Scottish Health Board figures on child and adolescent mental health expenditure highlight critical need for greater spending

• Only 0.45% of NHS Scotland expenditure is spent on child and adolescent mental health, compared with 0.7% in England
• Only 5.56% of the mental health budget is spent on child and adolescent mental health
• Across all 14 NHS Boards expenditure on child and adolescent mental health was 0.7% or less
• Call by the SCSC for Scotland to reach 1% of NHS Scotland budget; 12.3% of the mental health budget
• 20% of children have a mental health problem in any given year, and about 10% at any one time.
• Child and adolescent mental health services have seen a 35% increase in the number of those starting treatment over the last 2 years

A coalition of children and young people’s service providers, is calling on the Scottish Government to take urgent action to increase NHS Scotland expenditure on child and adolescent mental health services (CAMHS) to reach a minimum of 1%.

The call from the Scottish Children’s Services Coalition (SCSC) (see Notes to Editors for members) comes on the back of figures obtained from an answer to a Parliamentary Question from Jim Hume MSP. This highlights that only 0.45% of NHS Scotland expenditure was on child and adolescent mental health, with all 14 of the individual Health Boards spending 0.7% or less on the same area.¹

These range from 0.08% for NHS Fife to 0.7% in NHS Lothian (see Notes to Editors for full list by Health Board). By contrast, in England 0.7% of the NHS budget is spent on CAMHS, 7% of the total mental health budget.

Just over £45.2m is currently spent on child and adolescent mental health in Scotland, amounting to a mere 5.56% of the mental health budget and 0.45% of the total NHS budget.²  Increasing the budget to £100.5m, an additional £55.3m, to match a mere 1% of NHS expenditure, would mean that 12.3% of the mental health budget would be spent on child and adolescent mental health.

Estimates vary, but research suggests that 20% of children have a mental health problem in any given year, and about 10% at any one time. These include conditions such as depression, anxiety, suicide, OCD and self-harm.

The figures are set against CAMHS in Scotland being under increasing pressure due to a 32% increase in the number of those starting treatment over the last two years.³ This is then coupled with the fact that six out of 14 Health Boards are currently failing to achieve the Scottish Government’s 18-week waiting time target from a patient’s referral to treatment for specialist CAMHS from December 2014.⁴

The SCSC believes that if Health Boards were to increase expenditure on CAMHS, this would not only address diagnosis and treatment waiting times, but also the issue of addressing increasing number of children and young people being sent to non-specialist units.

The long-term cost to society of failing to treat these conditions is well-established, with many of these young people become unemployed, turning to crime, or ending up with long-term mental health conditions which could have been prevented through early intervention.

Sophie Pilgrim, Director of Kindred Scotland, speaking on behalf of the SCSC, said:

“As a coalition it is staggering to find that only 0.45% of the NHS Scotland budget is being spent on CAMHS, amounting to just over 5.5% of the total mental health budget. Yet we know that 1 in 5 children have a mental health condition in any given year and all the evidence points to the clear advantages of early intervention to tackle those suffering and the long-term cost to society of failing to do so.

“We would urge that the Scottish Government looks at radically rebalancing the NHS budget to ensure that we are increasing the proportion of spend on child and adolescent mental health services.

“The young people who require these services and indeed the families who support them are amongst the most vulnerable in our society and we must collectively look to ensure that they are given the support that they need. Demand for child and adolescent health services continues to increase and health board expenditure must be adapted in order to meet this need. If the situation is allowed to continue, not only will the consequences be costly in the long term, they will also have a devastating effect on the young people and families involved.”

¹ ISD Scotland, Child and Adolescent mental health expenditure 2013-14, Scottish Health Service Costs, Report R300, R04LSX and SFR 8.3.

² ISD Scotland, Op. Cit.

³ NHS Information Services Division, Child and Adolescent Mental Health Services Waiting Times in Scotland, 26^th May 2015. Available at: https://isdscotland.scot.nhs.uk/Health-Topics/Waiting-Times/Publications/2015-05-26/2015-05-26-CAMHS-Report.pdf.

⁴ Ibid.

 ENDS

 For further information please contact Alex Orr, Policy Adviser to the Scottish Children’s Services Coalition, on 0131 603 8996 or [email protected].

 Notes to Editors

1. Table 1: ISD Scotland, Child and Adolescent mental health expenditure 2013-14, Scottish Health Service Costs, Report R300, R04LSX and SFR 8.3.

1. The Scottish Children’s Services Coalition (SCSC) is an alliance of leading independent and third sector service providers. These providers have come together to work with political and other key stakeholders, campaigning to improve the delivery of children and young people’s services. SCSC members deliver specialist care and education services for children and young people with complex needs, such as learning difficulties and learning disabilities, as well as direct help and support for them and their families. They also provide independent advocacy, advice and representation for children and young people with care experience.
2. Members of the SCSC are:

• Falkland House School: An independent school based in Fife that specialises in the education and care of boys who require support for learning. It was one of the first independent schools in Scotland to be awarded Autism Accreditation by the National Autistic Society and offers day, 39 week and 52 week placements.
• Mindroom: A charity dedicated to creating awareness of all kinds of learning difficulties. Mindroom also provides one-to-one support to families and offer help advice and training to individuals and organisations who work with people with learning difficulties.
• Spark of Genius: An independent organisation offering residential care, education, autism services, post-16 employability programmes and adult services throughout the UK. It enables children, young people and adults who need a variety of support to achieve their potential.
• Who Cares? Scotland: A third sector independent advocacy organisation that provides individual and collective advocacy to children and young people with care experience across Scotland, as well as Corporate Parenting training and information.  Who Cares? Scotland has been working with children and young people for 35 years and uses this experience to campaign, lobby and speak out both with and on their behalf.
• Young Foundations:
• Kindred: A voluntary organisation that provides information, advocacy and emotional support to parents/carers of children and young people with additional support needs.