young people that are fit for purpose.
The call from the Scottish Children’s Services Coalition (SCSC), which campaigns to improve services for vulnerable children and young people, comes as the latest waiting time figures from the Information Services Division (PDF), part of NHS National Services Scotland, highlight that thousands of children and young people are failing to treated within a Scottish Government waiting time target. With an increasing number of children and young people being identified with mental health problems they also highlight a postcode lottery for mental health treatment across the country.
Covering the quarter July to September 2018, the figures highlight that 4,239 children and young people started treatment at specialist child and adolescent mental health services (CAMHS) in this period. The NHS in Scotland, including 10 of the 14 regional health boards, failed to meet the Scottish Government 18-week waiting time target for children and young people to receive treatment from CAMHS. This target should be delivered for at least 90 per cent of patients.
While 69.0 per cent in the NHS in Scotland are being seen within this 18-week waiting time, still in itself far too long, around a third (31.0 per cent) are failing to be seen within this period.
Individual health boards failing to meet this target are: NHS Borders (target achieved for 36.2 per cent), NHS Dumfries & Galloway (81.8 per cent), NHS Fife (78.1 per cent), NHS Forth Valley (62.5 per cent), NHS Grampian (44.7 per cent), NHS Greater Glasgow & Clyde (77.8 per cent), NHS Highland (89.9 per cent), NHS Lanarkshire (66.7 per cent), NHS Lothian (62.8 per cent) and NHS Tayside (35.8 per cent)
The figures also indicate that 93 children and young people in the quarter had been waiting for more than a year prior to being seen, an increase of 75 per cent from 53 in the previous quarter (April to June).
It should be noted that a mere 0.53 per cent of the NHS budget is spent on specialist CAMHS, amounting to £61.074 million. In addition to this, only 6.34 per cent of the overall mental health budget is spent on CAMHS.
These very low figures are despite the fact that mental health services are creaking at the seams due to greatly increasing demand, as evidenced by these waiting time figures. Research indicates that 10 per cent of children and young people (aged five to 16) has a clinically diagnosable mental health problem (around three in every classroom), with 50 per cent of mental health problems established by the age of 14 and 75 per cent by the age of 24.
While acknowledging the great efforts the Scottish Government is making, such as an additional £250 million of funding announced in its Programme for Government, the SCSC has called for the Scottish Government to greatly increased investment in CAMHS and for a more consistent approach to delivering these services across Scotland.
It has also called for a renewed focus on prevention and early intervention for those with mental health problem, reducing the need for referral to under-pressure specialist CAMHS.
The costs of failing to address mental health problems are well-established. Those affected are more likely, for example, to be unemployed, homeless, get caught up in the criminal justice system, or are in extremely costly long-term care. In many cases this can be prevented through early intervention.
Seona Weir from coalition member Young Foundations said:
“These latest waiting time figures demonstrate that we are continuing to fail many of our children and young people with mental health problems. No longer can mental health be viewed as a ‘Cinderella service’ and we must put money behind the rhetoric if we are to just keep pace with investment south of the border. In this respect we do acknowledge the great efforts the Scottish Government is making, including an additional £250 million for mental health over the next five years announced in its recent ‘Programme for Government’.
“It is clearly disappointing to note these newly released figures highlighting that the NHS in Scotland, including ten of our health boards, are failing to meet what is already a lengthy waiting time. This is no coincidence given that a very small proportion of the overall NHS and mental health budget is being spent on addressing the needs of children and young people, and yet we know that three children in every classroom has a clinically diagnosable mental health problem.
“There must be a radical transformation of our mental health services, with a focus on preventing such problems arising in the first place and intervening early, especially when we know that half of all mental health problems begin before the age of 14.
“With mental health and the issues associated with it representing one of the greatest public health challenges of our time, we must ensure that children and young people are able to get the care and support they need, when they need it. This includes investing in greater community support and support at school, reducing the need for referral to specialist CAMHS.”