A leading coalition of independent and third sector children and young people’s service providers has called on the new Mental Health Minister to act urgently to ensure that NHS Health Boards achieve waiting time targets for access to Child and Adolescent Mental Health Services (CAMHS).
The call from the Scottish Children’s Services Coalition (SCSC) (see Notes to Editors for members) comes as new figures are published today (7th June) from the Information Services Division of National Services Scotland, part of NHS Scotland, covering the quarter from January to March 2016. 1 This highlights that only eight out of 14 Health Boards are meeting mental health waiting time targets.
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 21.
While commending the Scottish Government on its progress with policies which promote the universal wellbeing of children, such as Curriculum for Excellence and GIRFEC (Getting it right for every child), the SCSC has called for greater investment in CAMHS.
The coalition has also called for a renewed focus on prevention and early intervention. This includes greater in-school and additional GP support. GPs are at present the only route of referring to CAMHS and such support would take the pressure off CAMHS and provide a more appropriate tiered approach.
The coalition has also called for Action Plans to be put in place for those Health Boards failing to achieve waiting time targets, 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 for the NHS in Scotland to deliver a maximum waiting time of 18 weeks from December 2014. The target should be delivered for at least 90 per cent of patients.
The new figures indicate that for the 14 Health Boards as a whole 84.2 per cent of people are being seen within this 18 week target, short of the 90 per cent set by the Scottish Government.
Six of the 14 Health Boards failing to achieve the 18 week waiting time target are NHS Borders (83.3 per cent), NHS Fife (83.6 per cent), NHS Forth Valley (44.2 per cent), NHS Grampian (49.1 per cent), NHS Lothian (66.6 per cent) and NHS Shetland (50.0 per cent)
This comes on the back of evidence pointing to the fact that only 0.46 per cent of NHS Scotland expenditure is spent on child and adolescent mental health.2
The SCSC has highlighted that if Health Boards increase expenditure on CAMHS 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 social and economic costs of failing to address these.
These costs are well-established. This is because 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:
“We know that half of all diagnosable mental health problems start before the age of 14 and 75% by the age of 21. As such it is vitally important that we look at preventing such problems arising in the first place and intervene early to ensure that these young people are able to realise their full potential. Our ultimate aim is that those children and young people requiring it get the help they need, when they need it.
“Many children are identified as having poor mental health and Scotland has some catching up to do in terms of ensuring that child and adolescent mental health is viewed in the same way as physical health.
“As a coalition we are delighted that the previous Scottish Government has committed an additional £150m 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.
“We would however urge the new Scottish Government and Mental Health Minister to act quickly and increase investment from the current figure of less than 0.5 per cent of the NHS budget, and put in place Action Plans for those Health Boards failing to meet waiting time targets. This will ensure that those requiring it are given the support they need, so that those children and young people requiring these services do not miss out.
"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.”
1 NHS Information Services Division, Child and Adolescent Mental Health Services Waiting Times in Scotland, 7th June 2016. Available at: https://isdscotland.scot.nhs.uk/Health-Topics/Waiting-Times/Publications/2016-06-07/2016-06-07-CAMHS-Report.pdf (Accessed 7th June 2016).
2 ISD Scotland, Child and Adolescent mental health expenditure 2014-15, Scottish Health Service Costs, Report R300, R04LSX and SFR 8.3.