A coalition of leading independent and third sector children and young people’s service providers has called for the Scottish Government to deliver a ‘Budget for Mental Health’ next week (Thursday 14th December), with an additional near £100 million investment a year in mental health services for children and young people, almost tripling the current budget.
The call from campaign organisation, the Scottish Children’s Services Coalition (SCSC) comes as figures obtained in the Written Answer to a Parliamentary Question indicate that a mere 0.48 per cent of the NHS budget is spent on specialist child and adolescent mental health services (CAMHS), amounting to just over £54 million (see Notes to Editors for Scotland and by health board). In addition to this, only 6.34 per cent of the overall mental health budget is spent on CAMHS.
These figures vary considerably across Scotland, ranging from 0.65 per cent of expenditure in NHS Shetland on CAMHS, 20.46 per cent of total mental health expenditure, to 0.01 per cent in NHS Highland, 0.19 per cent of total mental health expenditure.
These very low investment figures are despite the fact that mental health services are literally ‘creaking at the seams’ due to greatly increasing demand. 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.
The coalition notes that in England the percentage spend on CAMHS is 0.7 per cent of NHS expenditure and the Five Year Forward Plan will provide an additional £460 million by 2020/21. Alongside the Scottish Association for Mental Health (SAMH), the coalition is calling for an almost tripling of the CAMHS budget to £152 million a year.
The SCSC has called for the Scottish Government to deliver a ‘Budget for Mental Health’ with 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 problems. This includes greater school-based counselling services, on-demand counselling services in GP surgeries and greater community support generally, 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.
Latest figures on waiting times to access CAMHS indicate that of the 4,092 children and young people who started their treatment between April and June 2017, 80.7 per cent were being treated within an 18-week waiting time. This is short of the 90 per cent target set by the Scottish Government.
In addition, 37 children and young people have been waiting for over a year to be seen and 29 who started their treatment between April and June had been waiting over a year between referral and treatment.
A spokesperson for the SCSC said:
“We are urging the Scottish Government to make next week’s Budget a ‘Budget for Mental Health’ for our children and young people. No longer can mental health be viewed as a ‘Cinderella’ service and we must put money behind the rhetoric, tripling the current budget if we are to just keep pace with investment south of the border.
“It is clearly disappointing to note these newly released figures highlighting the very small proportion of the overall NHS and mental health budgets being spent on addressing the needs of children and young people, especially when 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.”
-ENDS-
Notes to Editors
Written Answer
5 December 2017
Index Heading: Health and Social Care
Miles Briggs (Lothian) (Scottish Conservatives and Unionist Party): To ask the Scottish Government how much each NHS board spent on child and adolescent mental health services (CAMHS) in 2016-17, and what percentage of (a) that board's and (b) the overall NHS mental health budget this represented. S5W-12931
Maureen Watt: Information on NHS expenditure, mental health expenditure and percentage of expenditure that have been spent on children and adolescent mental health services in the hospital and community sectors in year 2016-17 is shown in Table 1.
Table 1: Child and Adolescent mental health expenditure1, Total NHS expenditure2 and Mental Health expenditure3
Scotland 2016-17
| NHS Board | Child and Adolescent mental health expenditure1 (£000) | Total NHS expenditure2 (£000) | Percentage of Total NHS expenditure | Mental Health expenditure3 (£000) | Percentage of (CAMHS) on Mental Health expenditure |
| NHS Ayrshire & Arran | 3,565 | 761,573 | 0.47% | 58,395 | 6.10% |
| NHS Borders | 550 | 209,829 | 0.26% | 15,465 | 3.56% |
| NHS Fife | 245 | 658,131 | 0.04% | 48,432 | 0.51% |
| NHS Greater Glasgow & Clyde | 18,954 | 2,981,950 | 0.64% | 248,274 | 7.63% |
| NHS Highland | 85 | 630,778 | 0.01% | 45,179 | 0.19% |
| NHS Lanarkshire | 5,854 | 1,109,302 | 0.53% | 66,949 | 8.74% |
| NHS Grampian | 536 | 1,070,758 | 0.05% | 58,933 | 0.91% |
| NHS Orkney | 26 | 47,013 | 0.06% | 634 | 4.10% |
| NHS Lothian | 12,479 | 1,724,913 | 0.72% | 126,556 | 9.86% |
| NHS Tayside | 6,660 | 919,030 | 0.72% | 86,111 | 7.73% |
| NHS Forth Valley | 2,901 | 542,070 | 0.54% | 40,370 | 7.19% |
| NHS Western Isles | 293 | 70,418 | 0.42% | 3,294 | 8.89% |
| NHS Dumfries & Galloway | 1,609 | 304,543 | 0.53% | 19,541 | 8.23% |
| NHS Shetland | 317 | 48,636 | 0.65% | 1,549 | 20.46% |
| State Hospital | - | 33,053 | - | 33,053 | - |
| Golden Jubilee | - | 126,045 | - | - | - |
| Scotland | £54,074 | 11,238,042 | 0.48% | £852,736 | 6.34% |
Source: Scottish Health Service Costs, Report R300, R340, R04LSX and SFR8.3, ISD Scotland
