Mental health care in this country needs radical transformation. Both adult and children’s mental health services continue to be plagued by long waiting times, lack of access to treatment and chronic staff shortages. For children, the average wait between their first symptoms developing and being able to access treatment is estimated to be a horrifying 10 years. Once a referral has been made, The Children’s Society estimate that young people wait an average of 58 days until they are assessed and then a further 41 days until they begin treatment.
In a recent survey, a thousand GPs across the country expressed their concerns about access to Children’s Mental Health Services. It found that 78% of GPs are worried that too few of their young patients can get treatment for mental ill-health and a staggering 99% of them feared that under 18 years old will come to harm as a direct result of these delays in care.
For many of these children, the only way to access the care they need is for their mental health to deteriorate to crisis point or to turn to private care. In fact, almost two-fifths of GPs surveyed said they would recommend patients whose families can afford it to go private. It is completely unacceptable that we have such a growing divide between those who can pay for treatment and others who are left waiting. Seventy years after the creation of the NHS, families should not be forced to pay for the mental healthcare their children so desperately need.
The publication of the NHS Long Term Plan has provided an important opportunity to hold the Government to account over mental health provision. Last week I led a debate in the Lords on children’s access to mental health treatment and also spoke in a wider debate on the Long Term Plan. In both debates, I was clear that without urgent action to enlarge the workforce, as well as sustained investment in social care and public health, the Plan would be destined to fail.
That is not to say there is nothing to welcome in the Long Term Plan. As well as a focus on prevention, it contains some ambitious aspirations for improving mental health services, including increased funding and a target of ensuring that one hundred per cent of children needing specialist mental health care are able to access it. These are clearly steps in the right direction. What worries me is less what the Plan contains and more what it does not.
For example, the Plan contains precious little detail of how the NHS will recruit and retain a workforce large enough to deliver 100% access for children’s mental health services. It has been estimated that to treat all children and young people with mental health problems we would need over 20,000 additional staff. This will be a huge challenge, given that the workforce is shrinking – there are 6% less child and adolescent psychiatrists in the NHS than there were 4 years ago. Factor Brexit into the equation and it becomes clear that there will need to be a huge effort to recruit the staff needed to transform services.
This is why I asked an oral question in the Lords this week on whether the Government would consider funding a mental health careers campaign aimed at secondary school, college and university students. By showing students, particularly in related subjects such as psychology, that they can have fulfilling careers in mental health professions, we can help build the workforce and improve mental health treatment for all who need it. I was promised a written response which I eagerly anticipate – but frankly I’m not holding my breath!
* Claire Tyler, Baroness Tyler of Enfield, has been in the House of Lords since 2011, taking an active role in the areas of health and social care, welfare reform, social mobility, well-being, children and family policy, machinery of government and the voluntary sector. She is the Liberal Democrat member of the Lords Select Committee on Social Mobility, and co-chair of the APPG on Social Mobility
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6 Comments
Can anyone tell me where psychotherapy and counselling fit into this plan? I think children who are just finding life too demanding, rather than having a specific mental health problem, need to be able to take advantage of these kinds of services. I’m thinking of young carers, for example, but there are other cases where children need this kind of help rather than psychiatry.
The most obvious steps which need to be taken to improve mental health are concerned with improving the lives of millions of people. We can start with making houses available to those who need them. We can ensure that we rapidly end poverty by paying a living wage. We can stop putting needless stress on children in schools by stopping meaningless testing of children and testing schools by a discredited Ofsted system.
Some will cost money, some will save money.
In other words we can recognise that prevention is better than cure. That does not mean that we ignore I’ll people, but that our priority should be to work with people to ensure that they don’t become ill.
Tom Harney is quite right. Just a pity that Conference won’t be able to discuss Katharine Pindar’s motion on poverty next month : The following – plus a filmed interview – appeared on the BBC NEWS web site today :
More than a third of UK babies ‘live in poverty’.
Staff at a baby bank have said they have seen a 10-fold increase in referrals since opening two years ago. More than a third of babies are living below the poverty line in the UK, a leading social research group has said. The Joseph Rowntree Foundation (JRF) said low-paid families were struggling under a “rising tide of work poverty”.
Despite the government saying 300,000 fewer children are living in absolute poverty than in 2010, baby banks said they were seeing an increase in users.
Vicki Miller, who used a baby bank, said: “I didn’t know that support was out there.” There are more than 100 baby banks operating across the UK, providing essentials for newborns, including nappies, wipes and cots.
In an analysis of government data for the BBC, the JRF said in 2016-17 there were 302,838 children under the age of one living in families with a household income substantially below the UK average – its definition of poverty. That represented 35% of all children in that age group.
Of course you are right Tom and David. Many years ago Margaret Thatcher suppressed the Black report which established a correlation between poor housing and physical ill health and now we have a government which couldn’t be doing better at causing mental health problems if it was their declared policy.
No wonder people voted for Brexit in the belief it would make their lives better. I despair that our party hasn’t taken up the cause of the poorest in our society because many of the services that they rely on have been cut. Hatred and misery thrive when humans are competing for scarce resources which the poorest are having to do in our wealthy country in the 21st century. How can we stand by and let this happen?
Hi Sue and thank you for your comment. Unfortunately, children’s access to psychotherapy and counselling is another area the plan is silent on. The long term plan currently commits to expanding access to the NHS’ Improving Access to Psychological Therapies (IAPT programme) for adults. However, there isn’t anything in the plan about psychological therapies for children, which is quite an omission! There are some plans to roll out Mental Health teams in schools, but it is unclear whether these teams will include counselling or psychotherapy staff. This is a very important point given that many children do not currently have access to school counselling.
Tom and David – I wholeheartedly agree that prevention is a very important part of improving mental health. I haven’t discussed it in this particular article as the debate I was part of was specifically focused on the current crisis of access to children’s mental health services. There has been some very interesting research by the University of Birmingham which looked into the cost of early intervention schemes. They found that there were many early interventions which saved more money in the long run than they cost to run. As well as this we know poverty can have a particularly adverse effect on the mental health of children, so I agree with you that more needs to be done to tackle child poverty.
What we need is a completely new educational programme on the nature of thought and what a huge part it plays in our mental life.