Liz May, National Co-ordinator of Action for Sick Children Scotland (ASCS), member of the SCSC, writes for Friends of the Scotsman and asks that we deliver help for children with mental health issues faster.
The state of our children and young people’s mental health has hit the headlines time and again in recent months. A study of young people’s experiences has caused the Scottish Youth Parliament to describe the issue as 'our generation’s epidemic'. We hear that increasing numbers of children and young people are being prescribed anti-depressants and earlier this month Childline reported that over 900 children with suicidal thoughts contacted them last year – twice as many as five years ago.
If your child breaks an arm or leg you will be worried but at least you would have the comfort of knowing that a visit to A & E will result in prompt treatment and all things being well the fracture should heal within two to three months.
Imagine however that your child begins to suffer from anxiety, depression or they start to self harm or exhibit other mental health problems. Their distress is such that they regularly are unable to go to school. You would expect them to get help as soon as possible just as they would for a physical health problem wouldn’t you? Sadly this is not the reality experienced by many children and young people and their families. Action for Sick Children Scotland (ASCS) all too often hears from families who are desperate to get help for their child but who feel they have come up against a brick wall. Schools often struggle to help. Going to the GP may result in a referral to child and adolescent mental health services (CAMHS) but there will almost certainly be a lengthy wait. Latest figures show that across Scotland 22% of children and young people referred had to wait longer than the NHS waiting time target of 18 weeks – and 18 weeks is in itself too long for any child to wait.
Increasing pressure on CAMHS, with rising referrals and insufficient staff, also means that the service is having to focus on the most severe, complex cases. Between January 2015 and June 2016, 9,000 referrals to CAMHS were rejected. Where will these young people get the help they need?
Access to specialist beds is also problematic. I recall a foster carer ASCS worked with. Her young person was displaying such severe behavioural disorder that admission to a CAMHS specialist unit was imminent. There was no suitable provision nearby and she was desperately worried. The distance was too far for her to visit and yet she knew that visits would be so important for this child who had already gone through so much.
It is for such reasons that ASCS and other members of the Scottish Children’s Services Coalition have been campaigning for the mental health of children and young people to receive the same priority as their physical health.
The Scottish Government's commitment to allocate some of the additional £150 million mental health funding to CAMHS, and the appointment of a Minister for Mental Health are both positive moves. GIRFEC, our national approach which improves outcomes and supports the wellbeing of children and young people by offering the right help at the right time is deservedly the envy of other countries with a less child centred approach.
Earlier this month the Scottish Government’s consultation on its 10 year Vision for Mental Health in Scotland closed. It set out 8 priority areas for transforming mental health, actions needed and measures of success and the strategy is due to be published later in 2016. In my view the consultation document lacks detail around proposed actions and I would have liked a stronger focus on children and young people, but its human rights based approach and intention to ensure parity between mental and physical health is very welcome. The Scottish Government's aim is to deliver on its commitment of “Ask Once, Get help Fast”.
For this to succeed we need greater investment in specialist CAMHS, in outpatient and community based mental health services. We also need equal investment in early intervention and prevention to reduce the severity of mental health problems and the need to refer to CAMHS. For example, there must be more counselling support available in schools and more, not less, Educational Psychologists. Many local authority and third sector services support children and young people's emotional and mental well-being and we must ensure that these are not subject to spending cuts. We should also be paying more attention to infant mental health and the importance of early parent/child relationships and attachment.
For the sake of all our children and young people “Ask Once, Get Help Fast” must become a reality not an aspiration.
