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 a 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 October to December 2018, the figures highlight that 4,523 children and young people started treatment at specialist child and adolescent mental health services (CAMHS) in this period. The NHS in Scotland, including nine 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 72.8 per cent in the NHS in Scotland are being seen within this 18-week waiting time, still in itself far too long, more than a quarter (27.2 per cent) are failing to be seen within this period.
Individual health boards failing to meet this target are: NHS Borders (target achieved for 44.3 per cent), NHS Fife (89.3 per cent), NHS Forth Valley (84.9 per cent), NHS Grampian (41.1 per cent), NHS Greater Glasgow & Clyde (80.2 per cent), NHS Highland (82.2 per cent), NHS Lanarkshire (71.5 per cent), NHS Lothian (58.7 per cent) and NHS Tayside (49.5 per cent)
The figures also indicate that 108 children and young people in the quarter had been waiting for more than a year prior to being seen for treatment (PDF), an increase from 93 in the previous quarter (July to September).
The SCSC also highlighted that 198 out of 453, or 43.7 percent of inpatient admissions of children and young people in 2017-18 were to adult psychiatric wards (PDF). This means that these individuals may not be getting the specialist services that they require.
There are a number of differences between specialist units and wards designed to treat the needs of adults with serious mental illness, both in terms of staff training, experience and the overall ward environment. Given this, there is a clear concern that the needs of a young person may not be met in comparable way when admitted to an adult mental health ward as opposed to a specialist child and adolescent unit.
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 the 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.
A spokesperson for the SCSC commented:
“These latest waiting time figures highlight that fact we are continuing to fail thousands of children and young people with mental health problems. No longer can mental health be viewed as a ‘Cinderella service’ and 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.
“However, it is clearly disappointing to note these newly released figures highlighting that the NHS in Scotland, including nine of our health boards, are failing to meet what is already a lengthy waiting time. 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.
“It is also vital that we increase the number of beds available for children and young with a severity of mental health problems requiring these, given that over 40 per cent of admissions of children and young people were to adult psychiatric wards.
“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.”