A coalition of leading independent and third sector children and young people’s service providers has called for action from the Scottish Government to increase investment in and radically improve mental health services for children and young people.
The call from the Scottish Children’s Services Coalition (SCSC) comes as new waiting time figures are published today (7th March) from the Information Services Division of National Services Scotland, part of NHS Scotland, highlighting a ‘postcode lottery’ in mental health treatment.
Covering the quarter from October to December 2016, these figures indicate that NHS Scotland, including five of 14 health boards, failed to meet a Scottish Government 18 week waiting time target for children and young people to receive treatment from specialist Child and Adolescent Mental Health Services (CAMHS).
The NHS in Scotland provides mental health services for children and young people with a wide range of mental health problems including anxiety, behaviour problems, depression and early onset psychosis. Half of all diagnosable mental health problems start before the age of 14 and 75 per cent by the age of 24.
The SCSC has called for a radical transformation of mental health services, with greater investment in CAMHS, as well as a renewed focus on prevention and early intervention in the Scottish Government’s soon to be published Mental Health Strategy. This includes in-school counselling, on-demand counselling services in GP surgeries and greater community support generally, reducing the need for referral to pressed specialist CAMHS.
The coalition has also called for Action Plans to be put in place for those health boards failing to achieve the waiting time target, with its ultimate aim that those children and young people requiring it should get the help they need, when they need it.
The Scottish Government set a target, which dates from December 2014, for the NHS in Scotland to deliver a maximum waiting time of 18 weeks from a patient's referral to treatment for specialist CAMHS. The target should be delivered for at least 90% of patients.
The new figures indicate that of the 4,222 children and young people who started their treatment at CAMHS in Scotland between October and December, 82.5% were being treated within this 18 week waiting time. This is short of the 90% target set by the Scottish Government, but a welcome improvement on the previous quarter (79.0%).
The five health boards failing to achieve the 18 week waiting time target were NHS Ayrshire & Arran (88.9%), NHS Fife (76.6%), NHS Grampian (45.0%), NHS Lanarkshire (82.8%) and NHS Lothian (48.3%).
The figures published also indicate that while 8,520 children and young people were referred to CAMHS, only 6,628 were accepted for treatment. The coalition has raised concerns over what action is taken to address the more than a fifth (22%) not accepted for treatment.
In addition, more than 100 (101) children and young people who started their treatment between October and December had been waiting over a year between referral and treatment.
The SCSC has highlighted that if there is increased investment in mental health services, this will not only cut waiting times, ensuring the early diagnosis and treatment of those children and young people with mental health problems, but also address the social and economic costs of failing to address these.
These costs 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.
A spokesperson for the SCSC, said:
“These figures, while an improvement on the previous quarter, highlight that five of our health boards were failing to meet maximum waiting times, a clear ‘postcode lottery’ when it comes to treatment. In addition, more than 100 of those with mental health issues were waiting more than a year to be seen and we are deeply concerned about what is happening to the more than a fifth of children and young people not accepted for treatment.
“We know that half of all diagnosable mental health problems start before the age of 14 and 75 per cent by the age of 21. As such it is vitally important that we radically improve mental health services and increase investment in these, with an overall aim of ensuring that children and young people get the help they need, when they need it.
“We need to radically transform mental health services, with a focus on preventing such problems arising in the first place and intervening early to ensure that children and young people are able to realise their full potential. This includes investing in greater community support and reduces the need for referral to specialist CAMHS.
"As a coalition we are delighted that the Scottish Government has committed an additional £150 million in mental health services over the next five years, and that this is to be partly used to bring down child and adolescent mental health waiting times, but we clearly need to do more.
"Families usually experience months of waiting even before a referral to CAMHS. The consequent delay in diagnosis and appropriate support can lead to a crisis situation for the child or young person concerned, as well as for their family, and the need for costly extra resources to address this.”